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

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 [e-mail] 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

Story continues below

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'').

Comments

[ProfRob]

More unwanted children will help to fill the prisons and mental hospitals, creating more jobs in construction or facilities, for prison guards, and for psychiatric techs. Unhappily those babies won't be fit to fill our armies because most will be in the 75% who are unfit for service.
I wonder if the senators have read the books by child psychiatrist Jack Westman or the free ebook series "In Search of Utopia" (andgulliverreturns.info.info). If we have intelligent senators their minds might be changed with evidence.

[wspencer]

Does anyone know if "prayer healing therapy" is still going to be funded by this healthcare bill?

Does anyone know why the RNC has abortion coverage under their own healthcare plan?



Stop theocracy now.

[freeus]

abortion is a legal necessary medical procedure.
ignorant theocratic masogynists do not work as governors or law makers.

[freeus]

all of this language needs to be removed. single payer medicare for all.

[taddles]

Safe and available abortion is part of the Democratic platform. If Stupak is insinuating amendments into critical bills in a vile backhanded attempt to make them illegal or unavailable he needs to face a real Dem primary challenge and he needs to be removed from all committee's and chairmanships. We can not abide a Dem stabbing us in the back.

[AnotherAngle]

Are democrats not '"allowed" to have different opinions than those of the mainstream party line?

What do you want in congress, a bunch of robots that think alike on every cause?

[Weehawk]

Let's add similar language about testicular cancer. I don't want to pay to have that treated -- after all, I don't have a pair and I will never, ever use the coverage.

Besides that, in treatment, MILLIONS of potential human lives are destroyed forever. How can that be moral??

[KathrynKate78]

War?

[who38]

Absolutely. And there should be a law that any sperm ejaculated during masturbation must be frozen and stored---at government expense--- in order to ensure that the lives of innocent children are not sacrificed to the irresponsible behavior of males.

[AnotherAngle]

*rolling eyes*

I can't believe you are equating pregnancy, sometihng that occurs as a result of a CHOICE that is made that is NON life threatening, and Cancer, a disease that even the most innocent of children get through no choice or fault of their own.

From listening to you women, it would be no wonder if men opted for who38's version of self gratification.

I know I would.

[Uggg]

Believe in Roe V Wade , but if you are going to fool around then you need to pay out of your pocket the Gov does not need to pay for termination of pregnancy

[taddles]

Government does not now nor has it ever paid for abortion. This is not about keeping the Government from paying for abortion, this is about an amendment that will make it impossible for insurance companies to provide ancillary policies for women who need abortions due to medical issues.

[ldmason45]

I thought both the house and the senate bills allowed coverage for abortions in case of danger to the mom and baby's health, incest and rape. I'm a woman and a nurse and I don't think I should pay for a woman to have an abortion because a pregnancy or baby would be inconvenient to her. It is also my understanding that the cases of abortions for medical reasons, incest and rape are a very small percentage of the actual abortion cases. If you are old enough to have sex, you are old enough to act responsibly and use birth control. I've seen quite a few patients who used abortion for birth control. I think this is just pro-abortion groups trying to scare women, to believe they will have their right to choose abortion will be taken away. Not So ! But if you "play", you may "pay" yourself.

[JeffyBoy]

The Gov. most certainlly does pay for abortion. Ever heard of a group called planed paranthood. It is Gov. funded.

[KathrynKate78]

In defense of the bill, there is such a thing as a compromise that doesn't suppress the rights of one side or the other. I think this bill exhibits that compromise. I am firmly pro-choice but I don't buy the slippery slope reasoning that this bill will lead to the overturning of Roe v. Wade. From my standpoint, as long as this package gives an option to cover abortions, I am okay with that. What would not be okay is if they were not covered at all. To be fair, if I was pro-life I wouldn't want to be complicit in financing abortions if I believed them to be acts of murder; it could even be construed as religious intolerance. (However, if you adhere to that line of reasoning, it follows that I should also have the right to say that I will not let my tax money fund executions if I believe that the death penalty to be an act of murder. And that's just the tip of the iceberg...)

Bottom line: If we wait until everybody is satisfied with the legal status of abortion, health care reform won't even matter because we'll already be decomposing. If we accept this provision--allowing abortion to be covered but not demanding that it be covered through the funds of all taxpayers--we might just have the best compromise we're going to get in order to push health care reform through for all Americans, pro-choice and pro-life.

[kathy001]

Well said. I agree.

[mratcheson]

Agreed.

[tj101]

Agreed, Kathryn, but am interested in hearing more about "the slippery slope reasoning that this bill will lead to the overturning of Roe v. Wade"

I hadn't heard any of this.....

