Insurance Agency Execs Confirm Stupak Amendment Will Effectively Elminate Coverage for Abortion Care

Jodi Jacobson

This weekend, insurance company executives confirmed to NPR health reporter Julie Rovner what the pro-choice community has been saying since the Stupak amendment passed the House. In short, the amendment will lead to a virtual elimination of insurance coverage for abortion care, in turn leading to what one analyst calls "devastating outcomes" for some women.

This weekend on NPR, insurance company executives confirmed to NPR health reporter Julie Rovner what the pro-choice community has been saying since the Stupak amendment was added to the House Health reform bill. 

In short, the amendment will lead to a virtual elimination of insurance coverage for abortion care, in turn leading to what one analyst calls "devastating outcomes" for some women. 

As Rovner reports:

Backers of controversial abortion language added to the House health
overhaul bill last week say it merely continues longstanding policy
that bans federal funding of the procedure. But opponents say it could
have much more far-reaching consequences on access to abortion,
particularly in the private insurance market.  The
ultimate impact of the House abortion amendment could be to change
abortion from being a procedure routinely covered by most private
insurance plans to a procedure routinely excluded — even in cases of
medical emergency.

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The Stupak amendment has two parts with numerous ramifications.

The first part would write into permanent law the so-called Hyde
Amendment, which for three decades has been renewed annually to forbid
direct federal funding for abortions except in certain specific cases —
currently rape, incest and to save the life of the pregnant woman.

"Codification
of the Hyde language means if there is a government-run public option
available in the new health program, it won’t be able to provide
abortion as a covered benefit," reports Rovner.

But she notes, "the dispute is over the second
part of the amendment, [which would] bar health insurance plans in the new health
insurance marketplaces the bill would create — known as exchanges —
from offering abortion as a benefit to people who are receiving federal
subsidies to pay for their coverage."

Stupak and his supporters claim the fix is easy:

"I can go to the exchange as a private
individual and purchase a plan in the exchange that has abortion
coverage in it because I did not receive any affordability credits," he
said in an interview.

And as NPR notes:

The amendment does say that
health insurers can offer plans with abortion coverage to people who
are paying the full premiums themselves, as long as they offer
identical plans without abortion coverage to people who are getting
subsidies.

But, Rovner goes on to report that "most insurance experts say that’s not likely to happen."

"I
really think it would be impractical," says Robert Laszewski, a health
insurance industry consultant. Several health insurance companies
contacted for this story declined to comment, citing the sensitivity of
the subject matter.

Why?  Because insurance companies are, as we all know, nothing if not profit maximizers, and asking them to create "boutique policies" for unplanned events at a time when the main objective is to reduce costs will not be tenable.  Making the procurement of insurance coverage for abortion care virtually impossible is the unstated goal of the United States Conference of Catholic Bishops and the C-Street fundamentalists trying to impose their view of a Christian world order on Americans.

And Laszewski tells NPR this is precisely what will happen.  The problem is that by all
estimates, the vast majority of people who will be shopping in the new
exchanges will be getting subsidies, so they won’t be allowed to get
abortion coverage. Thus, if a health insurer did offer a separate plan
with abortion coverage, it would only be available to a small universe
of buyers, and it simply wouldn’t make much business sense.

"It’s
not an ideological issue, it’s not about abortion or not abortion,"
Laszewski says. "It’s about what is administratively simpler, easier to
administer. It just adds a level of complexity they will likely avoid."

"If more plans don’t have it than have it," says Laszewski, "then that becomes the standard of competition and everything else is the exception."

It’s about volume and profit margin, plain and simple.

Rovner also spoke to Sara
Rosenbaum, a health lawyer and professor at George Washington
University, who agreed with Laszewski that "it is impractical to expect health insurance
plans to cover abortion in the exchanges, even for people paying the
full premiums without federal help."

"If you speak to insurers in
the industry, they will tell you that they simply can’t operate under
these circumstances," Rosenbaum says. "They need to be able to offer
standard products that get administered in a standard way for
everybody."

