Q&A: Abortion & the health care bill

WASHINGTON (BP)--Pro-life groups are busy urging their constituents to call the House of Representatives and urge a "no" vote on the Senate health care bill. Following are some common questions, along with answers, about the bill's abortion provisions:

-- Why are most pro-lifers opposed to the Senate health care bill?

Pro-lifers argue that the health care bill 1) changes longstanding policy on coverage of abortion in federally subsidized insurance plans, 2) would lead to a drastic expansion of abortion coverage and 3) could result in federal tax dollars being directly used for abortions.

-- What is the current federal policy on abortion coverage within federally subsidized insurance plans?

Current law prohibits the federal government from funding insurance plans covering elective abortions. The Medicaid program for lower income people is prohibited from covering elective abortions, as are insurance plans for federal employees. Congress' own insurance plans, for instance, cannot by law cover elective abortions.

-- How would the Senate health care bill change current policy?

The Senate bill allows federal subsidies -- that is, federal assistance for lower income people -- to be used to purchase health insurance plans that cover elective abortions. Enrollees would have to make two payments: one for abortion coverage and one for the rest of the premium, and the company would be required to segregate the funds. Sen. Barbara Boxer, D.-Calif., a strong supporter of the bill and of abortion rights, called it an "accounting procedure" meant to guarantee that abortion is still covered. The bill requires "insurance exchanges" in each state to offer at least one insurance plan that covers abortion and one insurance plan that does not, although states would be allowed to opt out and not offer the abortion plan.

-- How would this lead to an expansion of abortion coverage?

Because more women would have abortion coverage as part of their insurance plans, the procedure would become far more accessible and affordable. In other words, women who for various reasons (for instance, financial) currently don't have abortion coverage will have it if the Senate bill becomes law. Planned Parenthood, the nation's largest abortion provider, said the bill would "significantly increase access to reproductive health care."

-- But doesn't the writing of separate checks prevent federal dollars from going toward funding elective abortions?

Pro-lifers have several objections to this section of the bill. First, anyone in an insurance plan that covers abortion -- even men and elderly women -- must write a separate check for abortion coverage, making them direct contributors to elective abortions. This becomes even more significant if a person's employer offers only this one plan. Second, the federal government would be mandating abortion coverage by requiring not only that at least one plan cover abortion, but that people write a check specifically for it. The U.S. Conference of Catholic Bishops argues, "Saying that this payment is not a 'tax dollar' is no help if it is required by the government." Third, the bill includes a loophole (on page 123) stating that separate checks would not be required and that direct federal subsidies would be allowed for elective abortions if the Hyde Amendment -- which prevents Medicaid from covering elective abortions -- is ever reversed. House Speaker Nancy Pelosi opposes the Hyde Amendment.

-- So, does the Hyde Amendment apply to the Senate bill?

No, although the explanation is somewhat complicated. The Hyde Amendment -- which must be renewed annually -- applies only to Medicaid and a handful of other Health and Human Services Department funding streams and prevents abortion coverage except in the cases of rape, incest and to save the mother's life. The health care bill references the Hyde Amendment only as a way to ensure that federal policy is standard across the board. If the Hyde Amendment is overturned and Medicaid is allowed to cover elective abortions, then federal subsidies for insurance plans would be allowed to cover them as well. In reporting about the issue March 5, the Associated Press said, "The Democratic bills created a new stream of federal money to help working households afford health insurance premiums. And those funds were not subject to the Hyde restrictions."

-- Do pro-lifers have any other concerns about the bills?

Yes, especially as it relates to the bill's $7 billion in funding of the nation's 1,200-plus community health centers. There is nothing in the bill, the National Right to Life argues, to prevent the centers from using tax dollars to pay directly for elective abortions. (The bill's limited abortion funding restrictions apply only to the issue of federal subsidies for enrollee insurance plans, the organization says.) The Senate bill also lacks language protecting health care workers who refuse to participate in providing abortions. National Right to Life calls the entire bill "the most pro-abortion single piece of legislation that has ever come to the House floor for a vote, since Roe v. Wade." The Southern Baptist Ethics & Religious Liberty Commission says "health care must honor all human life, from 'conception to natural death.'"


Michael Foust is an assistant editor of Baptist Press. The Senate health care bill can be read online at http://bit.ly/9cq4Kk. National Right to Life's detailed explanation of the bill's problems is available at http://www.nrlc.org/AHC/AbortionPolicyHCRBackgrounder.pdf. House members can be contacted through the capitol switchboard (202-224-3121) or through House.gov, where their local office numbers can be found.

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