Senate, House Health Reform Bills Change Abortion Status Quo

Opponents and supporters of abortion rights agreed early on, in theory, to maintain the “status quo” with “abortion neutral” health care legislation. The idea was that health care reform is not the appropriate place to continue the fight over abortion and neither side should attempt to use health care reform as a vehicle to further expand or restrict access to abortion.

Unfortunately, neither health reform bill preserves the status quo on abortion. The Stupak Amendment in the House bill is more restrictive than the Manager’s Amendment to the Senate bill, but both impose new and unprecedented restrictions on abortion coverage in private insurance plans. Specifically:

  • Under current law, federal money cannot be spent on an abortion unless it threatens the woman’s life or results from rape or incest. However, there are no federal restrictions on abortion coverage in private health plans and 87 percent of typical employer plans offer abortion coverage.
  • Under the Senate bill private insurance companies would have to separate private premiums from federal subsidies and only use the former to pay for abortion services to ensure that no federal money would be spent on abortion beyond what is currently allowed. State insurance commissioners would have to make sure companies in their state comply with the segregation requirements. Despite these precautions insurers would also have to charge enrollees two premiums each month-one for abortion coverage and one for all other coverage.
  • The House bill goes beyond prohibitions on direct federal funding of abortion and bars federal subsidies to health plans that include abortion services. Abortion could be offered in a health plan only if the plan accepted no federal subsidies, leaving only 14 percent of insurance exchange participants eligible to purchase such a plan, or abortion coverage could be purchased through a separate rider that is unlikely to be sold or purchased.

The two bills must now be reconciled in order for each chamber of Congress to take a final vote on a merged health reform bill. Simple changes to the Senate version, such as removal of the two-premium requirement, would prevent new restrictions on abortion coverage and preserve the status quo. But whether those changes can and will be made remains to be seen.

This article is republished from RH Reality Check, a progressive online publication covering global reproductive and sexual health news and information.