So-called abortion riders also are a figment of the far right spin machinery desperately trying to make its efforts to eviscerate women’s fundamental rights seem relatively innocuous and rational.

Stupak, for example, also helpfully suggests that women could use their own money to buy a separate
policy that just covers abortion.

But in real life, this also is not feasible.  (Hard when you have to live in the real world, isn’t it?)

According to Laurie Rubiner, Vice President of Public Policy and Advocacy for Planned Parenthood of America, in the five states that already ban private insurance
from covering abortion — Missouri, Idaho,
Kentucky, Oklahoma and North Dakota — no such riders exist.

"We haven’t been able to
find any kind of separate abortion rider, and it doesn’t surprise us
because there’s no market for it. Why is that? Because no woman plans
to have a catastrophic pregnancy, or an unintended or unplanned
pregnancy. Therefore, she doesn’t think about buying coverage
separately for abortion. And since there’s no market for it, the
product doesn’t exist."

As a result, according to both insurance consultant Laszewski and health lawyer
Rosenbaum, the House abortion amendment could dramatically reduce
the availability of insurance coverage.

Rosenbaum says this situation could become what would be a financial catastrophe for women who encounter problems later in pregnancy and do not have insurance coverage.

"The
consequence," says Rosenbaum, "…is to exclude from the insurance system a
procedure–[and] depending on the circumstances under which it’s needed [this could be] an
incredibly costly procedure — and even when it’s not life threatening,
[it may] leave a woman and her family with thousands of dollars in unpaid bills."

Commentary Contraception

For Students at Religious Universities, Contraception Coverage Isn’t an Academic Debate

Alison Tanner

When the U.S. Supreme Court sent a case about faith-based objections to the Affordable Care Act's contraceptive mandate back to lower courts, it left students at religious colleges and universities with continuing uncertainty about getting essential health care. And that's not what religious freedom is about.

Read more of our articles on challenges to the Affordable Care Act’s birth control benefit here.

Students choose which university to attend for a variety of reasons: the programs offered, the proximity of campus to home, the institution’s reputation, the financial assistance available, and so on. But young people may need to ask whether their school is likely to discriminate in the provision of health insurance, including contraceptive coverage.

In Zubik v. Burwell, a group of cases sent back to the lower courts by the U.S. Supreme Court in May, a handful of religiously affiliated universities sought the right to deny their students, faculty, and staff access to health insurance coverage for contraception.

This isn’t just a legal debate for me. It’s personal. The private university where I attend law school, Georgetown University in Washington, D.C., currently complies with provisions in the Affordable Care Act that make it possible for a third-party insurer to provide contraceptive access to those who want it. But some hope that these legal challenges to the ACA’s birth control rule will reverse that.

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Georgetown University Law Center refused to provide insurance coverage for contraception before the accommodation was created in 2012. Without a real decision by the Supreme Court, my access to contraception insurance will continue to be at risk while I’m in school.

I’m not alone. Approximately 1.9 million students attend religiously affiliated universities in the United States, according to the Council for Christian Colleges and Universities. We students chose to attend these institutions for lots of reasons, many of which having nothing to do with religion. I decided to attend Georgetown University Law Center because I felt it was the right school for me to pursue my academic and professional goals, it’s in a great city, it has an excellent faculty, and it has a vibrant public-interest law community.

Like many of my fellow students, I am not Catholic and do not share my university’s views on contraception and abortion. Although I was aware of Georgetown’s history of denying students’ essential health-care benefits, I did not think I should have to sacrifice the opportunity to attend an elite law school because I am a woman of reproductive age.

That’s why, as a former law clerk for Americans United for Separation of Church and State, I helped to organize a brief before the high court on behalf of 240 students, faculty, and staff at religiously affiliated universities including Fordham, Georgetown, Loyola Marymount, and the University of Notre Dame.

