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Opinion Column

Is the Price of Bipartisanship Eliminating Insurance Coverage for Abortion?

Earlier this week, Senate Majority Leader Harry Reid, D-Nev., ordered Senate Finance Committee Chairman Max Baucus, D-Mont., to stop chasing Republican votes for the Committee’s health care bill. Reid’s leadership style doesn’t lend itself to direct confrontations and the Committee’s reluctance to include a robust public health insurance option, its lackluster affordability measures, dubious financing mechanisms and insistence on delivering a bill under $1 trillion, may have forced Reid’s hand.

The truth is, despite attempts to “chase” down conservative votes, opponents of reform will continue to argue that greater government involvement in health care will lead to rationing of care and denial of coverage. Just listen to Finance Committee member Orrin Hatch, R-Utah, who says that a government-run health care system would place a bureaucrat between “you and your doctor,” a claim he repeated at least four times during a recent interview on Fox News.

Hatch isn’t just stubborn, he’s hypocritical. While he is afraid of bureaucrats inserting themselves into the process, he appears to be an advocate of lawmakers getting in the way. According to some reports, Republicans on the Finance Committee are pushing for language in the reform legislation that would require insurers operating within a new health insurance exchange to deny coverage for abortion services. Nineteen House Democrats have also sent a letter to House Speaker Nancy Pelosi, D-Calif., stating that they will not vote for health care reform legislation “unless it explicitly excludes abortion funding from the scope of any government-defined or subsidized health insurance planFurthermore, we want to ensure that the Health Benefits Advisory Committee cannot recommend abortion services be included under covered benefits or as part of a benefits package,” the members wrote.

The available language from the Health, Education, Labor and Pensions (HELP) Senate Committee and the House’s Tri Committee bill leaves the coverage decisions-the design of the so-called “essential benefit packages”-to the Secretary of Health and Human Services or a committee of experts. The chairman’s mark of the HELP bill states that “the Secretary shall ensure that the scope of the essential health benefits under paragraph (1)(A) is equal to the scope of benefits provided under a typical employer plan, as determined by the Secretary.” The Tri Committee legislation establishes a “private-public advisory committee which shall be a panel of medical and experts to be known as the Health Benefits Advisory Committee to recommend covered benefits and an essential benefits package.”

Should Republicans be successful, the Senate Finance version would be the only bill that specifically prohibits-takes away or “rations” in Republican parlance-a medical service. Approximately one in three American women will have an abortion by age 45 and private insurers typically cover the procedure. In 2002, The Guttmacher Institute found that 86.9 percent of “typical” employment-based health plans “routinely cover” surgical abortion and 86.5 percent “routinely cover” medical abortion. The language under consideration would take away this benefit from women receiving insurance through the Exchange, eliminating a service millions of American women currently have coverage for.

If denying important health services to women is the price of bipartisanship, then perhaps winning those one or two Republican votes in the Senate or holding on to some socially conservative Democrats isn’t worth the price of jeopardizing women’s health and well-being. Throughout the legislative process, Democrats should establish certain principles for reform – affordability, access, adequacy of coverage – and find ways to pay for them. Setting a price tag before developing an explicit goal in terms of adequacy coverage, may carry the lure of ‘bipartisanship,’ but it will only amount to incremental reform.

Igor Volsky is a healthcare researcher at the Center for American Progress and the co-author of the forthcoming book, Howard Dean’s Prescription For Real Health Care Reform. He blogs daily about health care reform at the Wonk Room (

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