Obama Administration Applies Stupak Amendment to High Risk Pools

July 16, 2010 6:30 AM

Although the Stupak amendment was defeated, women in the new high risk pools will be denied coverage for abortion. The "clarification" from the administration comes in the wake of a scuffle over Pennsylvania's plan to provide abortion coverage. Hopefully, building criticism will have an effect.
posted by stoneweaver (24 comments total)

Well, I mean, isn't that kinda what Obama said he'd do?

Either the Left was going to be unhappy because Obama wasn't cynical about the order or the Right was going to be unhappy because he was.

Someone was going to be unhappy about this either way.
posted by valkyryn at 6:41 AM on July 16, 2010

Someone was going to be unhappy about this either way.

That's a pretty good summary for any abortion discussions.

Either way, good on you, Pennsylvania.
posted by filthy light thief at 6:57 AM on July 16, 2010 [1 favorite]

The Federal Government should stay out of our personal lives and states' rights, except for women's uteruses where it belongs!

Do these people realize how stupid this sounds?
posted by schmod at 7:03 AM on July 16, 2010

Do these people realize how stupid this sounds?

Only if you consider women to be people.
posted by dinty_moore at 7:16 AM on July 16, 2010 [4 favorites]

Have we forgotten how close this thing came? Abortion is a hugely loaded issue that threatened to torpedo the entire legislation. This was a compromise Obama had to agree to, and while I'm disappointed that it had to happen I'm frankly impressed that they managed to reduce its form to an executive order that can be withdrawn in the future or overridden by legislation.

They probably got that compromise at such a bargain because both sides (blue dogs and the white house) realized it wouldn't benefit Obama to reneg on the offer. If the blue dogs end up on the hook for approving a bill that funds abortions, they're fucked. If they get replaced by republicans, Obama's legislative agenda for 2010-2012 is super fucked.

Obama had to follow through on this promise in order to get any good done after November. I'm disappointed but I don't even think it was the wrong thing to do.

Abortion is a polarizing topic that needs to be argued on its own merits. We don't gain anything by holding progressive legislation hostage to our passion about that one issue.
posted by Riki tiki at 7:16 AM on July 16, 2010

isn't that kinda what Obama said he'd do?

It's just that he seems to keep his word more when it comes to restricting abortion access and escalating in Afghanistan than when it comes to fighting for a public option or voting against telecom immunity.
posted by Joe Beese at 7:17 AM on July 16, 2010 [5 favorites]

You know, I believe 1000 percent in a person's right to have an abortion. But I really don't see any problem with denying federal funding for them.

At one point, the abortion issue nearly derailed the reform bill. But after Obama promised the executive order, the anti-abortion Democrats switched their votes to "yes" to help pass the measure pass 219-212 on Sunday night.

Stupak had led the anti-abortion Democrats in opposition to the new health care law because, he claimed, it would allow federal funding for abortions beyond the current limits of cases of rape or incest, or if the woman's life is in danger.

Does the anti-abortion crowd believe that abortion *isn't* murder in cases of rape or incest, or that those particular fetuses aren't deserving of the same "protections" they would give other fetuses because their biological fathers are criminals? This exception always makes my blood boil. It is the height of hypocrisy. If they think it is murder, then it is murder no matter where the sperm came from.
posted by gjc at 7:28 AM on July 16, 2010 [1 favorite]

It's just that he seems to keep his word more when it comes to restricting abortion access and escalating in Afghanistan than when it comes to fighting for a public option or voting against telecom immunity.

Perhaps. I'd argue that there's a difference between saying that you're going to magically end the war when you're stumping for votes and doing a complete about face on a promise you made to a political faction whose support you desperately need.

The former is something every politician does because that's what politicians do. The latter isn't something any politician can do if they want to survive. Legislative politics involves an incredible amount of quid pro quo, and this is one of the things Obama had to promise as a part of that. Telecom immunity and any number of other campaign promises aren't.

