03/18/2010 05:12 am ET | Updated May 25, 2011

The Assault on Choice

There is much to praise in the ground breaking health care reform bill that just passed the House. It will provide an additional 36 million more Americans with affordable health insurance, meaning that 96% of all Americans will be insured. There will be no more denials of coverage due to "pre-existing conditions." And there will be a public option to create choice and competition.

Yet the historic passage of a health care bill came with an inescapably cruel irony. There is an amendment in the bill that threatens the health of millions of American women. By dramatically restricting women's reproductive rights, the Stupak Amendment is a terrible step backwards and a serious threat to women's health. Fortunately, we have the President on our side. "This is a health care bill, not an abortion bill," Obama declared. And fortunately, there is still time to fix it to make it abortion neutral.

The Stupak Amendment effectively bans coverage for nearly all abortions from all public and private health plans in the health insurance marketplace known as the Exchange. This restriction goes far beyond the perennial Hyde amendment ban on federal funding for abortions. It would go farther than any current federal law to restrict women's access to abortion.

If you are one of the millions of women who will be using your own funds to purchase a private health insurance policy through the Exchange, the Stupak Amendment means you almost certainly won't have access to a policy offering coverage for abortion. Why? Because others purchasing health insurance on the Exchange are likely to be using federal subsidies offered to make health insurance premiums affordable - and the Stupak Amendment stipulates that any plan that accepts even $1 of federal subsidies cannot offer abortion coverage. Since every plan offered to you in the Exchange will have other policy-holders who are receiving federal subsidies, no plan can contain abortion coverage. This will effectively eliminate access to reproductive choice for low- and moderate-income women who cannot afford health care that is not covered by their insurance policies.

The Stupak Amendment does permit the coverage of abortion in the event of rape, incest, or where the woman is "in danger of death" unless an abortion is performed. It makes absolutely no provision whatsoever for consideration of the health of the woman, physical or psychological. Imagine a low-income woman who suffers from chronic kidney disease and unintentionally becomes pregnant. The maternal risks of such a pregnancy include new or worsening hypertension, diabetes, infection, preeclampsia, and a decline in kidney function. With extensive and invasive treatment - including more than 20 hours a week of dialysis - chronic kidney disease patients can carry a pregnancy to term, but not without serious health risks to the mother and the fetus. Because of the Stupak Amendment, that woman would not have any insurance coverage if she wished to terminate a potentially debilitating pregnancy.

The Stupak Amendment is an attempt to radically roll back reproductive rights. If you have any doubts about the larger implications, just listen to the cheers coming from the opponents of a woman's right to choose. "This historic vote in the United States House of Representatives signals the beginning of the end for 'Roe v. Wade,'" crows one. "Pounds a Nail in the Eventual Coffin of 'Roe v. Wade,'" celebrates another.

While the bill has passed in the House, there will be many changes before a health insurance reform bill reaches the President's desk. The President has made clear that "there needs to be some more work before we get to the point where we're not changing the status quo" on abortion rights. But it will take the full support of the millions of Americans who believe we cannot afford a march back toward the dark ages of back-alley abortions.