Health Bill is Not "Good Enough"

The following is a ChoiceUSA cross-post.
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Last night, pro-health care reform Senators obtained a 60-40 majority to pass the overhaul bill. The struggle to find a 60th vote ended, however, with a very troubling "compromise:" the reintroduction of anti-abortion language into the bill.

Two weeks ago, we celebrated the failure of the Nelson Amendment, an amendment that would restrict private insurance companies from providing abortion (and some contraceptive) coverage in the event they become federally-subsidized. Senator Nelson, however, continued to withhold his support for a health bill without his amendment, and the Senate capitulated last night in order to garner his support.

Senator Nelson's conditions are not moderate; he did not wish to "compromise" with his colleagues, but instead hold out until his previous conditions were met. And met they were. Throughout the health debate, it was women, not men, whose health care hung in the balance. We knew this by the staunch support for health care overhaul amongst the American people, the urgency in the language, and the cries of "Oh come on!" from even our own pro-choice comrades. I argued against choruses of, "So abortion coverage is restricted... people need basic health insurance now!" "You're just stuck on abortion; think of all the Americans who could benefit from this bill, whether or not their elective procedures are covered!" "Cancer treatment is more important than abortion care." "Why don't you guys just wait and see. We'll get health care reform now, and focus on abortion later!"

The dichotomous way in which our pro-health reform comrades spoke of abortion is perhaps most troubling. People need health care; women can get abortions later. In other words, women are not people, abortion is not health care. Or, at least, women's health care is not as important as "normal" health care, and abortion is certainly not a "normal" (or even important) aspect of health care.

And in the end, it was those dichotomous thought processes that left us in the dust. The Nelson "compromise," in the end, will harm many aspects of reproductive health care. RH Reality Check editor Jodi Jacobson outlined the implications of the Nelson language in an entry earlier today:

Pro-choice advocates are still examining the implications of the Nelson language. But conversations with several analysts over the past 24 hours suggest that if passed into law in the final health care bill, this language, at a minimum, does the following:

• Requires every enrollee--female or male--in a health plan that offers abortion coverage to write two separate checks for insurance coverage. One of these checks would go to pay the bulk of their premium, the other would go to pay the share of that premium that would ostensibly cover abortion care. Such a check would have to be written separately whether the share of the premium allocated for abortion care is .25 cents, $1.00, or $3.00 of the total premium on a monthly, semi-annual or annual basis. Employers that deduct employee contributions to health care plans from paychecks will also have to do two separate payments to the same company, again no matter how small the payment.

• Eliminates the provision in earlier versions of the Senate bill and in the original Capps language in the House bill to ensure that there is at least one insurance plan in each exchange that offers and one that does not offer abortion coverage.

• Prohibits insurance companies by law from taking into account cost savings when estimating the costs of abortion care and therefore the costs of premiums for abortion care.

• Includes "conscience clause" language that protects only individuals or entities that refuse to provide, pay for, provide coverage for, or refer for abortion, removing earlier language that provided balanced non-discrimination language for those who provide a full range of choices to women in need.

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Make no mistakes, it is not just abortion that is being restricted. With the growing number of "Personhood Amendments" being considered in state legislatures, and the fact that 17 states already prohibit insurance companies from providing abortion coverage, many states could additionally see their coverage for contraception and birthing options dwindle. This, with absolutely no restriction on men's reproductive health, and a "conscience clause" that only applies to the opposition, with no comparable protection for women with limited options.

As an American who just recently went from uninsured to under-insured, I do understand the urgency to reform our health care system. I've heard tales of hardship from folks battling serious disease, families that have lost their homes in order to pay for a child's cancer treatment. But I cannot stand idly by while the urgency of some outweigh the urgency of others, especially if it is women and only women who are forced to sacrifice health benefits so that others may receive affordable care. It comes down to this: we can have comprehensive health care, and yet we are allowing the opposition of a handful of anti-choice Senators cut us down. They are the ones forcing us to ration health care, to choose between exclusionary reform or none at all. The bill in its current form is not "good enough," nor does begin to scratch the surface of what is truly needed: comprehensive health care for all.

