Terence P. Jeffrey
CNSNews
November 19, 2009
Senate Majority Leader Harry Reid, D-Nev.,
The mandate appears on page 120 of the 2,074-page bill under the seemingly innocuous heading: ‘Assured Availability of Varied Coverage Through Exchanges.”
Specifically, the provision requires that the secretary of Health and Human Services make certain that at least one health insurance plan offered in government-regulated insurance exchanges where people will be able to purchase health insurance using government subsidies must provide coverage of abortion. The secretary also must make certain that at least one plan available in the exchanges not cover abortions.
The relevant language says: “The Secretary shall assure that with respect to qualified health plans offered in any Exchange established pursuant to this title—(I) there is at least one such plan that provides coverage of services described in clauses (i) and (ii) of subparagraph (B); and (II) there is at least one such plan that does not provide coverage of services described in subparagraph (B)(i).”
The clause “(i)” of “subparagraph (B)” referred to in this passage defines those types of abortions currently banned from receiving federal funding under the Hyde Amendment. The Hyde Amendment bans federal funding for all abortions except those done in cases of rape, incest and a threat to the life of the mother. So, the language of Sen. Reid’s health care bill mandates that at least one health insurance plan available to people buying health insurance with federal subsidies cover those abortions that are currently prohibited from receiving federal funding under the Hyde Amendment.
Reid’s bill attempts to mitigate the fact that it is mandating the use of tax dollars to pay for insurance plans that cover abortions by requiring the insurance plans to charge all customers at least $1 dollar of their own money to theoretically pay for the abortion part of their insurance coverage and segregate those funds from the funds the insurance plan receives from the federal government.
The National Right to Life Committee decried the abortion funding language in the Reid health care bill. But pro-abortion Rep. Lois Capps (D-Calif.), who pushed a provision similar to Reid’s in the House bill only to see her efforts trumped by the pro-life Stupak amendment, applauded Reid’s language.
National Right to Life Legislative Director Douglas Johnson said Reid’s bill “creates new tax-supported subsidies to purchase private health plans that will cover abortion on demand.”
Rep. Capps said she was pleased with Reid’s language. “I am pleased that the Senate has adopted a reasonable, common ground approach on this difficult question,” she said in a statement. “It appears that their approach closely mirrors my language which was originally included in the House bill.”
Here is the text of Section 1303 of the health care bill published by Senate Majority Leader Harry Reid that explains the federal subsidy of abortion. Section 1303 begins on page 116 of the 2,074-page bill.
SEC. 1303. SPECIAL RULES.
(a) SPECIAL RULES RELATING TO COVERAGE OF ABORTION SERVICES.—(1) VOLUNTARY CHOICE OF COVERAGE OF ABORTION SERVICES.—
A) IN GENERAL.—Notwithstanding any other provision of this title (or any amendment made by this title), and subject to subparagraphs (C) and (D)—(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) the issuer of a qualified health plan shall determine whether or not the plan provides coverage of services described in subparagraph (B)(i) or (B)(ii) as part of such benefits for the plan year.
B) ABORTION SERVICES.—
i) ABORTIONS FOR WHICH PUBLIC FUNDING IS PROHIBITED.—The services described in this clause are abortions for which the expenditure of Federal funds appropriated for the Department of Health and Human Services is not permitted, based on the law as in effect as of the date that is 6 months before the beginning of the plan year involved.
(ii) ABORTIONS FOR WHICH PUBLIC FUNDING IS ALLOWED.—The services described in this clause are abortions for which the expenditure of Federal funds appropriated for the Department of Health and Human Services is permitted, based on the law as in effect as of the date that is 6 months before the beginning of the plan year involved.
(C) PROHIBITION ON FEDERAL FUNDS FOR ABORTION SERVICES IN COMMUNITY HEALTH INSURANCE OPTION.—
(i) DETERMINATION BY SECRETARY.—The Secretary may not determine, in accordance with subparagraph (A)(ii), that the community health insurance option established under section 1323 shall provide coverage of services described in subparagraph (B)(i) as part of benefits for the plan year unless the Secretary—
(I) assures compliance with the requirements of paragraph (2); (II) assures, in accordance with applicable provisions of generally accepted accounting requirements, circulars on funds management of the Office of Management and Budget, and guidance on accounting of the Government Accountability Office, that no Federal funds are used for such coverage; and(III) notwithstanding section 1323(e)(1)(C) or any other provision of this title, takes all necessary steps to assure that the United States does not bear the insurance risk for a community health insurance option’s coverage of services described in subparagraph (B)(i).
