The Facts on Abortion and Health Reform

18 Jan

Disclaimer: This post is long. Go top off your coffee, make a pit stop, and attend to any other urgent matters before you settle in with this one. That said, if you’ll dare to wade through it, I think you’ll emerge all the better for it.

Fear is a powerful motivator for people. We dislike change because it generates within us a fear of the unknown. Anger is also a powerful motivator for people. If you can get fear and anger on your side, you can get people to say and do just about anything. Especially if they don’t really know what they’re afraid of (the unknown) or why they should be angry (other than that you told them to be so).

Consequently, it comes as little surprise that, on his website, Rush Limbaugh goes after the health reform movement by invoking the emotionally-charged, extremely divisive issue of abortion. He actually uses a video clip of an interview with Secretary of Health and Human Services, Kathleen Sebelius, to convince his audience that everyone will be paying–through their taxes–for women to get abortions. Here’s the transcript from his site (and my thoughts in italics):

“RUSH: Now, in case there remains any confusion about whether or not your taxpayer dollars will be used to pay for insurance policies that cover abortion, here is Kathleen Sebelius, that wizard of smart (is there really any need to attack the woman’s character?) who taught us all how to cough properly during the nonexistent swine flu epidemic (roughly 50 million cases leading to 10,000 U.S. deaths is nonexistent???), basically destroy your sleeve, cough up all the mucus on your sleeve, not in your hand, and she demonstrated how to do it, and she even chastised some idiot reporter (if one idiot chastises another idiot, does that make Rush the genius?) who didn’t get it right at a press conference. During an interview on yesterday, Kathleen Sebelius said this.

SEBELIUS: The Senate language, which was negotiated by Senators Barbara Boxer and Patty Murray, who are very strong defenders of women’s health services and choices for women, take a big step forward from where the House left it with the Stupak amendment. (Watch the video below and you might wonder where this part of Sebelius’ comment went: “And I think it does a good job making sure there are choices for women, making sure there are going to be some plan options, and making sure that, while public funds aren’t used, we are not isolating, discriminating against, or invading the privacy rights of women. That would be an accounting procedure, but”) Everybody in the exchange would do the same thing, whether you’re male or female, whether you’re 75 or 25, you would all set aside a portion of your premium that would go into a fund, and it will not be earmarked for anything, it would be a separate account that everyone in the exchange would pay. It’s really an accounting measure that would apply across the board and not just to women and certainly not just to women who want to choose abortion coverage.

RUSH: So you are going to forced to make a contribution to the exchange, whether you’re 75 or 25, a portion of your premium would go into that fund and it would cover abortions. She’s making it very clear. An accounting gimmick — you can call it an accounting gimmick, it sounds more like a policy to me, but if you had any doubts, okay, you had Nelson all worried about the language in the Senate, you got Stupak all worried about his language over there in the House, and here’s Kathleen Sebelius spelling out how it’s going to happen regardless what the language in the legislation is. (Right. The very pro-life Stupak and Nelson are both so clueless as to introduce amendments that don’t do anything.)

Here’s the version of the video available on Rush Limbaugh’s website. Watch it for the parts of Sebelius’ quote that Rush doesn’t put in print:

Here’s the video in its entirety from Blogher and the White House:

If you listen between 3:30 and 6 minutes, you’ll hear Sebelius’ entire remarks on abortion, which include the following, which Limbaugh conveniently left out:

“I certainly agree that the reproductive rights of women is an important issue and from the outset, again, the President made it clear that this was not an abortion bill, it’s a health care bill and what was very important was to essentially maintain the status quo and the status quo, which I know a lot of women don’t like, but that is the current law is that federal funds are not used to provide abortion coverage except for some rare exceptions. Except for when the life of the woman is in danger, or rape and incest. Those are the only two and that has been the public policy of this country for over a couple of decades. So that’s really the goal of both the House and the Senate. Not all members. Some members would like to take a big step, I would suggest backward to really ban not only coverage with public funds, but to really reach into the private market and make choices.”