Letter to my Senators

Dear Senators Bunning and McConnell,

I do not believe we have met. By which I mean, how dare you assume your position as my Senator entitles you to make my health care decisions for me. Earlier this week, you both stood in staunch support for the Nelson-Hatch amendment, an amendment that would keep struggling women like me from making decisions about my health care.

Let me elaborate: my husband, our family's breadwinner, works full time for a company that helps provide my family with decent health insurance. Unlike many Americans, I have few complaints about the insurance I carry. My children have top-notch pediatric care, emergency coverage, and dental. My husband and I both have preventative care, low emergency deductibles, and affordable copays. We paid very little out of pocket for the birth of our children, which is wonderful considering my last birth ended in a complicated c-section. This is not to say the insurance provider is not facing its own financial obstacles, which is why the Stupak-Pitts amendment in the House and its Senate counterpart troubled me. In the event the insurance company decided to become federally subsidized, my personal health benefits, from a private insurer, would be limited. And why? Because I am a woman. Because my health care is not my own business. Because legislators like the two of you believe the government should have the power to regulate the kind of health care I can access for myself. And all this from two Senators who routinely run attack ads condemning government intervention in private lives!!

Senators, I am no lawyer. I am a part-time pre-school teaching assistant with children of my own and a mortgage the size of Texas. I cannot fully grasp the interworkings of our government, much less the novel-sized health care bill now in consideration. My understanding of legal text is limited, but I have friends who work in health legislation and law. These friends have made it abundently clear to me that the Nelson-Hatch amendment, which you both supported, would not only limit abortion coverage in my health plan in the event my insurer became federally-subsidized: the language is such that my ability to make decisions regarding contraception or even pregnancy and birth would be severely limited, all because my insurance company decided, without my family's consent, to receive federal subsidy. Why the massive assault on women's health? Abortion is legal in this country, so why do you continue to strike down efforts to provide women with better access to choice?

Senators, I am not only writing for myself. I am writing for my daughter who will grow up in a world where her body is the basis for political attack, where my son's future family will be forced to make reproductive decisions based not on their personal preference, but on the way financial restriction dictates them to live.

Sincerely,

Rosa
Shepherdsville, KY

Statements from women's and repro-rights groups on Nelson-Hatch failure

I cannot yet find statements from SisterSong, ChoiceUSA, YWCA, or Fem Majority. But here are some of the statements released from women's and repro- rights groups regarding the failure of the Nelson-Hatch amendment last night. CPC Watch's quick and dirty statement can be found here.

From NARAL Pro-Choice America:

Senate Rejects Divisive Attack on Abortion Rights
NARAL Pro-Choice America credits activists, mobilization efforts for defeating abortion-coverage ban in Senate bill

Washington, D.C. – Nancy Keenan, president of NARAL Pro-Choice America, commended the Senate for standing up to anti-choice pressure groups and rejecting an amendment aimed at derailing the health-reform process.

Keenan also called the Senate's action a victory for pro-choice activists. Hundreds of thousands of Americans flooded Senate offices with calls, email messages, and petition signatures calling on senators to reject efforts to add an amendment similar to the House-passed Stupak-Pitts amendment.

The Senate voted by a 54-45 margin to table the amendment offered by anti-choice Sens. Ben Nelson (D-Neb.) and Orrin Hatch (R-UT), essentially defeating the amendment.

"My heartfelt appreciation goes to all the pro-choice Americans who joined us in calling on the Senate to reject anti-choice attacks in health reform," Keenan said. "We salute our pro-choice allies who worked so hard to stop this attack that could have caused women to lose coverage in the new health-care system. The bill already includes a ban on federal funding for abortion and a requirement that only women's personal funds may be used for abortion care. That's deeply disappointing to us, but the Nelson-Hatch proposal, like the Stupak-Pitts amendment in the House, would have gone much further, making it virtually impossible for private insurance plans that participate in the new system to offer abortion coverage to women.