Our brief defended the sensible accommodation crafted by the Obama administration. That compromise relieves religiously affiliated nonprofit organizations of any obligation to pay for or otherwise provide contraception coverage; in fact, they don’t have to pay a dime for it. Once the university informs the government that it does not want to pay for birth control, a third-party insurer steps in and provides coverage to the students, faculty, and staff who want it.

Remarkably, officials at the religious colleges still challenging the Affordable Care Act say this deal is not good enough. They’re arguing that the mere act of informing the government that they do not want to do something makes them “complicit” in the private decisions of others.

Such an argument stands religious freedom on its head in an attempt to impose one group’s theological beliefs on others by vetoing the third-party insurance providers’ distribution of essential health coverage to students, faculty, and staff.

This should not be viewed as some academic debate confined to legal textbooks and court chambers. It affects real people—most of them women. Studies by the Guttmacher Institute and other groups that study human sexuality have shown that use of artificial forms of birth control is nearly universal among sexually active women of childbearing years. That includes Catholic women, who use birth control at the same rate as non-Catholics.

Indeed, contraception is essential health care, especially for students. An overwhelming number of young people’s pregnancies are unplanned, and having children while in college or a graduate program typically delays graduation, increases the likelihood that the parent will drop out, and may affect their future professional paths.

Additionally, many menstrual disorders make it difficult to focus in class; contraception alleviates the symptoms of a variety of illnesses, and it can help women actually preserve their long-term fertility. For example, one of the students who signed our brief told the Court that, “Without birth control, I experience menstrual cycles that make it hard to function in everyday life and do things like attend class.” Another woman who signed the brief told the Court, “I have a history of ovarian cysts and twice have required surgery, at ages 8 and 14. After my second surgery, the doctor informed me that I should take contraceptives, because if it happened again, I might be infertile.”

For these and many other reasons, women want and need convenient access to safe, affordable contraceptives. It is time for religiously affiliated institutions—and the Supreme Court—to acknowledge this reality.

Because we still don’t have an ultimate decision from the Supreme Court, incoming students cannot consider ease of access to contraception in deciding where to attend college, and they may risk committing to attend an university that will be legally allowed to discriminate against them. A religiously affiliated university may be in all other regards a perfect fit for a young woman. It’s unfair that she should face have to risk access to essential health care to pursue academic opportunity.

Religious liberty is an important right—and that’s why it should not be misinterpreted. Historically, religious freedom has been defined as the right to make decisions for yourself, not others. Religious freedom gives you have the right to determine where, how, and if you will engage in religious activities.

It does not, nor should it ever, give one person or institution the power to meddle in the personal medical decisions of others.

Roundups Politics

Campaign Week in Review: Trump Selects Indiana Gov. Mike Pence to Join His Ticket

Ally Boguhn

And in other news, Donald Trump suggested that he can relate to Black people who are discriminated against because the system has been rigged against him, too. But he stopped short of saying he understood the experiences of Black Americans.

Donald Trump announced this week that he had selected Indiana Gov. Mike Pence (R) to join him as his vice presidential candidate on the Republican ticket, and earlier in the week, the presumptive presidential nominee suggested to Fox News that he could relate to Black Americans because the “system is rigged” against him too.

Pence Selected to Join the GOP Ticket 

After weeks of speculation over who the presumptive nominee would chose as his vice presidential candidate, Trump announced Friday that he had chosen Pence.

“I am pleased to announce that I have chosen Governor Mike Pence as my Vice Presidential running mate,” Trump tweeted Friday morning, adding that he will make the official announcement on Saturday during a news conference.

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The presumptive Republican nominee was originally slated to host the news conference Friday, but postponed in response to Thursday’s terrorist attack in Nice, France. As late as Thursday evening, Trump told Fox News that he had not made a final decision on who would join his ticket—even as news reports came in that he had already selected Pence for the position.

