Moving Backwards towards Progress

[epporsimuove]

As most people know, I am a big supporter of health care reform. I support a strong public option. I support universal health care. If I had my way, we would have socialized health care (whatever that means).

So, of course, I was happy that the health care bill passed the house last night. However, I am happy purely because we passed a health care bill. But that bill itself...

I cannot believe that an anti-abortion amendment was attached to this bill. What is more, I cannot believe that 64 Democrats, two of them women, voted for this amendment. The Democrats have a large majority in both chambers of Congress. There is a Democrat sitting in the Oval Office. Why, then, are my reproductive rights being taken away? This is a battle we have already fought. On a bill that is supposed to be progressive, moving us forward, why are women being moved back? What's more, why is it always women's rights that are the first to go? No one would ever consider taking away insurance coverage for Erectile Disfunction or other male health care issues.

I am so upset right now.

The text of the amendment:

The amendment will prohibit federal funds for abortion services in the public option. It also prohibits individuals who receive affordability credits from purchasing a plan that provides elective abortions. However, it allows individuals, both who receive affordability credits and who do not, to separately purchase with their own funds plans that cover elective abortions. It also clarifies that private plans may still offer elective abortions.

There is a lot more about this amendment and this bill (the influence of the Catholic church, the "move towards the right," the abysmal behavior of Republican male representatives during speeches by their female Democratic colleagues yesterday, the fear mongering by the right). Anyone who wants to talk about it, let me know. I need to blow off some steam, and I need to talk to people about it.

Cross posted at lj. There are some other comments there.

Comments

[angelbabe_cj]

As a Brit I've only ever really known a healthcare system which is free and available to me regardless of my circumstances. Yes, adults have to pay for prescriptions and certain non-required procedures are also payable for (I think), but I can go into a hospital and I won't be required to prove that I can pay before I have my treatment even if it's not a life and death situation.

So I find it very hard to understand how something that is so important and a part of everyday life in my country is only just coming in the USA and that people are fighting so hard against it. I'm very pleased that the bill has passed, I've read people's blogs who have gone through a period when they were unable to pay for health insurance and I just find it so hard to understand.

As for the abortion amendment. Argh. It makes me so mad. For myself I don't know that I'd ever choose to have an abortion. BUT I know if there was a situation where my unborn child was risking my life or doing me serious emotional damage I would take that option. And I've had friends who have taken that option and they're much better for it. Just, gah, again, living in a country where the choice is there as an option. Yes, we have people who campaign against it but it's very much NOT written into our laws (as far as I know). I just don't understand.

Which, I think, is my very long winded way of saying, I get what you're saying and back your point of view even though I find it hard to understand having had these privileges all my life.

[epporsimuove]

Thanks for the support. I have always found the British system interesting. In much the same manner that you can't imagine our system, I can not imagine being able to go to the emergency room or doctor without thinking about what it costs. I have twice this year made the decision not to go to the doctor because I could not afford it. One of these times, my problem cleared up on its own. The second issue is one I still deal with, but I simply cannot afford the visits nor the medication and testing necessary to take care of it. And I cannot imagine the lives of those who cannot wait to go tot he doctor. If I absolutely needed to, I could work out how to go. Others cannot. Ours is a very broken system.

[slippedinred.livejournal.com]

Hey. :)

I fully support the right of people to have access to health care. 100 percent. It's the right thing to do. And I am fine with my tax dollars being spent to make sure that the public has access to medical support. Of course.

That being said, I would not want my tax dollars going towards abortions. And, because they have to support the entire American populace, not just those who would be all right with it, I think it's very smart of our political leaders to respect both sides of the issue. They are not outlawing abortion, and they are not trampling on human rights. They are merely making the health care bill something that ALL Americans can morally support. That's important.

Try to see this not as an issue about the legality of abortion, because it's not. It's an acknowledgment that government money, and money brought in from the tax payers, must be spent in a way that represents the entire populace.

I would be interested in talking with you about your views on human rights sometime.