"We had an important win today, but the fight is far from over. We will mobilize our activists and work with our allies in Congress to stop additional attacks in the Senate and work to ensure that the final health bill does not include the dangerous and divisive Stupak-Pitts language that's currently in the House bill."

Last week, NARAL Pro-Choice America unveiled a TV ad that's running in key markets in four states. The ad followed a December 2 event on Capitol Hill where the organization and many of its state affiliates participated in a grassroots lobby day that called on the Senate to say "no" to the Stupak language. Prior to that, on November 23, the organization delivered a petition with 97,128 signatures to Senate Majority Leader Harry Reid, calling on the Senate to keep the Stupak-Pitts language out of its bill. More than 229,000 NARAL Pro-Choice America and state affiliate activists called, wrote to, and visited their lawmakers during the summer months, and the media have reported on NARAL Pro-Choice America's other mobilization efforts, including automated calls and volunteer-led phone banks in 20 states.

Like the House-passed Stupak-Pitts amendment, the Nelson-Hatch amendment would make it virtually impossible for private insurance companies that participate in the new system to offer abortion coverage. This would have the effect of denying women the right to use their own personal funds to purchase an insurance plan with abortion coverage in the new health system—a radical departure from the status quo. Presently, more than 85 percent of private-insurance plans cover abortion services.

The amendment also includes other egregious provisions that undermine a women's right to choose:

• Like the Stupak-Pitts amendment, the Nelson-Hatch proposal also forbids any plan offering abortion coverage in the new system from accepting even one subsidized customer. Since more than 75 percent of the participants in the exchange will be subsidized, it seems certain that all health plans will seek and accept these individuals. In other words, the Nelson-Hatch amendment would force plans in the exchange to make a difficult choice: either offer their product to 75 percent of consumers in the marketplace or offer abortion services in their benefits package. It seems clear which choice they would make.
• Stupak-Pitts and Nelson-Hatch supporters claim that women who require subsidies to help pay for their insurance plan would have abortion access through the option of purchasing a "rider," but this is a false promise. According to the respected National Women's Law Center, in the five states that require a separate rider for abortion coverage, there is no evidence that plans offer these riders. In fact, in North Dakota, which has this policy, the private plan that holds the state's overwhelming share of the health-insurance market (91 percent) does not offer such a rider. Furthermore, the state insurance department has no record of abortion riders from any of the five leading individual insurance plans from at least the past decade. Nothing in this amendment would ensure that rider policies are available or affordable to the more than 75 percent of individuals who will receive federal subsidies in order to help purchase coverage in the new exchange.

From the National Organization for Women:

NOW Applauds Senate Defeat of Abortion Ban Amendment,
Urges Removal of Stupak-Pitts in Conference

Statement of Terry O'Neill, NOW President

December 8, 2009

The National Organization for Women applauds the Senate for voting to table and effectively defeat the Nelson-Hatch Amendment to the health care reform bill. This victory is just one small step, however, toward enacting health care reform that recognizes health care as a human right, abortion as health care and women as deserving of coverage that meets all of their medical needs.

The Nelson-Hatch Amendment would have instituted a ban on abortion care coverage in the proposed health insurance exchanges, which are expected to serve tens of millions of people. It would have far extended the Hyde Amendment's already shameful restrictions on abortion funding. It would have betrayed the promise that no one would lose health care coverage they currently have due to reform. And, in all likelihood, this prohibition on abortion coverage would have spread industry-wide in little time.

That's why NOW is thanking all of our activists for the many messages they sent and calls they made to their senators. Our early and strong call to reject any health care legislation containing Stupak-Pitts language made its mark. Our virtual and physical presence on Capitol Hill helped send the message that health care reform should not be negotiated on the backs of women. We thank the 54 senators who listened to our concerns and considered women's health and well-being as they voted.

The bad news is that the similar Stupak-Pitts Amendment, which the House did pass last month, is still in place. When the two versions of the bill are reconciled and merged into one, abortion opponents will no doubt demand that the Stupak language be maintained in order to win their votes on the bill. We cannot let this happen.

