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Abortion Politics
Roughly speaking, the Stupak amendment is simple: it says that anyone receiving a federal subsidy can't buy healthcare insurance that includes abortion coverage. There's a bit more, but that's the piece that's causing most of the backlash from pro-choice forces.
But as bad as that is, there's a fear that it might be even worse than it sounds. Anyone who gets a federal subsidy to buy private healthcare insurance is 
required to buy a policy through the "exchange," but not everyone who buys through the exchange gets a federal subsidy. So what if insurance companies decide it's too much trouble to offer multiple options, and simply remove abortion coverage from every policy offered through the exchange, regardless of how it's paid for? Ezra Klein:
If health-care reform began with huge exchanges, in which only a small portion of the participants were on subsidies and the Stupak amendment only applied to a fraction of the market, insurers would probably offer mostly policies that included abortion coverage. In reality, almost 90 percent of the population on the exchanges will be subsidized, so there is no real market for insurers to present a policy that covers abortion. That presents a much bigger problem.
The exchanges are not likely to stay small. They will gradually add larger and larger employers....Over time, that could mean that the norm becomes an insurance market that doesn't cover abortion as opposed to an insurance market that does....If it sets the standards for the exchanges and the exchanges eventually become the standard for the whole insurance market, then the Stupak amendment could transform coverage for not just poor women, but all women.
But here's my question: how much trouble is it, really, for insurance companies to offer two different policies that are identical except for their abortion coverage? Not much, I'd guess. As one data point, the Republican National Committee was embarrassed recently when reporters found out that their group health policy included abortion coverage. Here's Politico on the RNC's response:
According to several Cigna employees, the insurer offers its customers the opportunity to opt out of abortion coverage — and the RNC did not choose to opt out.
....“We were not aware of this, obviously, and this will, of course, be fixed,” said James Bopp Jr., a Republican National Committeeman from Indiana. “I think Chairman Steele will see to it that that’s the case.”
So with Cigna, anyway, they already have separate insurance policies because that's what the market wants. I'll bet other insurance carriers do the same, and that means that offering multiple options on the exchange is no trouble at all. They already have them, there's no reason not to offer both, and even a modest amount of public pressure will almost certainly be enough to make sure of it.
I'd be happiest if the Stupak amendment were removed entirely in conference, but failing that, it wouldn't be much trouble to add language requiring insurers to offer both kinds of policy on the exchange. Ditto for language ensuring that the amendment isn't interpreted to mean that small businesses getting federal subsidies are prohibited from opting to include abortion coverage if they want to. If it's really true that the Stupak bloc in the House merely wants to replicate current restrictions on federal funding of abortions, they shouldn't have a problem with this.
And on a slightly different topic, I'll add this: I sure wish that overall subsidy levels in the current healthcare bills produced the same kind of uproar as abortion and the public option. In terms of real-world effect on real-world people, subsidies are the biggest issue by a mile. But not a very sexy issue, apparently. That's too bad.
I don't like Stupak, but
I don't like Stupak, but this has been one of the dumbest talking points ever, and it's promoted by lots of the MoJo writers.
As if the insurance companies don't already offer thousands of subtly different plans.
But what I really like are MoJo writers like Rachel Morris (IIRC) claiming that women are too stupid to use insurance to plan for unplanned events, and that insurance companies will prove free market economics are wrong by not offering lucrative policies.
http://www.motherjones.com/politics/2009/11/price-health-reform-abortion...
Guttmacher says there are 20 abortions for every 1000 women (2008) http://www.guttmacher.org/pubs/fb_induced_abortion.html
And they say the average cost of an abortion is $500 (in 2001), so let's say the average cost is $1500.
So we have $30,000 in abortion costs each year to be covered by 1000 women, or a rider of about $30.00 plus some outrageous markup. Call it a $100 rider based on 2001 costs multiplied by three and a 200% markup.
Does that sound at all in the ballpark?
and
Are you telling me that women are smart enough to buy car insurance, apartment insurance, trip insurance but are too stupid to understand they may want unwanted pregnancy insurance?
I can understand an argument saying that woman should not have to pay this charge, or that the rider may be too expensive for many, but I think you spit on women when you say they are so stupid.
I for one, don't believe they are as stupid as you claim. Why are you so sexist?
and
Rachel, if Stupak were law tomorrow, why wouldn't Planned Parenthood or NOW be offering a $50 abortion insurance rider by Friday, just as DAN insures divers, AOPA insures pilots, etc.?
There's apparently an amazing free market breakdown that you, as MoJo Reporter should be covering. Are there really states that permit/require such insurance and yet there are no providers of that insurance? WHY NOT FIND OUT WHY! There are investigative reports to write, economists that would be interested, and even entrepreneurs you could partner with to make some real money.
Women won't buy a $40 abortion policy? Which women? Would you buy such a policy, and if not, why not? Which women would not buy a $40 policy to cover a hole in their coverage? Please name names. Is it Sheppard? Baurlein? Jeffrey?
Do these people buy car insurance? Home/Apartment insurance? Disability insurance?
If they won't buy an insurance policy that's available for X, why should anyone care if they come to need X and have to pay for it out of their pocket?