[MoeB]

Simply put, it just means that those of us who are anti-death penalty, for instance, are actually having our tax monies go to fund state-sanctioned executions...so if your argument is that you don't want your tax dollars going towards things you don't believe in, then it can lead us down a road that we don't wanna go, as I'm sure EVERYONE has something that their tax dollars go towards that they don't agree with politically or morally.

[KathrynKate78]

Thanks. As for your question, I may have overstated it, in which case I'm glad you challenged it. Maybe this will help clarify...

The long answer: Such sentiments were mostly voiced with regard to the House bill and the Stupak amendment. What I was referring to was a generally voiced implicit assumption on message boards, etc. that abortion restrictions in the House bill are a sign of a potential rollback of reproductive rights ensured under Roe v. Wade. To use the words of one post, if abortion opponents are successful, "access to abortion will be practically eliminated in health care reform. And without access, there is no choice." This is true, logically, but I don't see evidence that current measures in health care reform are going to be able to legally obliterate choice.

The short answer: Just look at the photograph Huff Po chose to associate with this article and consider how it directs readers' mindsets as they consider this debate.

[ssg13565]

This bill does not have a Stupak-like amendment in it. That is the major point.

The outcry is against Stupak.

[KathrynKate78]

You're right. Which is why the outcry is worth discussing.

[who38]

Federal funding regulations re/ elective abortions is already in effect. It is not more needed in this lbill than is a section on repealing slavery. The reason why the section on abortion is an issue is because it limits the types of programs insurance companies can offer to women and it makes the law permanent. Both are good reasons to reject this portion of the health care reform bill.

[ssg13565]

It's cute the way they some people bring private school vouchers into the picture when they want to talk about the hypocrisy of pro-choice people.

The established policy of the country has been that women have the freedom to choose abortion, but no federal government funds will be used to provide it.

After grudgingly accepting that compromise for the time being, pro choice people are called hypocrites when they say you have the free choice to send your kids to private school but we don't want tax money to support it.

[TDawgSC]

In what year did abortion become a constitutional right, and what was the constitutional provision passed in that year making it so?

[deeppeace]

Roe v. Wade, 410 U.S. 113 (1973)

[BCALM]

ERROR,,,, Roe V Wade just made it legal

[TDawgSC]

Roe v. Wade was a constitutional amendment?

[ssg13565]

Was it about 1792 when the Constitution was adopted? I'd have to look it up. I'd say that was when abortion became a constitutional right.

Is that the right answer?

[KathrynKate78]

So you don't believe in any constitutional amendments? Think about this before you commit to it.

[KathrynKate78]

In what year did eating sandwiches become a right? The question is no different. Neither needs to have a constitutional provision passed for it to be permissible. Both are permissible because they are not illegal.

[goodog]

It's called precedent.

January 22, 1973

"right of privacy, whether it be founded in the Fourteenth Amendment's concept of personal liberty and restrictions upon state action, as we feel it is, or, as the District Court determined, in the Ninth Amendment's reservation of rights to the people, is broad enough to encompass a woman's decision whether or not to terminate her pregnancy."

It's called precedent.

The court found a "right of privacy" in the due process clause of the Constitution, just as the court had previously found support for various privacy rights in several provisions of the Bill of Rights and the Fourteenth Amendment as well as the penumbra of the Bill of Rights.

Just as many believe the government has no business standing uninvited between you and your doctor, the court found that the government has no business standing uninvited between a woman and her doctor.

[Norm]

I was once in a hospital bed beside an uninsured 15 year old girl who, after throwing herself down the stairs to induce an abortion and failing, had her boyfriend drive his car into her at 25 mph.

It worked.

This little girl was not a Republican or a Democrat, but she was some Republican or Democrat's child, and may in the future be the child of a rigid "my way or the highway" moralist who opted out. It is this desperation choice is intended to prevent. No compromise on choice. Ever.

[AnotherAngle]

How would insurance have helped her? At 15 years old, can you walk into an abortion clinic on your own? You certainly SHOULDN'T be able to.

I would hope my daughter would come to me, that's the way it's supposed to be. A parent's love is unconditional and it's shameful this young girl didn't realize this.

The ironic part of this story is, if YOU know the story, all 4 parents probably know now too, and the car insurance probably wouldn't pay for what happened either, so what is your point?

[Norm]

The girl's first abortion method was also her mother's, taught to her by her mother.

The point is that in all the yammer, cases like hers are the reality, the nuts and bolts of the issue. As horrifying as this child's choice was (and the choice of her mother was), it is what some future child's choice will be no matter what the parents stance on the issue
if the government places abortion restrictions on the use of health care dollars.

Too soon we forget.

[Norm]

If you judge and judge rigidly, your child will not come to you. Your chances of having a daughter like this girl rise exponentially with the severity of your judgment.

[who38]

"the way it's supposed to be" Like world peace. And, do you really believe that a paren'ts love is unconditional? What planet do you live on?