[violacoye.livejournal.com]

I fully support your desire not to have abortions paid for by your tax dollars. However, the health care bill as it stood before the Stupak amendment would not have paid for abortions using government dollars. Firstly, the bill states a "Prohibition of use of public funds for abortion coverage" (pg 246, ln 11). Secondly, The Hyde Amendment (http://www.nchla.org/datasource/ifactsheets/4FSHydeAm22a.08.pdf), passed in 1976, already prohibits the use of public funds for abortion.

What the Stupak amendment does is outlaw the use of funds in private insurance companies, funded by patient's premiums not tax dollars, from being used to provide abortion coverage if even one patient in that plan gets a government credit to help mitigate the cost of insurance. Since 80% of the population will be receiving affordability credits, it is highly unlikely that any insurance company will refuse to service this population and offer abortion coverage.

This is absolutely an issue of the legality of abortion. Government money was not going to be used to fund abortions. Tax dollars were not going to be used to fund abortions. This amendment will make access to abortions extremely difficult, if not impossible, for lower and middle class women. Should this amendment be included in the final bill, I would find it extremely difficult, if not impossible, to get an abortion. Making abortion extremely difficult, if not impossible, is an issue of the legality. There is no other provision in the bill that restricts LEGAL health care procedures.

The way the bill stood before the Stupak amendment reflected the entire populace. People in insurance plans that covered abortions paid for those abortions in their premiums. Same as it stands now. In fact, if your current insurance plan covers abortions, you are currently paying for women to have abortions through your premiums.

I would be happy to talk about human rights with you sometime. What views, specifically, are you interested in?

[slippedinred.livejournal.com]

Ok.

On the point that this will end up prevent the vast majority of abortions...probably not. If affordability credits banned most coverage plans, there would still be demand for abortions (since they would still be legal), and it would not be hard for the market to adjust. Insurance companies could simply set up abortion rider plans which were stand alone, meaning a person could buy an additional insurance plan that only covered abortions (kinda like how people sometimes buy really nice cigars and get them insured). Because these plans would only cover abortions, they would be pretty cheap, and the whole point of health care reform is to cover more people cheaply, so middle and lower class women would in theory have more money to spend on abortion insurance. That's using this administration's own line that this will save people money. So I don't think that it would somehow be impossible for women to get abortions under Stupak. After all, the average first trimester abortion costs is between $375-485. And interestingly, as it stands, 74% of women pay for abortions out of pocket. And that quote comes from the Guttmacher Institute, the world's leading research center on abortion statistics. Interestingly enough, Guttmacher is a pro-choice institution. The relevant quote:
http://www.guttmacher.org/in-the-know/cost.html

Some 74% of women pay for abortions with their own money; 13% of abortions are covered by Medicaid, and at this time only 13% are billed directly to private insurance. Some women who pay for the procedure themselves may receive insurance reimbursement later.(31)

So we're really only talking about 13% of women getting abortion covered by insurance. And again, by proponents of the bill's own rationale, health care will be cheaper and save people money, meaning their relative purchasing power for getting abortions would be greater.

It is true that if a current private insurance plan covers abortions and I'm a member, my premiums will go towards abortions. But I have the freedom currently to choose a different plan if I wish.

The two biggest points you brought up were that abortion is not in the bill (via the quote from page 246 of the bill), and that federal funding of abortion is prevented by the Hyde Amendment. Hyde is more quickly explained.

The Hyde Amendment is a periodically renewed (meaning it has to be re-approved by Congress) rider attached to Medicaid Funding. It basically says that nothing in Medicaid funding can be used to pay for abortions except in the cases of life/rape/incest (yeah, it's not all abortions, just most, actually about 93%). It only applies to Medicaid, and nothing else.

too long to fit into one comment....

[slippedinred.livejournal.com]

Onto abortion in the bills. The quote from page 246 that says "prohibition of use of public funds for abortion coverage" is actually a paragraph caption, not actual language with force of law (i.e. it's a synopsis, and a misleading one). The *actual bill language* right after that is a bit different.