This has nothing to do with the arguments that the amendment is unfair, it is, or that some women will find the insurance prohibitive, they will, just as other citizens will find the new health care requirement to be too expensive too. The question is that for women that can afford it, why won't they buy it, and why won't Planned Parenthood provide it?
rider
A check box for different riders that add different services for different fees?
Beutler had a piece the
Beutler had a piece the other day that reveals, among other tidbits, that about 83% of abortions are paid for out of pocket under the status quo.
I understand the very real consternation and fears of reproductive rights advocates, but Stupak -- like Hyde before it -- seems to me fairly symbolic. Regulations like Hyde and Stupak are about sending messages and conveying attitudes about what we as a society think about abortion. Clearly they don't in practice actually prevent many abortions.
I think the balance that has more or less stuck since Henry Hyde's day -- abortion is a constitutionally protected right, just don't ask Joe Sixpack to pay for it -- isn't the worst compromise in the world for progressives, especially when you need the votes of reasonable but less progressive people to get anything done.
If progressives draw a line in the sand over Stupak I'm not only afraid that it might kill HCR (lack of health insurance claims the lives of far more American women than lack government cash for abortions), I'm very fearful it will gin up the anti-choice community to record turnout in 2010 (Socialist Obama wants YOUR money for kill babies!!!).
be careful what you wish for
"Regulations like Hyde and Stupak are about sending messages and conveying attitudes about what we as a society think about abortion."
This is not "we as a society" deciding anything. This is a small group of anti-choicers telling the rest of the country what kind of health care women deserve, and what kind they don't. (How much do you want to bet that these very same anti-choicers support the provision in the Senate bill which requires insurers to cover prayer treatments?)
"I think the balance that has more or less stuck since Henry Hyde's day -- abortion is a constitutionally protected right, just don't ask Joe Sixpack to pay for it -- isn't the worst compromise in the world for progressives, especially when you need the votes of reasonable but less progressive people to get anything done."
And what if Jane Sixpack (who, it's worth noting, demographically outweighs Joe Sixpack) says the same thing about, as Katha Pollit puts it,
"male-exclusive stuff, like prostate cancer, Viagra, male infertility, vasectomies, growth-hormone shots for short little boys, long-term care for macho guys who won't wear motorcycle helmets and, I dunno, psychotherapy for pedophile priests. Men could always pay in advance for an insurance policy rider, as women are blithely told they can do if Stupak becomes part of the final bill."
You think it's fair to do a line by line screening of the procedures for which women can receive federal subsidies. Fine. But you damn well better be prepared to turn around and apply the same set of standards to men. Holding my breath for that one.
That's another one of the
That's another one of the stupider arguments against Stupak.
17 women voted FOR Stupak, way over a hundred men voted against Stupak.
Abortion is NOT all of "women's health issues". Abortion is NOT sexual dysfunction.
For Pollitt, and other women and idiots to equate these things is basically just their hatred and inability to argue or respect others flowing out.
17 women voted for Stupak, and abortion has a long history of controversy in the US. It's not black and white and just about angry white men that want to control women's vaginas. It's well meaning men and women on both sides of the issues.
If you want to know why we haven't advanced very far, its because Pollitt, you, and so many others insist on polarizing the issue and disrespecting many people, of both sexes and many faiths (including atheists) who have put a lot of thought into it.
And you disrespect that and turn it into a simplistic divisive gender war.
So enjoy Stupak. Women didn't deserve it, but you and Pollitt certainly did.
irony alert
"If you want to know why we haven't advanced very far, its because Pollitt, you, and so many others insist on polarizing the issue and disrespecting many people, of both sexes and many faiths (including atheists) who have put a lot of thought into it."
Abortion is a medical procedure. Full stop. End of sentence. In some cases, it's a medically necessary procedure. In some cases, it's an elective procedure. News flash -- procedures for vasectomies, male sterility, & erectile dysfunction (cute euphemism, that one) are elective procedures, too, but nobody wails about taxpayer dollars funding those. Healthcare insurance is designed to cover the costs of medical procedures -- even those we might not need ourselves, or those we might not want others to have. I realize that, when it comes to a woman's right to choose abortion, this drives you, Stupak, & the religious right bonkers. The best you can do is attribute opposition to your viewpoint to the stupidity of "idiots," and their "hatred and inability to argue or respect others." That's rich. Even richer is that you can spew that utter horseshit and dismiss opposition to your position as disrespectful & simplistic.
"Abortion is a medical
"Abortion is a medical procedure. Full Stop." Well ya, and so weren't those showers in the concentration camps . Funny how both result in death.
Sorry Junebug- such a cute name for a stick up the asshole like you- your reasoning never goes as far as your arrogance. Not that you'd notice but there is a slight difference between getting a hard on from a reimbursed pill- which insurance should never cover- and ripping a fetus from the womb. The fact that you can't recognize that some people might have a differing opinion about the morality of it only contradicts the "disrespectful and simplistic " accusation you make. In fact Junebug, your arguments are usually simplistic and always snarky.
Try not to post any more comments before taking your reimbursed meds again. They won't make you any smarter, hopefully just less mean.
