Guttmacher: Mixed Bag For Womens' Reproductive Health Care In ObamaCare

By Big Tent Democrat, Section Other Politics
Posted on Tue Mar 30, 2010 at 09:35:29 AM EST
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Digby quotes the Guttmacher Institute:

Abortion: Insurance Coverage Now an Endangered Species [. . .] the complex, politicized arrangements the legislation necessitates militate heavily against the likelihood that [. . .] plans [covering abortions] will be purchased—or even offered.

Paradoxically, the Guttmacher Institute asserts that "taken together, a number of other provisions in this sweeping measure constitute a clear and significant step forward for the reproductive health of America’s women and men." This sounds good. How does it work? The essence is this:

Medicaid: A Huge Advance for Lower-Income Americans’ Reproductive Health

According to the Congressional Budget Office, a provision expanding eligibility to all Americans with a family income below 133% of the federal poverty level will allow 16 million more Americans to join Medicaid by 2019 than would otherwise be the case. All Medicaid recipients receive the program’s guarantee of family planning services without cost sharing, along with coverage for its comprehensive package of reproductive health services beyond family planning. (The major exception, of course, is abortion; however, this provision effectively would expand abortion coverage in the 17 states that fund abortions for their Medicaid recipients with state dollars.) The legislation, moreover, goes one step further: It allows states to expand Medicaid coverage solely for family planning services to the same income eligibility levels they use for pregnancy-related care, typically around 200% of poverty.

(Emphasis supplied.) I argued for a different solution to the Stupak Problem (junk the exchanges, expand Medicaid and Medicare instead) without even realizing that the my solution actually would have done the most to forward the interests of womens' reproductive health care. that it would have expanded public insurance programs beyond ObamaCare would have also been a benefit.

Progressives should have tried to find a way to work with Stupak to forward progressive goals. In hindsight, I think this may have been the biggest missed opportunity on health care for progressives.

Speaking for me only

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Guttmacher: Mixed Bag For Womens' Reproductive Health Care In ObamaCare | 24 comments (24 topical)

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Well, only in comparison (5.00 / 5) (#2)
by Emma on Tue Mar 30, 2010 at 09:57:54 AM EST

"The most" only in comparison to a Dem party that is throwing women under the bus as fast as it ever can.

: Heh (5.00 / 3) (#7)
by cawaltz on Tue Mar 30, 2010 at 11:33:35 AM EST

President Feminist better not be depending on women to get out the vote for him. I really don't care how much he wants to sell this plan as a win for women, I'm not buying.

I know this isn't your angle (5.00 / 8) (#6)
by Kimberley on Tue Mar 30, 2010 at 11:20:20 AM EST

But, speaking strictly for myself, the instinct to deal with Stupak rather than use the party's machinery to force him (and other Democrats like him) to adopt the party's platform on this issue is exactly what went wrong.

Here's what should have happened:

The Democratic Party strongly supports Roe v. Wade and a woman's right to choose a safe and legal abortion, regardless of ability to pay, and we oppose any and all efforts to weaken or undermine that right.

From p. 50, Democratic Party platform for 2008 entitled: "Renewing America's Promise."

We all know what happened instead. And calling it hypocrisy is far too generous and polite a term.

If the Democratic Party had an ounce of respect for the intelligence of women, they would upload a redacted version of this platform, striking that paragraph out with a bold line and notation:

Something like, "Redacted because Democrats only use the national party's machinery to ensconce the power of individual Representatives and Senators and position the Democratic Party for electoral victories that are inconsistent with this party's ability to govern in predictable ways, according to its stated principles."

I'm sure it will rub, well, everybody the wrong way to learn that this woman doesn't care what the Democratic Party got in the Faustian bargain. And I maintain that it is only because women are not considered true equals of men in this country that anybody thinks I should be easily persuaded to find it fulfilling to make the sacrifice of this philosophical territory.

I do not.

The moment I find anything even remotely resembling standing to challenge this and throw three hundred million people off my back, I'm going for it. Come what may.

: 11th Dimensional Chess. No need to take platform (5.00 / 1) (#8)
by Dan the Man on Tue Mar 30, 2010 at 11:37:01 AM EST

seriously. Or perhaps you just didn't understand WT2008DPRM (What the 2008 Democratic Platform Meant).