Make no mistake, the efforts of the radical right are to outlaw all abortion. They will use whatever method is convenient, and right now that happens to be health care reform. They want women's rights supporters to compromise, but they won't budge an inch. Well, in case they haven't noticed, we're done compromising. NOW urges legislators to oppose the entire bill unless the Stupak-Pitts provisions are removed in conference. Women's lives are at risk, and our rights are not for sale.

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For Immediate Release
Contact: Mai Shiozaki, 202-628-8669, ext. 116; cell 202-641-1906


From the National Abortion Federation:

Dear supporter,

Thank you for taking action during the past several weeks by writing letters to the editor and urging your Senators to vote against the Nelson-Hatch Amendment. We defeated this restrictive amendment in the Senate today.

Last week, NAF brought a group of patients to Capitol Hill to share their abortion experiences with legislators. Each of these women had a different experience with insurance coverage for their abortion care, and they represent the women who could be affected by restrictions like the Stupak-Pitts and Nelson-Hatch amendments.

Today, Senator Diane Feinstein (D-CA) cited some of our patient's stories during debate on the Senate floor. NAF member and author, Professor Carole Joffe joined us last week in DC and spoke with some of the patients we brought forward. This week, she blogged about her experience:

"The day was full of fiery speeches by legislators and advocates...however, the most moving and significant part of the day was my conversation with three women who had later abortions. They were introduced to me by staff from the National Abortion Federation. All three women--Dana, Christie, and Mary--had experienced much wanted pregnancies that took nightmarish turns. Read more

Even though we were victorious in the Senate today, the fight is not over; we must continue to work to stop additional attacks in the Senate and ensure that the final health reform bill does not include the Stupak-Pitts language that’s currently in the House bill. Support NAF's work to bring the voices of patients forward to ensure health care reform does not further restrict women's access to abortion care.

From the Planned Parenthood Action Fund:

Great news — minutes ago, the Senate voted on the anti-choice Nelson/Hatch amendment to health care reform, and we won! Unlike the Stupak amendment that passed the House of Representatives, this amendment did not pass the Senate!

This is a huge victory — and your e-mails and phone calls helped make it happen. Thank you. While we still have a long way toward health care reform that ensures quality, affordable health care — including reproductive health care — for all, defeating the Nelson/Hatch amendment today was a big step forward.

As you likely know, Democratic Senator Ben Nelson and Republican Senator Orrin Hatch were behind the anti-choice amendment, and the language was virtually identical to the Stupak amendment. As we saw during the vote in the House of Representatives, anti-choice groups were lobbying hard to pass it. But, the Senate agreed with us this time: eliminating choice for millions of women with private health insurance is a price we can't afford to pay for passing health reform.

We still have a long way to go. I'm certain that there will be significant hurdles ahead, and I'm glad to know, as always, that we can count on your help. Just for today, though, please know that we did something great together. Thank you.
Sincerely,

Cecile Richards, President
Planned Parenthood Action Fund


From the Religious Coalition for Reproductive Choice:

Breaking News!
An Important Victory

The Senate voted on Dec. 8 to table - and therefore defeat - the onerous Nelson-Hatch Amendment to the health care reform bill. This amendment, which mirrored the Stupak-Pitts language approved by the House of Representatives, would have expanded abortion restrictions and trampled on the rights of those who believe that abortion is a moral option.

The work of religious advocates was key to this success. We will keep working with our congressional allies and sister organizations to ensure that health care reform is finally approved and that it protects against further assaults on women's reproductive rights.

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Feel free to link to other statements below. I'm feeling unified and fired up!

Quick statement on the failure of the Nelson-Hatch amendment

The Senate voted today to reject the anti-choice Nelson-Hatch amendment, a clear attempt to limit access to comprehensive reproductive health care.

The Nelson-Hatch amendment was the Senate's version of the Stupak-Pitts amendment, passed in the House of Representitives earlier this month.

CPC Watch applauds the work of the groups and individuals who came out last week to lobby, really, demonstrate, and otherwise work to protect women's health. Also, a heartfelt thanks to those Senators who voted to table the amendment.

We've protected the little ground we already had, now let's reclaim what we've lost! They're our organs, after all.

-The Organizers