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Fact check on abortion funding in the Senate Health Care Reform Bill

March 4, 2010, 12:20 pm | Posted by Dan Nejfelt

Facts are important in the debate over coverage in the health care reform bill. Last night on Hardball, Rep. Bart Stupak (D-MI) said (video here):

STUPAK: The Speaker is incorrect. In the Senate bill — in the Senate bill, and that’s what they’re telling us the vehicle we’re using. In the Senate bill, it says you must offer insurance policies that will be paid for by the federal government that covers abortion. You must do so.

In fact, the Senate bill prohibits the Secretary of HHS from requiring the coverage of any abortion services as part of the essential health benefits for any qualified health plan offered in a state insurance Exchange. It furthermore allows each insurance company to decide whether or not to include coverage of abortion services, including the Hyde abortion exceptions (cases of rape, incest and the life of the mother), in a qualified plan offered in an Exchange[1].

Rep. Stupak continued:

STUPAK: Also in that same language, if you come in the Senate version, in the OPM, Office of Personnel Management, policies they’ll be putting forth, you must pay — every enrollee must pay one dollar per month into a fund to help fund abortions. It’s very clear. I direct the Speaker’s attention to pages 33 to page 44 of the Senate bill as written in the Senate and passed on Christmas Eve.

In fact, the Senate bill requires insurance companies to include in their benefit descriptions whether or not they cover abortion[2] and requires only those insurance companies that choose to offer a plan with general abortion coverage to collect a separate second premium payment from each enrollee for the cost of the abortion coverage[3]. This provision was added at the behest of Sen. Ben Nelson (D-NE), who is pro-life, to ensure that no taxpayer money would be spent on abortion (see Sen. Nelson’s floor speech on the abortion language in the bill).

Further, the Senate Bill requires the insurance company to deposit all separate payments into a separate account that consists solely of abortion premium payments and that it is used exclusively to pay for such services[4]. The Senate bill also requires the state health insurance commissioners to ensure that insurance companies comply with these requirements in accordance with guidance and accounting standards set by the Office of Management and Budget and the Government Accountability Office[5].

The exact language from the Senate bill may be found on pages 2069-2078 (note: not pages 33-44), available here. Citations below the fold:

[1] From page 2070 of the full text of the Patient Protection and Affordable Care Act as Passed (note that “services described in subparagraph (B)(i) or (B)(ii)” refers, respectively, to abortions that are not allowed under the Hyde amendment and those that are allowed — cases of rape, incest and the life of the woman):

”(1) VOLUNTARY CHOICE OF COVERAGE OFABORTION SERVICES.–

”(A) IN GENERAL.–Notwithstanding any other provision of this title (or any amendment made by this title)–

”(i) nothing in this title (or any amendment made by this title), shall be construed to require a qualified health plan to provide coverage of services described in subparagraph (B)(i) or (B)(ii) as part of its essential health benefits for any plan year ; and

”(ii) subject to subsection (a), the issuer of a qualified health plan shall deter- mine whether or not the plan provides cov- erage of services described in subparagraph (B)(i) or (B)(ii) as part of such benefits for the plan year.

[2] From page 2076 of the full text of the Patient Protection and Affordable Care Act as Passed:

”(A) NOTICE.– A qualified health plan that provides for coverage of the services described in paragraph (1)(B)(i) shall provide a notice to enrollees, only as part of the summary of benefits and coverage explanation, at the time of enrollment, of such coverage.

[3] From pages 2072-2073 of the full text of the Patient Protection and Affordable Care Act as Passed:

”In the case of a plan to which sub- paragraph (A) applies, the issuer of the plan shall–

”(i) collect from each enrollee in the plan (without regard to the enrollee’s age, sex, or family status) a separate payment for each of the following:

”(I) an amount equal to the portion of the premium to be paid directly by the enrollee for coverage under the plan of services other than services described in paragraph (1)(B)(i) (after reduction for credits and cost-sharing reductions described in subparagraph(A)); and ”(II) an amount equal to the actuarial value of the coverage of services described in paragraph (1)(B)(i), and ”(ii) shall deposit all such separate payments into separate allocation accounts as provided in subparagraph (C).

[4] From pages 2073-2074 of the full text of the Patient Protection and Affordable Care Act as Passed:

The issuer of a plan to which subparagraph (A) applies shall deposit–

”(I) all payments described in subparagraph (B)(i)(I) into a separate account that consists solely of such payments and that is used exclusively to pay for services other than services described in paragraph (1)(B)(i); and

”(II) all payments described in subparagraph (B)(i)(II) into a sepa- rate account that consists solely of such payments and that is used exclusively to pay for services described in para- graph (1)(B)(i).

[5] From page 2075 of the full text of the Patient Protection and Affordable Care Act as Passed:

State health insurance commissioners shall ensure that health plans comply with the segregation requirements in this sub- section through the segregation of plan funds in accordance with applicable provi- sions of generally accepted accounting re- quirements, circulars on funds management of the Office of Management and Budget, and guidance on accounting of the Govern- ment Accountability Office.

2 Responses to “Fact check on abortion funding in the Senate Health Care Reform Bill”

  1. pearl says:

    I want to thank you very much for posting FACTS about the healthcare bill and for calling Stupak out as the liar that he is.

    Honesty should be important to anyone of faith and I should think they’d be insulted by the lies being propagated in the name of “Christian values.”

    I intend to read more items on your site.

  2. Michael Heath says:

    Rare and needed analysis on this issue.

    Regarding Rep. Stupak’s OPM quip: Is Mr. Stupak’s argument that the federal government as an employer will be covering their employees’ health insurance at the OPM, just like private employers do? His reference appears to frame this as a mandatory payment but I’m not sure who is paying it, the employer/feds or the federal employee.

    I’m still trying to get at the nuance regarding Rep. Stupak’s description of the Senate Bill where he claims that federal dollars will fund abortion coverage. I believe that is already the case when it comes to certain health plans now for federal employees and am wondering if he’s raising a novel point or leveraging a current reality to further restrict insurance coverage for abortions.