ProgressOhio

A new study by the George Washington University School of Public Health and Health Services adds some expert imprimatur to what many progressives have been saying all along: The Stupak amendment to the House health care bill--which will prevent millions of women from buying health insurance policies that cover abortion--is likely to have consequences that reach far beyond its supposedly intended scope.

The report concludes that "the treatment exclusions required under the Stupak/Pitts Amendment will have an industry-wide effect, eliminating coverage of medically indicated abortions over time for all women, not only those whose coverage is derived through a health insurance exchange."

In other words, though the immediate impact of the Stupak amendment will be limited to the millions of women initially insured through a new insurance exchange, over time, as the exchanges grow, the insurance industry will scale down their abortion coverage options until they offer none at all.

Although the Amendment appears to address only plans that receive federal exchange subsidies, even health plans sold to private, large employers that purchase outside the exchange ultimately are likely to be affected, the analysis concludes. These findings are based on an assessment of the extent to which the health benefits services industry adjusts its products over time to conform to the regulatory environment in which it operates.

"Under national health reform, millions of women, including women who are covered by small employers (as employees or spouses or dependents of employees) as well as those who are currently uninsured, will receive their coverage through health insurance exchanges. By barring the sale of subsidized products that cover medically indicated abortions as part of a broader package of benefits, the Amendment can be expected to cause the industry to re-design its offerings in order to avoid violating the legal restrictions on abortion applicable to exchange products that receive subsidies," said Professor Sara Rosenbaum, JD, lead author and Chair of the Department of Health Policy. "The Amendment also can be expected to chill efforts to develop supplemental coverage for medically indicated abortions, because it appears to prohibit the joint administration of both a basic and supplemental product," Rosenbaum noted.

Additionally, "based on past experiences with claim administration decisions involving treatment exclusions," the analysts conclude that insurers are likely to interpret the exclusion broadly, and exclude not just elective abortions, but also medically indicated abortion and "treatments for serious illnesses, injuries, and medical conditions that include an abortion undertaken for health reasons." Insurance administrators, they find, are likely to err on the side of coverage denail in order to avoid sanctions.

The report also includes findings on the "rider" provision of the legislation, the provision that would supposedly allow women to purchase supplemental abortion coverage. From the full analysis [pdf].

The provisions of the legislation, as well as the technical challenges that arise in benefits administration, militate against the creation of a supplemental coverage market. Thus, if the result of national health reform is to move millions of women into a market that operates subject to the exclusion, then it is fair to predict that the entire market for coverage ultimately will be affected as a product tipping point is reached and virtually no supplemental market appears." (p. 14)

Orrin Hatch plans to introduce the Stupak amendment in the Senate.

This amendment isn't just a reiteration of Hyde, it's a direct attack on a legal, medical procedure, not to mention the women who might need it.