From the Third Way, a group that "develops and advances the next generation of moderate policy ideas":
The Stupak-Pitts Amendment, which was included in the final version of the House bill, is not abortion neutral, and it would disrupt the delicate federal balance already in place. We believe that by upsetting this balance, health care reform is now in jeopardy. Below, we explain the three ways in which the Stupak-Pitts Amendment is not abortion neutral and why the pro-life Ellsworth Amendment represents a far better approach that adheres to common ground.
The Stupak-Pitts Amendment Violates Abortion Neutrality in Three Ways
1. The Stupak-Pitts Amendment changes a decades-long balance of existing federal law on abortion coverage.
The Hyde Amendment, which has been on the books for over 30 years, prevents federal funds from being used to pay for abortion in the Medicaid program, except for cases of life endangerment, rape or incest. The Stupak-Pitts Amendment goes much further, by preventing even private premiums from being used to pay for abortion in the Exchange. The Stupak-Pitts Amendment prohibits health insurance plans in the Exchange that receive any federal funding from covering abortion, even with segregated private funds. Because all Exchange plans will likely receive federal tax dollars through subsidies to individuals, individuals will not be able to purchase health insurance that covers abortion, even with their own premiums. The fact that the millions of Americans participating in the Exchange will not have abortion coverage is also a dramatic change from the status quo, since the majority of Americans with health insurance have plans that include abortion coverage.
The logic of the Stupak-Pitts Amendment also rejects the current noncontroversial scheme whereby year after year, hundreds of billions of dollars are consistently used to subsidize health insurance policies that cover abortion. Until the Stupak-Pitts Amendment emerged, none of this funding was deemed controversial in any way by pro-life stalwarts from President Ronald Reagan to President George W. Bush.
The employer deductibility of health coverage has yielded trillions of dollars in federal tax subsidies for insurance plans, whether or not they covered abortion. Flexible Savings Accounts (which started in 1978 and grew in popularity under President Reagan) allow for individuals to deduct the direct cost of abortions from their taxable income. Health Savings Accounts (which started under President Bush) allow for tax-favored savings to be used to pay for abortions.
Each of these tax subsidies has, at one time or another, received the support of nearly all members of Congress—whether ardently and unequivocally pro-life or pro-choice. Yet as far as we can tell there has never even been a debate about whether these subsidies could cover plans that offer abortion coverage, even though most do.
2. The Stupak-Pitts Amendment changes longstanding policies regarding the segregation of funds.
Supporters of the Stupak-Pitts Amendment dismiss efforts at finding a compromise on abortion in health care reform through the segregation of funds as an “accounting trick.” Whether or not one believes this argument, supporters of the Stupak-Pitts Amendment must now reconcile this view with longstanding policies that allow the segregation of funds in order to let religious organizations accept federal money.
The reasoning of the Stupak-Pitts Amendment would call into question countless activities by religious organizations that rely on federal funds, including Head Start, homelessness relief, food banks, substance abuse counseling, prison fellowship, afterschool programs for troubled youths, adoption services, ESL programs for immigrants, and veterans’ services.2 Of course, in the context of abortion, the segregation of funds is also accepted in Medicaid, where 17 states supplement the federal program with abortion coverage.
3. The Stupak-Pitts Amendment means no plans in the Exchange would offer abortion coverage.
Even though there is a provision in the Stupak-Pitts Amendment that would allow the purchase of separate supplemental coverage of abortion, it is implausible that insurance companies would offer this coverage. Unintended pregnancies are unplanned by definition, so demand would likely be low. And unlike other medical
procedures, abortions are relatively inexpensive. That is why in the five states where abortion coverage is prohibited except through such “riders,” there are only isolated examples of insurers actually offering such coverage, , and even then only as part of a small group package, rather than to individuals.
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