The ironic part of this story is that all four parents now know that their children did not trust them enough or were afraid of being punished if they went to the parents for help. And the very, very ironic part is that none of these four people should have been parents in the first place.

[BCALM]

BS ...a 15 year old didn't do this because she had no insurance......She did this because she was an immature 15yr old,,,,, What your saying is she went to an abortion clinic and they wouldn't do it and probably didn't council her ....

[Norm]

Of course she did this because whe was an immature 15 year old girl. She never went to an abortion clinic because there were none. Her family had insurance, but abortion was not covered. She never thought about insurance; she only thought about abortion.

BTW, her friends used the same method.

There were no options. This was 1968. It well could be 2018.

[Bernique]

In the 1970s (when the planet had a billion people fewer) the greatest worry was overpopulation. The Zero Population Growth movement was picking up steam. Then Reagan and his free marketers saw population growth as a big plus (more workers everywhere, especially in poor countries --where we now have OUR factories). The "abortion" taboo has been with us ever since, and not for the reasons that the Bible-Thumpers think!

[mratcheson]

Abortion was illegal in most of the country before 1973. You don't think the timing of the "abortion taboo" has something to do with that?

[viper234]

Shouldn't our legislators, legislate based on established law and not on "political expediency?" How on earth can they pass legislation that so blatantly flies in the face of established law? This language alone is a precedent, a very significant challenge to Roe v. Wade and will be used as a hammer in future arguments to overturn the law. Women in America need to recognize that the clock is turning backwards in time on legal rights concerning their private health decisions. No right-wing, self-proclaimed "pro-life" Republican, "anti-abortion," conservative Democrat, nor religious groups whose beliefs drive their positions on this issue have the right to overrule the rule of law. Doctors in confidential consultation with their physicians make decisions about what is in a woman's best interest. The government has no right to find ways to breach or limit a woman's access to such services if it is truly committed to providing health care to American women.

[Joel Redman]

Conservatives are always looking for an end run around the law. They also do it with their religion, cherry picking the parts of the bible that they want to believe and ignoring the rest.

[AnotherAngle]

You paint the world with such a broad brush.

I guess this saves you on paint.

[who38]

Remember Stupak is a Dem but you are correct, he did try an end run around the law. And this bill doesn't help much.

[MercyOtis]

Roe vs. Wade created law which the Supreme Court is not supposed to do. In addition, abortion specifications are outside of the scope of the enumerated powers of the federal government and therefore according to the 10th amendment ("The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people. ") should be reserved to the states and to the people. In other words, it shouldn't be a federal issue at all.

[viper234]

Whether or not Roe v. Wade created law is not the issue. Abortion is legal in the US. The challenge to that legality has been reaching fever pitch in recent years with states rights and federal encroachment under the Constitution frequently underscored in the debate. My point is that this legislation will be used as yet another assault weapon to erode the legality of abortion by myriad political and religious groups. Shredding of the Constitution aside, I don't see very many Americans referencing the Constitution when it comes to the Legislative Branch's responsibility to vote on a Declaration of War. Congress has ceded its power to the Executive Branch in matters of war which is one of the reasons we are bogged down in 2 wars today.

[taddles]

Oh noo, another tenther.

Roe did not create law, it enumerated a right and that's exactly what the SC is supposed to do.

[BCALM]

Once again , those who selectively are of Choice ( as you don't support choice of vouchers ) NO ONE is taking away your legal right to terminate your child... Abortion ( except in the exceedingly rare instances of rape , incest and health of the mother ) is being relegated to procedures such as tattos , boob jobs and body piercings ...... not tax payer funded

[Onion87]

You obviously missed the entire point of the argument about Stupak, which forces insurance companies to not allow insurance plans that cover abortion. Therefore, women who buy insurance plans with their own money may not buy a plan that covers abortion because it simply won't be offered. Let's be clear about the kind of abortions that women need insurance companies to cover. Most abortions only cost a few hundred dollars, and it's not unreasonable to ask that those be covered by individuals when they will likely only get one in their lifetime if they get one at all. Later term abortions, the ones that cost thousands of dollars and many require extensive care after they are performed are the ones really in question in terms of insurance coverage. Those are the ones performed only in very serious cases of health risk or the risk of death to the mother, and are expensive procedures with risks of complications.

[deeppeace]

I was with you until the 'exceedingly rare' part. Pregnancies resulting from rape and incest are, unfortunately, not rare. And I could write pages on 'the health of the mother.'

[who38]

Cases of rape would be much more rare if police departments used more funding to test rape kits. The number of untested kits in the US is shameful. Perhaps the money the government saves by not allowing abortions each year should be used to test these kits. It could be called a preventive health measure.

[karlo5]

Evangelical christian terrorists want to protect from sperm to birth.........then they don't give a rat's ass.