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Read The Abortion Compromise In Harry Reid's Senate Health Care Bill

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The health care reform package unveiled by Senate Majority Leader Harry Reid (D-Nev.) Wednesday night bars the use of federal funds for abortion services, but does not go as far as the House bill -- which prevents women in many cases from buying insurance with their own money that covers abortion.

The Senate version would require at least one plan within the health insurance exchange that the bill sets up to offer a plan that covers abortion and one that doesn't. It would also authorize the Health and Human Services Secretary to audit plans to make certain that abortion isn't being paid for with federal dollars.

Rep. Lois Capps (D-Calif.), who authored compromise abortion language in the House that both sides had agreed to before the more restrictive measure won out, is pleased with the Senate version.

"I am pleased that the Senate has adopted a reasonable, common ground approach on this difficult question," she said in a statement. "It appears that their approach closely mirrors my language which was originally included in the House bill. It ensures that federal funds do not pay for abortions but allows continued access to this legal medical procedure. This is a bill about health insurance reform not about expanding or contracting access to abortion services. I am glad that the Senate has rejected the more extreme Stupak language and look forward to continuing to work with my pro-life and pro-choice colleagues on a reasonable compromise on this issue."

Sen. Barbara Boxer is also pleased with the language of the Senate's abortion compromise:
"Senator Reid did an excellent job of crafting language that maintains the decades long compromise of no federal funds for abortion, while allowing a woman to use her own private funds for her reproductive health care. In this Senate bill, there is a complete separation of public and private funding when it comes to purchasing insurance that includes legal reproductive health care procedures."

HuffPost scored a copy of Reid's bill, which you can read here. The abortion compromise begins on page 116 with section 1303.

Write ryan@huffingtonpost.com if you notice any unexpected restrictions that could result from this language. Please refer to the page numbers and the line numbers to the left.

14 SEC. 1303. SPECIAL RULES.
(a) SPECIAL RULES RELATING TO COVERAGE OF ABORTION SERVICES.--
VOLUNTARY CHOICE OF COVERAGE OF ABORTION SERVICES.--

19 (A) IN GENERAL.--Notwithstanding any
20 other provision of this title (or any amendment
21 made by this title), and subject to subpara22
graphs (C) and (D)--
23 (i) nothing in this title (or any
24 amendment made by this title), shall be
25 construed to require a qualified health plan

Page 117

1 to provide coverage of services described in
2 subparagraph (B)(i) or (B)(ii) as part of
3 its essential health benefits for any plan
4 year; and
5 (ii) the issuer of a qualified health
6 plan shall determine whether or not the
7 plan provides coverage of services described
8 in subparagraph (B)(i) or (B)(ii) as part
9 of such benefits for the plan year.
10 (B) ABORTION SERVICES.--
11 (i) ABORTIONS FOR WHICH PUBLIC
12 FUNDING IS PROHIBITED.--The services
13 described in this clause are abortions for
14 which the expenditure of Federal funds ap15
propriated for the Department of Health
16 and Human Services is not permitted,
17 based on the law as in effect as of the date
18 that is 6 months before the beginning of
19 the plan year involved.
20 (ii) ABORTIONS FOR WHICH PUBLIC
21 FUNDING IS ALLOWED.--The services de22
scribed in this clause are abortions for
23 which the expenditure of Federal funds ap24
propriated for the Department of Health
25 and Human Services is permitted, based

Page 118

1 on the law as in effect as of the date that
2 is 6 months before the beginning of the
3 plan year involved.
4 (C) PROHIBITION ON FEDERAL FUNDS
5 FOR ABORTION SERVICES IN COMMUNITY
6 HEALTH INSURANCE OPTION.--
7 (i) DETERMINATION BY SEC8
RETARY.--The Secretary may not deter9
mine, in accordance with subparagraph
10 (A)(ii), that the community health insur11
ance option established under section 1323
12 shall provide coverage of services described
13 in subparagraph (B)(i) as part of benefits
14 for the plan year unless the Secretary--
15 (I) assures compliance with the
16 requirements of paragraph (2);
17 (II) assures, in accordance with
18 applicable provisions of generally ac19
cepted accounting requirements, circu20
lars on funds management of the Of21
fice of Management and Budget, and
22 guidance on accounting of the Govern23
ment Accountability Office, that no
24 Federal funds are used for such cov25
erage; and

Page 119

1 (III) notwithstanding section
2 1323(e)(1)(C) or any other provision
3 of this title, takes all necessary steps
4 to assure that the United States does
5 not bear the insurance risk for a com6
munity health insurance option's cov7
erage of services described in subpara8
graph (B)(i).
9 (ii) STATE REQUIREMENT.--If a State
10 requires, in addition to the essential health
11 benefits required under section 1323(b)(3)
12 (A), coverage of services described in sub13
paragraph (B)(i) for enrollees of a commu14
nity health insurance option offered in
15 such State, the State shall assure that no
16 funds flowing through or from the commu17
nity health insurance option, and no other
18 Federal funds, pay or defray the cost of
19 providing coverage of services described in
20 subparagraph (B)(i). The United States
21 shall not bear the insurance risk for a
22 State's required coverage of services de23
scribed in subparagraph (B)(i).
24 (iii) EXCEPTIONS.--Nothing in this
25 subparagraph shall apply to coverage of

