The House just released the new draft of its health reform bill. Ezra Klein and Jonathan Cohn have full wrap-ups. Here are my bullet points on what this particular proposal means for reproductive health:
- An expert medical commission led by the surgeon general will decide what services must be covered by the public plan and all private plans operating within the new Health Insurance Exchanges. This is a victory for reproductive rights organizations, which were worried that if such decisions were left up to the Health and Human Services secretary, access to contraceptives and abortion would be limited under future anti-choice administrations.
- The bill mentions "family planning" coverage both in the context of Medicaid and the public plan, but uses a definition of "family planning" that excludes abortion. So it refers explicitly to contraceptive coverage, but not to abortion coverage.
- Yet according to Democrats' summary of the bill, the public plan will "meet the same benefit requirements and comply with the same insurance market reforms as private plans." This could be interpreted as friendly to contraception and even abortion coverage within the public plan, since 90 percent of all current private health plans cover abortion at least in some cases, and 89 percent cover contraception.
- Medicaid currently covers only very poor women and their kids. Under this plan, all individuals and families within 133 percent of poverty are eligible for the program, a huge expansion. But as expected, nothing in the bill appears to threaten the Hyde Amendment, which currently bans Medicaid from paying for abortions. So we could be looking at a public plan that has generous reproductive health coverage, alongside a Medicaid plan for the poorest Americans that continues to severely limit states when it comes to abortion and contraception benefits.
All that said, this is very much still a work in progress, and the Senate bill -- with which this one must be reconciled -- is likely to be less progressive. For a complete look at the landscape for reproductive freedom during the health reform debate, check out my recent piece. --Dana Goldstein
