Stupak’s NYT Op-Ed: Congresswoman Capps Responds

Here is the response to Stupak’s NYT Op-Ed By Rep. Lois Capps Created Dec 10 2009 – 7:00am

Published on RHRealityCheck.org (http://www.rhrealitycheck.org)

On Wednesday, December 9th, the New York Times published an op-ed by Congressman Bart Stupak in which he makes misleading claims about the Stupak-Pitts Amendment in the House Health Care Reform bill.  Here, Congresswoman Lois Capps (D-CA), author of the Capps Amendment, provides a reality check to the claims in that op-ed.

 Stupak Claim:  Our amendment maintains current law, which says that there should be no federal financing for abortion.

Reality:   The Stupak-Pitts Amendment goes well beyond current law by contracting access to abortion services and is in no way the simple extension of the Hyde Amendment its proponents claim.  It dramatically restricts consumers’ ability to purchase comprehensive health plans that include coverage for abortion services in the health exchange.  In contrast the Capps Amendment, which was included in the original version of the House bill, continued the prohibition of federal funding of abortion services, but did so without restricting insurance coverage of this legal medical procedure when it is paid for with private funds.  Reputable third parties, like a recent study from George Washington University [1], have found that the Stupak-Pitts Amendment would restrict coverage of abortion services even when paid for entirely with private funds

Stupak Claim:  Under our amendment, women who receive federal subsidies will be prohibited from using them to pay for insurance policies that cover abortion. The amendment does not prevent private plans from offering abortion services and it does not prohibit women from purchasing abortion coverage with their own money. The amendment specifically states that even those who receive federal subsidies can purchase a supplemental policy with private money to cover abortions.

Reality:  There is nothing in the Stupak-Pitts Amendment to ensure that riders are available or affordable to individuals purchasing coverage in the Exchange.  There is no evidence that insurance companies actually offer such riders in the five states that currently require women to purchase a separate rider for abortion coverage.  It is not practical to expect women to plan ahead for an unintended pregnancy, or a pregnancy that goes terribly wrong, by purchasing a supplemental rider.  Furthermore, if only women of childbearing age purchase such a rider then the premium for the rider will likely cost almost as much as the service.

Stupak Claim:  Some opponents of the amendment have tried to argue that it would effectively end health insurance coverage of abortion in both the private and public sectors. This argument is nothing more than a scare tactic.

Reality:  It is highly unlikely that any insurance plan is going to go through the pain staking process of setting up two separate plans —one with abortion services offered and one without – to cater to less than 20% of the Exchange participants who are allowed to buy plans that include abortion services. As noted by Robert Laszewski, consultant to the insurance industry, in a recent interview with NPR [2], it wouldn’t make any business sense to offer a plan that would only be available to such a small number of potential customers. A recent report by George Washington University similarly concluded that the effect of the Stupak amendment would “militate against the creation of a supplemental coverage market.”  The argument that this amendment won’t restrict access for women who are paying for insurance entirely out of their own pockets is false.

Stupak Claim:  The language in our amendment is completely consistent with the Hyde Amendment, which in the 33 years since its passage has done nothing to inhibit private health insurers from offering abortion coverage. There is no reason to believe that a continuation of this policy would suddenly create undue hardship for the insurance industry — or for those who wish to use their private insurance to pay for an abortion.

Reality:  The Stupak-Pitts Amendment goes well beyond current law by contracting access to abortion services and is in no way the simple extension of the Hyde Amendment its proponents claim.  The Hyde Amendment prohibits federal funding for abortion in Medicaid programs except in cases of rape, incest and to protect the life of the women, but it allows states to use their own funds to pay for abortions in other cases.  Applying this same principle, the Capps Amendment, would have prohibited federal funding to pay directly for abortions in insurance plans in the Exchange, but would allow plans to pay for these services using private funding from patient premiums.  Just as churches and military contractors are able to segregate federal funds from other sources of funding, insurance companies can do the same. 

Stupak Claim:  Given that insurance companies are able to offer separate plans with and without abortion coverage now, it seems likely that they would be able to continue to do so on the newly established health insurance exchange.

