Like illegal immigration, the issue of abortion in health reform has been a hotly contested one. The Baucus proposal released Wednesday does mark a departure from the House Democratic bill in one key area, while remaining vague about other areas of concern for the pro-life and pro-choice communities.
The biggest difference is the fact that Baucus does not propose a public health option, which under the House Democratic bill would have covered abortion services beyond instances involving rape, incest or the life of the mother. This was, for groups like the National Right To Life Committee, the most objectionable part of the House effort.
In other areas, Baucus sides with House Democrats in trying to find a way for the federal government to help subsidize private health insurance without disrupting the industry’s current approach to abortion coverage. Under the Baucus plan, like the House plan, certain individuals would get government subsidies to help buy private insurance in a publicly-established exchanges. There would be a guaranteed choice in each health insurance exchange between at least one plan that does not offer abortion services beyond rape, incest and the life of the mother, and at least one plan that does, allowing consumers to choose their preference. Those private plans that do offer the services would have to segregate funds internally, so that only private dues, and not federal subsidies, pay for actual abortion services.
The Baucus plan also authorizes federal loans and grants to help create new state-level Co-Ops, which will compete with private insurance companies as private non-profit companies. As far as I can tell, the Baucus document does not explicitly authorize or bar the Co-Ops from providing abortion services. Under the Baucus plan, these new insurance plans would be “member run.” “Governance of the organization must be subject to a majority vote of its members (i.e. beneficiaries),” the plan reads. Presumably, this would allow for each Co-Op to make its own decision about what abortion services to cover, but this is not explicit in the document.
One reproductive rights lobbyist I spoke with says Republicans are expected to offer two amendments to the Baucus plan in committee over the coming days. The first amendment concerns the “essential community provider” provision, which was included in the House bill, requiring health insurance companies to contract with a number of different private clinics, including family planning entities like Planned Parenthood, for certain non-abortion services. Republicans are expected to attempt an amendment that would remove this requirement.
The second amendment is expected to try to ban the federal government from subsidizing any insurance company that offers abortion services beyond rape, incest or the life of the mother. If passed, this amendment would effectively mandate that no private insurance companies that receive federal subsidies be allowed to offer most abortion services, and thereby deny the option of abortion coverage for those low-income Americans who would become insured as a result of the bill.
Under the current private health care system, a significant share of private health plans–numbers range from 46 percent to 87 percent, depending on the survey–offer abortion services.