Will Health Reform Mean Easier Access to Abortion?

In his recent Time piece on abortion and health reform, Mike Scherer confuses the issue. As he writes, under the current House compromise, both private and public health plans operating in the exchanges would not be able to use government subsidies or taxes to provide abortion -- abortions would have to be paid for from the pool of self-paid consumer premiums.

But there is little evidence health reform would dramatically increase access to abortion in the United States, or represent a major victory for pro-choice groups. Even if the public plan does end up including abortion coverage in its minimum benefit package -- if the public plan exists at all! -- it would cover only a small number of American women, since it would be closed to anyone with an employer-provided option. Meanwhile, the majority of private insurers already offer at least some abortion coverage in their plans, but usually only in cases of rape, incest, genetic abnormalities, or risks to the pregnant woman's health.

The basic fact is that under both our current health care system or under reform, people will -- and do! -- subsidize other people's abortions, through health insurance premiums. The difference between a private company collecting this premium or the government collecting this premium (as in the case of a public plan) is academic -- consumers have never had any power over what their insurance premiums fund. Lastly, it's important to remember that 76 percent of abortions are paid for out-of-pocket. Health reform would probably bring this number down very little or not at all, since the vast majority of people will remain yoked to employer-provided insurance plans that offer only very limited abortion services, or none at all.

Still, this isn't enough for anti-choice legislators such as Rep. Bart Stupak (D-Mich.), who is offering up an amendment that would essentially ban all non-crisis abortion coverage, even in private insurance plans. This is an attempt to use health reform as an excuse to push a broader agenda against reproductive rights. It is not an attempt to "maintain the status quo." Under the status quo, insurers choose whether to cover abortion, and they decline to cover most abortions. The existing health reform bills would not change that.

--Dana Goldstein

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