(ii) STATE REQUIREMENT.—If a State requires, in addition to the essential health benefits required under section 1323(b)(3)(A), coverage of services described in subparagraph (B)(i) for enrollees of a community health insurance option offered in such State, the State shall assure that no funds flowing through or from the community health insurance option, and no other Federal funds, pay or defray the cost of providing coverage of services described in subparagraph (B)(i). The United States shall not bear the insurance risk for a State’s required coverage of services described in subparagraph (B)(i).
(iii) EXCEPTIONS.—Nothing in this subparagraph shall apply to coverage of services described in subparagraph (B)(ii) by the community health insurance option. Services described in subparagraph (B)(ii) shall be covered to the same extent as such services are covered under title XIX of the Social Security Act.
D) ASSURED AVAILABILITY OF VARIED COVERAGE THROUGH EXCHANGES.—
(i) IN GENERAL.—The Secretary shall assure that with respect to qualified health plans offered in any Exchange established pursuant to this title—
(I) there is at least one such plan that provides coverage of services described in clauses (i) and (ii) of subparagraph (B); and (II) there is at least one such plan that does not provide coverage of services described in subparagraph (B)(i).
(ii) SPECIAL RULES.—For purposes of clause (i)—(I) a plan shall be treated as described in clause (i)(II) if the plan does not provide coverage of services described in either subparagraph (B)(i) or (B)(ii); and(II) if a State has one Exchange covering more than 1 insurance market, the Secretary shall meet the requirements of clause (i) separately with respect to each such market.
(2) PROHIBITION ON THE USE OF FEDERAL FUNDS.—
(A) IN GENERAL.—If a qualified health plan provides coverage of services described in paragraph (1)(B)(i), the issuer of the plan shall not use any amount attributable to any of the following for purposes of paying for such services:
(i) The credit under section 36B of the Internal Revenue Code of 1986 (and the amount (if any) of the advance payment of the credit under section 1412 of the Patient Protection and Affordable Care Act).
(ii) Any cost-sharing reduction under section 1402 of the Patient Protection and Affordable Care Act (and the amount (if any) of the advance payment of the reduction under section 1412 of the Patient Protection and Affordable Care Act).
(B) SEGREGATION OF FUNDS.—In the case of a plan to which subparagraph (A) applies, the issuer of the plan shall, out of amounts not described in subparagraph (A), segregate an amount equal to the actuarial amounts determined under subparagraph (C) for all enrollees from the amounts described in subparagraph(A).
(C) ACTUARIAL VALUE OF OPTIONAL SERVICE COVERAGE.—
(i) IN GENERAL.—The Secretary shall estimate the basic per enrollee, per month cost, determined on an average actuarial basis, for including coverage under a qualified health plan of the services described in paragraph (1)(B)(i).
(ii) CONSIDERATIONS.—In making such estimate, the Secretary—(I) may take into account the impact on overall costs of the inclusion of such coverage, but may not take into account any cost reduction estimated to result from such services, including prenatal care, delivery, or postnatal care; (II) shall estimate such costs as if such coverage were included for the entire population covered; and (III) may not estimate such a cost at less than $1 per enrollee, per month.
(3) PROVIDER CONSCIENCE PROTECTIONS.—No individual health care provider or health care facility may be discriminated against because of a willingness or an unwillingness, if doing so is contrary to the religious or moral beliefs of the provider or facility, to provide, pay for, provide coverage of, or refer for abortions.
(b) APPLICATION OF STATE AND FEDERAL LAWS REGARDING ABORTION.—
(1) NO PREEMPTION OF STATE LAWS REGARDING ABORTION.—Nothing in this Act shall be construed to preempt or otherwise have any effect on State laws regarding the prohibition of (or requirement of) coverage, funding, or procedural requirements on abortions, including parental notification or consent for the performance of an abortion on a minor.
(2) NO EFFECT ON FEDERAL LAWS REGARDING ABORTION.—
(A) IN GENERAL.—Nothing in this Act shall be construed to have any effect on Federal laws regarding—(i) conscience protection; (ii) willingness or refusal to provide abortion; and (iii) discrimination on the basis of the willingness or refusal to provide, pay for, cover, or refer for abortion or to provide or participate in training to provide abortion.