Page 120

1 services described in subparagraph (B)(ii)
2 by the community health insurance option.
3 Services described in subparagraph (B)(ii)
4 shall be covered to the same extent as such
5 services are covered under title XIX of the
6 Social Security Act.
7 (D) ASSURED AVAILABILITY OF VARIED
8 COVERAGE THROUGH EXCHANGES.--
9 (i) IN GENERAL.--The Secretary shall
10 assure that with respect to qualified health
11 plans offered in any Exchange established
12 pursuant to this title--
13 (I) there is at least one such plan
14 that provides coverage of services de15
scribed in clauses (i) and (ii) of sub16
paragraph (B); and
17 (II) there is at least one such
18 plan that does not provide coverage of
19 services described in subparagraph
20 (B)(i).
21 (ii) SPECIAL RULES.--For purposes of
22 clause (i)--
23 (I) a plan shall be treated as de24
scribed in clause (i)(II) if the plan
25 does not provide coverage of services

Page 121

1 described in either subparagraph
2 (B)(i) or (B)(ii); and
3 (II) if a State has one Exchange
4 covering more than 1 insurance mar5
ket, the Secretary shall meet the re6
quirements of clause (i) separately
7 with respect to each such market.
8 (2) PROHIBITION ON THE USE OF FEDERAL
9 FUNDS.--
10 (A) IN GENERAL.--If a qualified health
11 plan provides coverage of services described in
12 paragraph (1)(B)(i), the issuer of the plan shall
13 not use any amount attributable to any of the
14 following for purposes of paying for such serv15
ices:
16 (i) The credit under section 36B of
17 the Internal Revenue Code of 1986 (and
18 the amount (if any) of the advance pay19
ment of the credit under section 1412 of
20 the Patient Protection and Affordable Care
21 Act).
22 (ii) Any cost-sharing reduction under
23 section 1402 of thePatient Protection and
24 Affordable Care Act (and the amount (if
25 any) of the advance payment of the reduc122
O:\BAI\BAI09M01.xml [file 1 of 9] S.L.C.
1 tion under section 1412 of the Patient
2 Protection and Affordable Care Act).
3 (B) SEGREGATION OF FUNDS.--In the case
4 of a plan to which subparagraph (A) applies,
5 the issuer of the plan shall, out of amounts not
6 described in subparagraph (A), segregate an
7 amount equal to the actuarial amounts deter8
mined under subparagraph (C) for all enrollees
9 from the amounts described in subparagraph
10 (A).
11 (C) ACTUARIAL VALUE OF OPTIONAL
12 SERVICE COVERAGE.--
13 (i) IN GENERAL.--The Secretary shall
14 estimate the basic per enrollee, per month
15 cost, determined on an average actuarial
16 basis, for including coverage under a quali17
fied health plan of the services described in
18 paragraph (1)(B)(i).
19 (ii) CONSIDERATIONS.--In making
20 such estimate, the Secretary--
21 (I) may take into account the im22
pact on overall costs of the inclusion
23 of such coverage, but may not take
24 into account any cost reduction esti25
mated to result from such services, in123
O:\BAI\BAI09M01.xml [file 1 of 9] S.L.C.
1 cluding prenatal care, delivery, or
2 postnatal care;
3 (II) shall estimate such costs as
4 if such coverage were included for the
5 entire population covered; and
6 (III) may not estimate such a
7 cost at less than $1 per enrollee, per
8 month.
9 (3) PROVIDER CONSCIENCE PROTECTIONS.--No
10 individual health care provider or health care facility
11 may be discriminated against because of a willing12
ness or an unwillingness, if doing so is contrary to
13 the religious or moral beliefs of the provider or facil14
ity, to provide, pay for, provide coverage of, or refer
15 for abortions.
16 (b) APPLICATION OF STATE AND FEDERAL LAWS
17 REGARDING ABORTION.--
18 (1) NO PREEMPTION OF STATE LAWS REGARD19
ING ABORTION.--Nothing in this Act shall be con20
strued to preempt or otherwise have any effect on
21 State laws regarding the prohibition of (or require22
ment of) coverage, funding, or procedural require23
ments on abortions, including parental notification
24 or consent for the performance of an abortion on a
25 minor.

Page 124

1 (2) NO EFFECT ON FEDERAL LAWS REGARDING
2 ABORTION.--
3 (A) IN GENERAL.--Nothing in this Act
4 shall be construed to have any effect on Federal
5 laws regarding--
6 (i) conscience protection;
7 (ii) willingness or refusal to provide
8 abortion; and
9 (iii) discrimination on the basis of the
10 willingness or refusal to provide, pay for,
11 cover, or refer for abortion or to provide or
12 participate in training to provide abortion.
13 (3) NO EFFECT ON FEDERAL CIVIL RIGHTS
14 LAW.--Nothing in this subsection shall alter the
15 rights and obligations of employees and employers
16 under title VII of the Civil Rights Act of 1964.
17 (c) APPLICATION OF EMERGENCY SERVICES
18 LAWS.--Nothing in this Act shall be construed to relieve
19 any health care provider from providing emergency serv20
ices as required by State or Federal law, including section
21 1867 of the Social Security Act (popularly known as
22 ''EMTALA'').