... in which our hero hits the trifecta
Wow... strawmen, ad hominem, & Godwin's Law. Reverting to any one of these is a pretty good sign you're on shaky ground, but when you nail all three in one rant while managing to avoid any substance whatsoever, well, that's a pretty special moment.
Free advice is worth what you pay for it & all that, but here's some, anyway -- argument by tantrum just makes you look insecure.
I hadn't generally
I hadn't generally considered the Stupak debacle in the context you layed out, but I think you're largely right. Good point.
Now, really
"If it's really true that the Stupak bloc in the House merely wants to replicate current restrictions on federal funding of abortions, they shouldn't have a problem with this."
Can I get a chorus of "Beautiful Dreamer, please?"
Of course they'd have a problem with this. They are anti-choice and anti-abortion, period, full stop. Gimme a break.
Isn't one of the new
Isn't one of the new regulations that insurance companies cannot take gender into consideration when charging customers? Nor pre-existing conditions? How many men do you think will sign up for this rider? What's the next step? Separate riders for breast cancer, prostate cancer, ovarian cancer, testicular cancer, tubal ligations, vasectomies, pregnancy, priapism, etc., etc.? Before you know it, there will be a basic policy that covers an annual check-up, and a lot of riders that allow the insurance companies to slice and dice the market about as well as they do right now. How much are you prepared to bet that insurance companies won't behave this way, once policies are allowed that cover everything except condition X (broken legs?), but for an additional $N you can get a special rider that will cover X?
Well for one thing, Anonymous,
parents may not buy unwanted pregnancy riders for the daughters who are covered by their policies.
Can you explain why that is?
Can you explain why that is? If my coverage doesn't cover my kids, I fully intend to buy such a rider.
Are you saying they can't buy, or they wouldn't buy?
If "can't", why? If "wouldn't", well, their daughters probably already had a lot of problems getting an abortion, so what has changed? And if it's like diver's/pilot's/Hiker's insurance/... it's not clear the daughter's can't buy their own policy.
Yeah....
That's a brilliant plan, Kevin, which is why that was essentially the language in the bill before the Stupak Amendment was passed. Of course, I'm guessing the Stupak supporters won't embrace that language, since they deliberately stripped it from the bill in order to play abortion politics.
I know, silly me, pointing out that conservatives and anti-choicers play abortion politics, and that they should on occasion bear the brunt of making concessions. We all know that only liberals need make concessions. Alas, but it's how I feel.
Incidentally, let me be frank: as the father of a daughter who may some day need abortion coverage, I'm willing to let the bill die rather than send it through with Stupak's language. Enough's already been done to whittle away her right to choose, thanks.
"Incidentally, let me be
"Incidentally, let me be frank: as the father of a daughter who may some day need abortion coverage, I'm willing to let the bill die rather than send it through with Stupak's language. Enough's already been done to whittle away her right to choose, thanks."
Homeless families vs. Elitist Feminist Bloggers With Principles(TM)
If it's really true that the
Is there a question on this? Of course the Stupak bloc isn't acting out of some abstract desire for abortion neutrality. This is most easily seen by the fact that the Stupak amendment isn't abortion neutral, even slightly. And then there's the 'it would go against everything we know about the anti-abortion movement' part.
just die, please
I don't think Rep. Grayson's criticism of Republican's attitudes towards health care was reckless hyperbole. Eventually the Right would prefer the health care system evolved into a model where the poor just crawled off into a darkened alley and died, leaving various assets (hospital beds, money, doctor's time and energies, experimental drugs and treatments) to those more deserving. You know, Republicans. If poor people want to spend their own "real" money (not funds ill advisedly expropriated from an insurance company) on health care that's fine. Just don't be a drag on the system while Brittany and Logan are awaiting their veneer fittings.
The progressive
The progressive establishment was perfectly fine with the status quo - poor women needing to pay out of pocket for abortion services. Now that professional class women might be required to do the same by purchasing a rider, the entire health insurance reform process is threatened.
real-world effect on real people
Kevin, you missed the mark on this one.
contraception was kept out of the required basic coverage by the same anti-choice assholes. somehow, i see forced-birth for women who can't scrape together $500 as likely to have pretty serious impact. on families, not just women. on children. on society in general.
we're not worried (well, i'm not worried, and i suspect many progressives would agree with me) about insurance companies being 'too lazy' to offer multiple plans or egregiously expensive riders. i'm worried about insurance companies being run by private market Stupaks, who will happily institute (more) anti-women policies. i'm worried about those egregiously expensive riders effectively wiping out subsidies if women expect to protect themselves. we're worried about the erosion of our constitutional right to bodily autonomy and equal protection under the law, which is what this is.
the real-world effect is the codification into legislation of the uterus as a pre-existing condition.
Premiums will be higher for non-aborton-coverage
Policies that don't cover abortion will probably cost more than those that do, since the non-abortion policies will have to cover a lot more (expensive) childbirths.
options
Companies have no problems offering multiple options if there is a chance you might be enticed into paying for something you don't need. Examples: cell-phone plans, or even medicare supplements or prescription plans.