: Startling to read the platform on (5.00 / 1) (#12)
by oculus on Tue Mar 30, 2010 at 12:02:31 PM EST

the exact issue at hand.

: Women Democrats (5.00 / 5) (#20)
by norris morris on Tue Mar 30, 2010 at 12:49:56 PM EST

Are very disaffected as the real downside caused by inserting Stupak and Nelson was unnecessary, and very harmful.
Others have pointed out here that the Democratic platform has clearly stated the defense of RoevWade. Duh.
This bit of a so called benefit released today is a simply PR device to quiet the anger democratic and independent women feel about the Reform bill which slices and dices abortion rights. Even the possibility of abortion coverage to be carried by insurers seems very unlikely.
It seems Democrats had no problem making abortion rights the sacrificial lamb. Women were used politically to advance this bill, and we were swindled out of hard earned rights that had become
settled law. No one cared. Even women in congress caved. So we cannot consider Democrats as the party that cares about women any longer, because we see that we have become dispensable.

: couldn't agree more (none / 0) (#22)
by Bornagaindem on Tue Mar 30, 2010 at 06:54:49 PM EST

This woman doesn't care either. It wasn't worth it. As far as I am concerned my only agenda is to defeat all incumbents regardless of party and to do it every election. It is the one way to send the message that you work for me - the voter- not the special interests that fund your campaigns. Special interests will have no power if they can't keep a lawmaker in office and lawmakers will pass public financing of campaigns if they can't get that special interest money to fund their campaigns. Win- win.

Progressives? (none / 0) (#1)
by SOS on Tue Mar 30, 2010 at 09:45:58 AM EST

The problem is progressives still can't relate to the common person. The less affluent, disadvantaged and salt of the earth folks.

Farmers for example aren't interested in BMW's and Starbucks. Hint hint . . . .

: Some can relate and some can't (5.00 / 1) (#3)
by ruffian on Tue Mar 30, 2010 at 11:01:07 AM EST

Unless we are defining 'progressives' as liberals who can't relate to the common people.

Seems like an excuse to me (none / 0) (#4)
by ruffian on Tue Mar 30, 2010 at 11:06:27 AM EST

I fail to understand why insurance companies cannot offer separate abortion coverage policies. There are many very complicated insurance policies on the market now - why is this so hard?

I'm getting suspicious that there were more deals made than we know about.

I can tell you why they might not want to (5.00 / 3) (#10)
by Kimberley on Tue Mar 30, 2010 at 11:41:02 AM EST

They're publicly traded, right?

Before, anti-abortion activists had to fan out across the country to protest in small, out-of-the-way places that only clinicians and distraught women visited. Now, they can use the national spotlight and stock exchanges to remind parent companies how dangerous it is to offer a rider. And if that fails, well, there's always the old standby of assassinations and domestic terrorism to look forward to.

This is a de facto overturn of Roe, and every single politician in Washington DC knows it.


Actually, this should be amended (5.00 / 3) (#14)
by Kimberley on Tue Mar 30, 2010 at 12:07:22 PM EST

to add that it is either a de facto overturn or they've decided to use CEOs as human shields in a terribly contentious political debate.

As expressed as visual, it's sort of like Democrats maneuvering corporate executives onto the front lines and then slipping away, leaving those executives to answer for and defend political territory.

In either case, the decision to do it this way is appalling cowardice.


I think this is exactly what (none / 0) (#16)
by ruffian on Tue Mar 30, 2010 at 12:16:54 PM EST

I suspect but could not articulate. Thanks!


Meanwhile, according to Digby, (none / 0) (#17)
by oculus on Tue Mar 30, 2010 at 12:23:40 PM EST

Stupak now states the Catholic Bishops should have backed off and supported HCR with the Nelson language.


: Heh (5.00 / 1) (#18)
by cawaltz on Tue Mar 30, 2010 at 12:30:00 PM EST

He's getting it from BOTH sides. And might I add it couldn't happen to a nicer person from where I am sitting.