Reality:  The Stupak-Pitts Amendment severely limits private plans’ ability to cover abortions.  The Stupak-Pitts Amendment would prohibit any abortions beyond the Hyde exceptions within the public option and any plans sold in the Exchange to individuals who receive affordability credits.  Although insurance companies are permitted to offer plans that cover abortion to individuals who do not receive affordability credits, they would only be able to do so if they offered two nearly identical plans with the only difference being coverage and exclusion of abortion services.   Furthermore health insurance companies would be unlikely to even offer a plan that does receive any funding from affordability credits because the risk pool would be too small.  In effect, this ensures there will not be any private plans covering abortion available to individuals and small businesses that purchase health insurance in the new Exchange. 

Stupak Claim:  It is also disingenuous to argue (as some have) that it would be a hardship for insurance companies to provide plans with and without abortion coverage — when the health care bill as introduced in the House and Senate mandated exactly that. Under language suggested by Representative Lois Capps, Democrat of California, the new insurance exchange would be required to provide at least one plan that covers abortion and one plan that does not. If offering separate abortion-free plans in this way was acceptable under the Capps language (which has been endorsed by abortion-rights groups), then it should also be acceptable under the Stupak-Ellsworth-Pitts Amendment.

Reality:  Under the Capps language the Exchange would have to ensure that there is at least one plan that does not include abortion services and one that does.  These plans could be offered by the same company or different companies, so long as consumers were offered at least one of each option.  In contrast the Stupak-Pitts Amendment requires private plans that want to offer a comprehensive plan including abortion services – and most private plans currently do offer comprehensive plans – they would have to offer an identical plan that does not include abortion services.  So if Blue Cross Blue Shield wanted to offer a comprehensive plan they would also have to offer an identical plan without those services.  According to insurance industry consultants like Robert Laszewski [2] it wouldn’t make any business sense to offer a plan that would only be available to such a small number of potential customers (since less than 20 percent of the exchange customers would even be allowed to purchase a comprehensive plan).  And that is why anyone in the Exchange – even those paying for insurance completely on their own – wouldn’t have access to abortion coverage.  The argument that this amendment won’t restrict access for women who are paying for insurance entirely out of their own pockets is false. 

Stupak Claim:  While many accusations have been thrown around in recent months, the intent behind our amendment is simple and clear: to continue current law, which says that there should be no federal financing of abortions. Our intent was not to change, add or take anything away from federal law.

Reality:  Again, the Stupak-Pitts Amendment goes well beyond current law by contracting access to abortion services and is in no way the simple extension of the Hyde Amendment its proponents claim.  Regardless of intent, the amendment does dramatically restrict consumers’ ability to purchase comprehensive health plans that include coverage for abortion services in the health exchange.  In contrast the Capps Amendment continued the prohibition of federal funding of abortion services, but did so without restricting insurance coverage of this legal medical procedure when it is paid for with private funds.  Reputable third parties, like a recent study from George Washington University, have found that the Stupak-Pitts Amendment would restrict coverage of abortion services even when paid for entirely with private funds

Stupak Claim:  This goal is consistent with the opinion of a majority of Americans. Recent CNN and Washington Post-ABC News polls found that 61 percent of Americans do not want taxpayer dollars to pay for abortions. And while the Senate voted down a similar amendment on Tuesday, I’m hopeful that the spirit of our legislation will make it into the final bill.

Reality:  The Capps language is consistent with both current law and public opinion because it explicitly prohibits federal funding for abortion services except those allowed by the Hyde Amendment:  rape, incest, and to protect the life of the woman.  Furthermore, recent polling conducted by the Mellman Group found that:

  • 54% of voters would oppose a health care reform plan that prevented private insurance plans from covering abortion. 
  • 56% of voters believe that those who receive partial subsidies should be able to buy plans that cover abortion – surpassing those who oppose this choice by a 20 point margin.
  • 52% of voters support the “Capps compromise,” which would prohibit federal dollars, including partial subsidies, from being used to pay for abortions, though abortions could be paid using private funds generated by patients’ premiums.
  • 47% agreed that “Political differences should not prevent us from moving forward on an otherwise good healthcare reform plan.”

  As pollster Mark Mellman noted [3]a column in The Hill recently [3], “Americans do not want reform to be an excuse for tightening restrictions on abortion or for taking away health coverage millions already have. Nor do they want an abortion debate to stop reform. Voters want an abortion-neutral healthcare reform.”

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