As Rewire Editor in Chief Jodi Jacobson explained in a Thursday commentary, Pence “has problems with the truth, isn’t inclined to rely on facts, has little to no concern for the health and welfare of the poorest, doesn’t understand health care, and bases his decisions on discriminatory beliefs.” Jacobson further explained: 

He has, for example, eagerly signed laws aimed at criminalizing abortion, forcing women to undergo unnecessary ultrasounds, banning coverage for abortion care in private insurance plans, and forcing doctors performing abortions to seek admitting privileges at hospitals (a requirement the Supreme Court recently struck down as medically unnecessary in the Whole Woman’s Health v. Hellerstedt case). He signed a ‘religious freedom’ law that would have legalized discrimination against LGBTQ persons and only ‘amended’ it after a national outcry. Because Pence has guided public health policy based on his ‘conservative values,’ rather than on evidence and best practices in public health, he presided over one of the fastest growing outbreaks of HIV infection in rural areas in the United States.

Trump Suggests He Can Relate to Black Americans Because “Even Against Me the System Is Rigged”

Trump suggested to Fox News’ Bill O’Reilly that he could relate to the discrimination Black Americans face since “the system [was] rigged” against him when he began his run for president.

When asked during a Tuesday appearance on The O’Reilly Factor what he would say to those “who believe that the system is biased against them” because they are Black, Trump leaped to highlight what he deemed to be discrimination he had faced. “I have been saying even against me the system is rigged. When I ran … for president, I mean, I could see what was going on with the system, and the system is rigged,” Trump responded.

“What I’m saying [is] they are not necessarily wrong,” Trump went on. “I mean, there are certain people where unfortunately that comes into play,” he said, concluding that he could “relate it, really, very much to myself.”

When O’Reilly asked Trump to specify whether he truly understood the “experience” of Black Americans, Trump said that he couldn’t, necessarily. 

“I would like to say yes, but you really can’t unless you are African American,” said Trump. “I would like to say yes, however.”

Trump has consistently struggled to connect with Black voters during his 2016 presidential run. Despite claiming to have “a great relationship with the blacks,” the presumptive Republican nominee has come under intense scrutiny for using inflammatory rhetoric and initially failing to condemn white supremacists who offered him their support.

According to a recent NBC News/Wall Street Journal/Marist poll released Tuesday, Trump is polling at 0 percent among Black voters in the key swing states of Ohio and Pennsylvania.

What Else We’re Reading

Newt Gingrich, who was one of Trump’s finalists for the vice presidential spot, reacted to the terrorist attack in Nice, France, by calling for all those in the United States with a “Muslim background” to face a test to determine if they “believe in sharia” and should be deported.

Presumptive Democratic nominee Hillary Clinton threw her support behind a public option for health insurance.

Bloomberg Politics’ Greg Stohr reports that election-related cases—including those involving voter-identification requirements and Ohio’s early-voting period—are moving toward the Supreme Court, where they are “risking deadlocks.”

According to a Reuters review of GOP-backed changes to North Carolina’s voting rules, “as many as 29,000 votes might not be counted in this year’s Nov. 8 presidential election if a federal appeals court upholds” a 2013 law that bans voters from casting ballots outside of their assigned precincts.

The Wall Street Journal reported on the election goals and strategies of anti-choice organization Susan B. Anthony List, explaining that the organization plans to work to ensure that policy goals such as a 20-week abortion ban and defunding Planned Parenthood “are the key issues that it will use to rally support for its congressional and White House candidates this fall, following recent setbacks in the courts.”

Multiple “dark money” nonprofits once connected to the Koch brothers’ network were fined by the Federal Election Commission (FEC) this week after hiding funding sources for 2010 political ads. They will now be required to “amend past FEC filings to disclose who provided their funding,” according to the Center for Responsive Politics. 

Politico’s Matthew Nussbaum and Ben Weyl explain how Trump’s budget would end up “making the deficit great again.”

“The 2016 Democratic platform has the strongest language on voting rights in the party’s history,” according to the Nation’s Ari Berman.