: Catholic Bishops.... (5.00 / 2) (#21)
by Dr Molly on Tue Mar 30, 2010 at 01:00:54 PM EST

I just love how the group that likes to perpetrate and/or cover up the rampant sexual abuse of children gets to tell women what to do with their bodies.
Not interesting in their version of morality.

not only that (none / 0) (#5)
by CST on Tue Mar 30, 2010 at 11:18:07 AM EST

but if the insurers cover other reproductive care, it would be in their own best (financial) interest to provide seperate abortion policies.


Apparently (5.00 / 2) (#9)
by cawaltz on Tue Mar 30, 2010 at 11:37:58 AM EST

The insurance companies are anxious for women to create their next market full of people they can overcharge and undercover.

It's the only logical conclusion I can come to when it is less expensive to provide an abortion rider than pay for a labor and delivery and be required to cover that child for 26 years.


: That thought has crossed my mind. (none / 0) (#11)
by oculus on Tue Mar 30, 2010 at 12:00:40 PM EST

Maybe they know (none / 0) (#13)
by TeresaInSnow2 on Tue Mar 30, 2010 at 12:03:32 PM EST

what a bad value it would be to the consumer? Why would anyone buy such a policy, for a single statistically uncommon procedure wherein the insurance company has to build profit into the premium? Say it costs you $15/month to insure for abortion. In 3 years, you could have paid for an abortion. It's better to put that money into a passbook savings account and use it for abortion if you need it. Better to "self-insure".

For-profit insurance (And "non-profit" (LOL) plus highly paid executives and money funneled into subsidiaries insurance) is generally not a good value on the individual market. The abortion rider is just a case in point where the poor value is plainly obvious.


I thought of it that way (none / 0) (#15)
by ruffian on Tue Mar 30, 2010 at 12:15:53 PM EST

too. It is more of a marketing issue than a 'it's too complicated' issue. They would never be able to get an ad for it on TV without a huge uproar.


: Heh (none / 0) (#19)
by cawaltz on Tue Mar 30, 2010 at 12:46:29 PM EST

That's a pretty convenient excuse considering they just managed to get it passed into law that people are "required" to purchase their product. It would almost be worth it to see the radical fundies cut off their noses to spite their faces by attempting to go insuranceless.
No, I'm convinced this has less to do with consequences for the companies then it is an excuse for them to drop coverage on something and make people pay for it out of pocket.

Kaiser summary of HCR provision: (none / 0) (#23)
by RonK Seattle on Tue Mar 30, 2010 at 08:11:45 PM EST

... may include significant details Guttmacher failed to note:

Permit states to prohibit plans participating in the Exchange from providing coverage for abortions. Require ... segregating premium payments for coverage of abortion services ... at no less than $1 per enrollee per month ... cannot take into account any savings that might be reaped as a result of the abortions. Prohibit ... discriminating against any provider because of an unwillingness to provide, pay for, provide coverage of, or refer for abortions.

( http://www.kff.org/healthreform/sidebyside.cfm )

Unsafe abortions to rise? (none / 0) (#24)
by Lora on Tue Mar 30, 2010 at 10:17:14 PM EST

I'm reminded of an old saying told to women in the 50's and 60's who were "frigid,": Having sex without orga$m is like having the egg without the salt. The idea was to reassure the woman that she wasn't missing out on anything all that important.

That's what this health care bill reminds me of. The provisions for women's health care minus abortion is like having the egg without the salt, right, ladies? No worries. At least you have the egg. Who cares if you don't get a little salt?

As one woman put it back in the day, it's more like having the salt without the egg.

Having "health care" for women without supporting the right to access a safe abortion is dangerous, despicable, dastardly, devious, dirty, and disgusting.

Will we see a return to back street abortions and see the increase in serious complications or death of more women, especially teenagers?

From Saultes, Devita, and Heiner's case report of 2009:

Young women choosing to abort may face barriers that lead them to a self-induced or otherwise unsafe termination of pregnancy. In the US the number of abortion providers has decreased and about one-third of women live in a county with no abortion provider. States are increasingly mandating parental involvement...In 2001 the inflation adjusted cost of an abortion rose...These issues are likely to influence the young women who will eventually seek care...for complications associated with an unsafe abortion.

This bill has just upped the barriers.