Health Care Reform, Abortion and the Truth

If you were thinking that either side of the abortion debate had forgotten about the health care reform bill, forget it. Anti-abortion (pro-life) groups are claiming the bill absolutely requires the government to pay for abortions. Pro-abortion (pro-choice) groups say that it absolutely does not. That leaves quite a wide gap where the truth can be hiding.

An Abortion-Neutral Bill?
You will not currently find the words "abortion," or "reproductive" printed on any of the bill's 1,017 pages. In fact, the current version of the America's Affordable Health Choices Act of 2009 (H.R. 3200), succeeds in remaining "abortion-neutral," just the way some members of Congress intended.

While the bill does not specifically say the government will pay for abortions, it also does not say it won't. That's exactly what bothers abortion opponents, who want the bill to clearly exclude abortion from coverage under the government-provided public health insurance option.

What Medical Services Would Be Paid For?
Another fact is that the bill as approved by the House Committee on Energy and Commerce, but not yet debated by the full House, spells out what essential medical services would be paid for under the public insurance option (H.R. 3200, Title 1, Subtitle C, Section 122-b):

• Hospitalization.
• Outpatient hospital and outpatient clinic services, including emergency department services.
• Professional services of physicians and other health professionals.
• Such services, equipment, and supplies incident to the services of a physician's or a health professional's delivery of care in institutional settings, physician offices, patients' homes or place of residence, or other settings, as appropriate.
• Prescription drugs.
• Rehabilitative and habilitative services.
• Mental health and substance use disorder services.
• Preventive services, including those services recommended with a grade of A or B by the Task Force on Clinical Preventive Services and those vaccines recommended for use by the Director of the Centers for Disease Control and Prevention.
• Maternity care.
• Well baby and well child care and oral health, vision, and hearing services, equipment, and supplies at least for children under 21 years of age.

Could terms like "Professional services of physicians and other health professionals," be interpreted as applying to a range of professional medical services including abortions? Abortion opponents fear it could.

Abortion and Medicare -- Current Law
As presently drafted, the health care reform bill is no more or less restrictive toward the use of federal funds to pay for abortions than current law. The 1976 Hyde Amendment barred the use of federal funds for abortions in the Medicaid program, with exceptions allowed in cases of rape, incest and danger to the mother's life. The Medicaid program, however, allows the states the option of using their own funds to pay for abortions, thus leaving state legislatures to deal with the pro-life vs. pro-choice debate.

What President Obama Has said and Done
In an online conference call of August 26, President Obama addressed the issue of abortion in the health care reform bill. "You've heard this is all going to mean government funding of abortion," President Obama said. "Not true."

On the other hand, as a presidential candidate, Obama consistently presented a pro-choice platform. "Barack Obama understands that abortion is a divisive issue, and respects those who disagree with him," states Obama's 2008 campaign web site. "However, he has been a consistent champion of reproductive choice and will make preserving women's rights under Roe v. Wade a priority as President."

Shortly after taking office, President Obama rescinded the "Mexico City Policy" that had prohibited the U.S. Agency for International Development (USAID) from contributing money to international family planning agencies that offered abortions or abortion counseling.

What Does the Future Hold?
Will the health care reform bill be amended to directly address reproductive rights? Will it specifically include or exclude federal payments for abortions? Remember that actual congressional consideration of the health care reform bill will not even begin until later this fall. In addition, a Senate version of the bill has yet to be introduced, and before any bill is finally voted on, many amendments and compromises will be proposed. In short, the future of abortion coverage in the health care reform bill remains clouded by politics.

• For an objective, non-politicized summary of the health care reform bill as currently proposed, it's hard to beat the article Key Provisions of the House Healthcare Bill, by About Guide Deborah White.