Stupid/Pitts: 5 Things To Consider In The Health Care Debate

Suffering from outrage overload over reproductive rights? Try not to lose sight of the major issues, including the availability of riders and second trimester costs and complications. After the jump, considerations to be made via today's healthcare reform headlines.

We have no idea if we can get riders, or what they will cost.

Abortion-rights activists say the option of buying additional coverage for abortion - a so-called rider - is a false promise. They cite the examples of Oklahoma and North Dakota, where riders have had negligible use even though allowed under state laws that otherwise ban insurance coverage of elective abortions.

"Abortion coverage should be part of the regular package," Crane said. "Women don't expect unplanned pregnancies and don't expect their wanted pregnancies to go wrong. ... They don't anticipate needing abortion coverage so they wouldn't buy a rider."

Kristin Binns of WellPoint, Inc., which oversees health plans serving 35 million Americans, said it's impossible for the insurance industry at this stage to estimate how much such riders would cost and the extent to which they might be offered.

"We don't have a clue," she said.


The Republicans' crap-ass plan still covers abortion...by accident.

The Republican National Committee's health insurance plan covers elective abortion – a procedure the party's own platform calls "a fundamental assault on innocent human life."

Federal Election Commission Records show the RNC purchases its insurance from Cigna. Two sales agents for the company said that the RNC's policy covers elective abortion.

Informed of the coverage, RNC spokeswoman Gail Gitcho told POLITICO that the policy pre-dates the tenure of current RNC Chairman Michael Steele.

"The current policy has been in effect since 1991, and we are taking steps to address the issue," Gitcho said.

While many women do opt to pay cash for their abortions, that is not the end of the story.

Stupak says one reason his amendment's impact would be limited is because only a small fraction of abortions - 13 percent by Guttmacher Institute estimates - are paid for directly by private insurance. The vast majority are paid for in cash, even by women with abortion coverage who do so out of privacy concerns.

However, Dr. Willie Parker, an abortion provider in Washington, D.C., noted that insurance coverage could be vital for women with health problems who need hospital abortions costing many thousands of dollars, compared to roughly $400 to $800 for a first-trimester abortion in a clinic.

"The cash option was a challenge for many women even in more reasonable economic times," Parker said. "I see that becoming worse as people have to make hard decisions because abortion is not considered part of health care."

There are issues trying to play to both sides.

Other lawmakers said, in effect, that they voted for the Stupak amendment but didn't really mean it, because they expected the amendment to be stripped out later, either in the Senate or in a conference committee.

As a result, Democratic leaders are in some danger of having the worst of both worlds: letting a compromise pass, thereby angering their liberal wing, while appearing cynical in suggesting that they now intend to drive it out of the bill, thereby angering the party's moderates and the bishops. That's a problem with consequences: The simple math in the House suggests the health bill wouldn't have passed without the votes of the moderates who came to the "yes" side after the Stupak amendment.



If we become apathetic about our right to choose, we will lose that right.

The pro-choice, pro-health reform advocates I spoke with this week remained confident that they would be able to nudge Congress to soften the Stupak-Pitts restraints in a final health care reform compromise. They took heart from the fact that a vigorous public insurance option - an idea pronounced a dead letter not so many months ago - did at last make it into the House's legislation. But there's one key difference: the American public widely supported the public option, polls showed this fall. The support for abortion rights now isn't so solid.

A Pew Research Center survey released last month showed Americans' support for abortion rights is at a striking low - down to 47 percent - after hovering consistently just above 50 percent since at least the mid-1990s. And despite the passionate outrage expressed by high-profile abortion rights supporters this week, most of the pro-choice public just doesn't appear to be all that fired up about fighting for the freedom to choose anymore. According to the Pew poll, only 15 percent of people overall say abortion is a "critical" issue today, and even among those described as liberal Democrats, that proportion has dropped 26 points, from 34 percent to 8 percent, since 2006.

Stupak-Pitts passed not just because a group of Catholic bishops bore down on Democratic lawmakers. It passed because it could.

Tough choices for women on abortion coverage [MSNBC]
RNC insurance plan covers abortion [Politico]
Abortion Upends Health-Bill Alliance [WSJ]
‘Mad Men,' Maddening Times [NY Times]