"An affordability credit may not be used for payment for services" described in section 222(d)(4)(A)[i.e., elective abortions]. But an “affordability credit” is only one type of federal funding. The language on page 246 does not restrict the use of all other types of federal funds to pay directly for elective abortions -- and the use of other types of federal funds is explicitly authorized by the “nothing in this Act shall be construed” clause on page 110.

That reference to "nothing in this Act..." clause on page 110 refers to the following part of the bill: “nothing in this Act shall be construed as preventing the public health insurance option from providing for . . . coverage of services described in paragraph (4)(A).” The services described in paragraph (4)(A) ”are elective abortions" (i.e., all abortions, abortions without any limitations whatever).

Now what's interesting is that so many people have fallen into the error of assuming that the Hyde Amendment DOES prevent all funding of abortion. As I said above, it does not, and has no legal ramifications on the proposed legislation. But it has acted as something of a precedence, people have taken it to be a sensible proposition that tax dollars shouldn't pay for abortion, and have cited Hyde as a sensible reason for doing so.

Now the whole purpose of the Stupak amendment was to do to Health Care Reform what the Hyde Amendment did/does for Medicaid. It's the same thing, preventing federal funding of abortion (removing abortion from the bill) except in the cases of life/rape/incest (so for any of the "hard" cases that people like to bring up, those are actually covered).

A final point. The bill before Stupak did not reflect the stance of the general populace. With Stupak, placing the same protections on life as those in Hyde, it now does. I don't have time to look up the exact percentages at the moment, but I believe it's about 69% of the populace which opposes taxpayer funding of abortion, which Stupak ensures.

Interesting: http://www.magnetmail.net/actions/email_web_version.cfm?recipient_id=200925393&message_id=864150&user_id=NRLC

Re: too long to fit into one comment....

[violacoye.livejournal.com]

Sorry I took so long to reply. Life has become more than a little insane!

You are correct, I was wrong in two points in my previous response to you so I want to start by correcting myself.

The Hyde amendment would not be extended to the health care bill. You are absolutely correct. The portion of the bill which did extend a provision equivalent to the Hyde amendment was the Capps amandement. This was the amendment originally agreed upon, but was replaced by the much more restrictive Stupak amendment. The reason so many people assume that the Hyde amendment covered the bill is because the Capps amendment was sold as extending the Hyde amendment to the health care bill.

Onto the other points. Firstly, regarding the cost of an abortion. $372-487 is a lot of money to women working minimum wage or slightly higher jobs. For instance, in Orlando, $400 is half a month's rent in a good sized apartment; it is probably close to a full month's in a not great place. Also, the reported cost does not include the cost of travel, since many women have to travel to reach an abortion provider (25% travel more than 50 miles). It also does not include any time they may need to take off work.

My final point regarding those statistics, these numbers are already skewed because so many women are already without health insurance. I searched and was unable to find any research on how many women do not have abortions because they can not pay for them, but two points suggest that those numbers would likely be large. Firstly, 60% of women who delayed having an abortion cite the time it took for them to raise money and make arrangements as the main reason for their delay. Often, these delays result in the women having second term abortions which are more expensive and have more complications than first tern abortions. Secondly, organizations that help women pay for abortions are constantly tapped out of funds and must turn away women. Obviously, there is a need for some form of financial assistance for women and abortions.

About the rider that the amendment claims women can buy to cover abortion, three points. First of all, insurance companies have stated that they would be highly unlikely to offer this rider because of the cost. (Link to NPR story: "Health Bill Abortion Clause May Derail Insurance" (http://www.npr.org/templates/story/story.php?storyId=120406487)). Secondly, the rider plan asks women to plan to have an unplanned pregnancy. Thirdly, this rider is sex/gender dependent. Only women will be asked to purchase this rider; men are exempt. Once more, the cost of an unplanned pregnancy will be on the woman, even pregnancy can only occur with two peoples participation.