I find, when there’s a disagreement like this, that it helps to look at the actual source material. So let’s do that. Here’s excerpted text taken directly from the Stupak amendment (in the House):

“No funds authorized or appropriated by this Act…may be used to pay for any abortion or to cover any part of the costs of any health plan that includes coverage of abortion, except in the case where a woman suffers from a physical disorder, physical injury, or physical illness that would, as certified by a physician, place the woman in danger of death unless an abortion is performed, including a life-endangering physical condition caused by or arising from the pregnancy itself, or unless the pregnancy is the result of an act of rape or incest….Nothing in this section shall be construed as prohibiting any nonfederal entity…from purchasing separate supplemental coverage for abortions for which funding is prohibited under this section…so long as such coverage or plan is paid for entirely using only funds not authorized or appropriated by this Act; and such coverage or plan is not purchased using individual premium payments required for a Exchange-participating health benefits plan towards which an affordability credit is applied; or other nonfederal funds required to receive a federal payment, including a State’s or locality’s contribution of Medicaid matching funds.”

Now what about the Nelson Amendment in the Senate? Take a look:

“A State may elect to prohibit abortion coverage in qualified health plans offered through an Exchange in such State if such State enacts a law to provide for such prohibition…nothing in this title (or any amendment made by this title), shall be construed to require a qualified health plan to provide coverage of [abortion] services…as part of its essential health benefits for any plan year;…the issuer of a qualified health plan shall determine whether or not the plan provides coverage of [abortion] services…as part of such benefits for the plan year…If a qualified health plan provides coverage of [abortion] services…, the issuer of the plan shall not use any amount attributable to any of the following for purposes of paying for such services: (i) The credit under section 36B of the Internal Revenue Code of 1986 (and the amount (if any) of the advance payment of the credit under section 1412 of the Patient Protection and Affordable Care Act). (ii) Any cost-sharing reduction under section 1402 of the Patient Protection and Affordable Care Act (and the amount (if any) of the advance payment of the reduction under section 1412 of the Patient Protection and Affordable Care Act)…In the case of a plan [funded in part by (i) or (ii), the issuer of the plan shall—(i) collect from each enrollee in the plan (without regard to the enrollee’s age, sex, or family status) a separate payment for each of the following: (I) an amount equal to the portion of the premium to be paid directly by the enrollee for coverage under the plan of services other than [abortion] services…(after reduction for credits and cost-sharing reductions described in subparagraph (A)); and (II) an amount equal to the actuarial value of the coverage of [abortion] services…and (ii) shall deposit all such separate payments into separate allocation accounts….The issuer of [such] a plan shall deposit— ‘‘(I) all payments [for non-abortion services]…into a separate account that consists solely of such payments and that is used exclusively to pay for services other than [abortion] services…and (II) all [“separate”] payments…into a separate account that consists solely of such payments and that is used exclusively to pay for [abortion] services…A qualified health plan that provides for coverage of [abortion] services…shall provide a notice to enrollees, only as part of the summary of benefits and coverage explanation, at the time of enrollment, of such coverage…No qualified health plan offered through an Exchange may discriminate against any individual health care provider or health care facility because of its unwillingness to provide, pay for, provide coverage of, or refer for abortions.”

If either of those amendments suggest to you that tax revenues will be used to fund abortions, might I suggest you read again more carefully, or perhaps attend law school. (Note: Listening to Rush on the radio is NOT a suitable alternative.) The bottom line is that no tax money is going to be used to fund abortions. In fact, no private insurance plan –participating in the Exchange or not–is required to offer abortion coverage, and no provider can be discriminated against for refusing to provide abortions.

Here’s what can happen: Insurance plans can offer supplemental abortion coverage under Stupak that folks buy on their own with money out of their own pocket. Or, under Nelson, insurance plans can include abortion services as a benefit, but they must maintain two separate accounts, and any federal money they receive is kept wholly separate from the account from which abortion services are paid for. Is it an accounting procedure? Yes. Is it somehow different from what exists today? Not at all. Go pull your insurance benefits summary off the shelf (you kept it, right?) and take a look. I’ll bet it covers abortion services in at least some capacity. If it does, guess what? A portion of your monthly premium is being used to fund abortions. Rush’s abortion argument–most especially his claim that you’re going to be forced to contribute to the Exchange–is nothing but a straw man designed to be knocked down with the goal of fostering more animosity among opponents of health reform. It takes a fair bit of digging to prove him wrong, and that’s exactly what he’s counting on when he–and others–sell you the policy equivalent of Florida swampland.

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Posted by on January 18, 2010 in Uncategorized


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