Tuesday, July 20, 2010

New HHS Abortion Restriction Goes Beyond Current Law

Oppose Restrictions for Abortion Access in the Federal Pre-existing Condition Insurance Plans

Post-script:
This time they did not have to do it. There was no Ben Nelson, no Joe Lieberman. No applicable federal law. Not even much to lose. The Obama Administration chose to deny abortion funding in the new high risk pools, due to start next month. These enrollees will be among the most vulnerable women in the US: uninsured, with an existing health condition. The high risk pools were not already subject to the infamous Executive Order banning use of federal funds for abortion through the health insurance exchanges (due to start in 2014). The Executive Order was part of the price for heath reform. Well, ok, something to be fixed down the road. The road seems to have come to our door.

Why did the Administration extend this bad ruling to the high risk pools? Anti-choice groups went viral about the President betraying them if he did not extend to the already unconscionable Executive Oder to the high risk pools. Who thanked him? The Catholic bishops.

We have allowed abortion to become toxic. A procedure experienced by at least a third of women during our lives has been stigmatized. It is not enough to appoint and elect many fine, smart, progressive women – and pro-choice men – to government. They need, and we need, militant mobilized advocacy for reproductive choice and justice.

Keely Monroe, Lisa Kernan Social Justice Fellow; Ellen R. Shaffer, Co-Director; EQUAL Health Network

The Department of Health and Human Services has released an announcement stating that abortion coverage may only be obtained in the new high risk pool plans in cases of rape or incest, or where the life of the woman would be endangered. This wording mirrors the restrictions articulated in the Hyde Amendments to certain appropriations bills. (See below for full text of announcement)

As federal law currently stands, there are no restrictions placed upon federal or state money regarding abortion coverage in the Pre-existing Condition Insurance Plans (PCIP). The PCIPs are temporary insurance pools to provide insurance coverage to those deemed “high risk,” meaning the individual has some kind of pre-existing condition.

Because no law specifically addresses PCIPs and abortion coverage, the HHS statement would create a new sphere of abortion restrictions, undermining women’s reproductive autonomy.

The EQUAL Health Network believes these new restrictions are a response to pressure from anti-choice activist groups, and are unwarranted.

None of the current federal abortion restrictions that are in place apply to the PCIPs. The Hyde Amendment, which restricts abortion coverage to rape or incest, or where the life of the woman is in danger, only applies to funding appropriated through the Departments of Labor and Health and Human Services, including Medicaid. The appropriations for the Federal Employee Health Benefits Plan also restrict abortion coverage, but this clearly does not apply to the PCIPs.

In addition to nonexistent precedent for this action in prior federal law, there is no precedent in the Patient Protection and Affordable Acre Act (PPACA). The Nelson Amendment, adopted in the new law, only applies to plans obtained in the healthcare exchanges, which will not be active until 2014. Lastly, the Executive Order that the President signed regarding abortion coverage through PPACA gives no indication that it was meant to apply to more than the healthcare exchanges and community health centers.

The abortion coverage restrictions placed on the PCIPs is reminiscent of the Stupak Amendment first seen in the House version of PPACA, but later removed. The Stupak restrictions would have forbidden use of any funds, even those procured privately or through states, to provide abortion coverage to individuals participating in the PCIPs.


Objections to the White House and HHS Secretary Kathleen Sebelius.

White House:
Call: 202 456 1111
Email: public@who.eop.gov

Department of Health and Human Services
Call: 877 696 6775
Email: healthinsurance@hhs.gov

References:
Raising Women’s Voices
http://www.raisingwomensvoices.net/raisingwomensvoices-blog/2010/7/15/white-house-hhs-restrict-abortion-coverage-in-high-risk-pool.html#entry8268887

Jessica Arons from the Center of American Progress
http://www.rhrealitycheck.org/blog/2010/07/15/obama-administration-applies-stupak-amendment-high-risk-pools

Text of HHS announcement:
As is the case with FEHB plans currently, and with the Affordable Care Act and the President’s related Executive Order more generally, in Pennsylvania and in all other states abortions will not be covered in the Pre-existing Condition Insurance Plan (PCIB) except in the cases of rape or incest, or where the life of the woman would be endangered.

Our policy is the same for both state and federally-run PCIP programs. We will reiterate this policy in guidance to those running the Pre-existing Condition Insurance Plan at both the state and federal levels. The contracts to operate the Pre-existing Condition Insurance Plan include a requirement to follow all federal laws and guidance.

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