Yeah, and promise is a promise and all that, but come on.
posted by valkyryn at 7:30 AM on July 16, 2010 [1 favorite]

Does the anti-abortion crowd believe that abortion *isn't* murder in cases of rape or incest,

It depends. Pro-life activists come from a range of positions, not all of which are mutually consistent. A lot of the most vocal ones don't tend to have positions which are worked out very well or very clearly, they just know they don't like abortion. So compromising on something like rape or incest, while not terribly coherent, is easier to do.

Others take a principled stance on the sacredness of human life, e.g. the Roman Catholic Church. They tend to oppose abortion under any circumstances, period, no exceptions. Not an easy sell, but it's consistent.

Then there are others, like myself, who view abortion as a moral evil but acknowledge the fact that we live in a world where moral evils are sometimes necessary. My father, a physician, is strongly pro-life, but doesn't blink about prescribing abortions for his patients when their lives are in danger. These people tend to have less absolute beliefs about the nature of human life and don't even necessarily base our objections to abortion on something like "life begins at conception."

The argument has more to do with virtue and even natural law to a certain extent. Choosing one evil over another, e.g. prescribing an abortion where the mother has Marfan syndrome, is one thing, but deciding to have an abortion because children aren't convenient is something different. The former assumes that when given a choice between two evils, one has to make a carefully considered choice. It may not even come out the same way every time. But the latter operates from an assumption that human rights are real, that one's own preferences and convenience are paramount, that no other person may impinge upon them, that one has the right to choose the consequences of one's own actions, and that sexuality is and ought to be completely distinct from procreation. Indeed, on-demand abortion can contribute to these assumptions going entirely unconsidered. All of these, and particularly when unreflected upon, can be objected to on moral grounds, leading one to object for on-demand abortion without requiring one to say that it is an absolute moral evil which should be completely outlawed.*

The problem with this position is that "Abortion is generally contrary to human flourishing!" doesn't make for as great a sound-bite as "Abortion stops a beating heart!"** It's also a lot harder position to maintain, as you actually have to think about stuff. So the wingnuts get the press coverage, leaving more nuanced and philosophically rigorous positions in the background.

*It is not my intent to debate any of these things here. I'm only trying to explain the argument, to show that it exists, not to defend it.

**Because it does, obviously. I mean, duh. The question isn't whether that's what's happening, it's why it's happening and whether we're okay with that. This isn't nearly as easy a question to answer, and it isn't an empirical one either.
posted by valkyryn at 7:45 AM on July 16, 2010 [3 favorites]

>that one has the right to choose the consequences of one's own actions

You don't need to believe that in order to support convenient, on-demand abortion. When a woman gets pregnant and doesn't want to, she can't actually just choose not to be pregnant. What she can do is mitigate the consequences of her previous (probably bad) decision by getting an abortion. Depending on her views vis-a-vis how human a fetus is, this might be a moral evil, or might be merely expensive.

None of that means you get to choose the consequences of your actions. You get to choose how to handle the consequences.

>"Abortion stops a beating heart!"**Because it does, obviously.

That rather depends on when during the pregnancy the abortion is performed, doesn't it?
posted by LogicalDash at 8:12 AM on July 16, 2010 [1 favorite]

LogicalDash, you can argue that the position I've described is wrong, but I won't respond. Not interested in having that discussion. All I'm looking for is recognition that it is, in fact, coherent, and does, in fact, make room for the sort of distinction that gjc was concerned about.
posted by valkyryn at 8:22 AM on July 16, 2010

Sharron Angle's Advice For Rape Victims Considering Abortion: Turn Lemons Into Lemonade
posted by homunculus at 8:32 AM on July 16, 2010

It's just that he seems to keep his word more when it comes to restricting abortion access and escalating in Afghanistan than when it comes to fighting for a public option or voting against telecom immunity.

Yeah, like when he did what he promised and repealed the Bush administration's ban on providing funding to international organizations that provide abortion services. That was totally another case of Obama only keeping his promises when it comes to restricting abortion access or escalating the war in Afghanistan.

Look, this President more than any in recent history generally does what he says. You might not always agree with what he says and does, but it seems hard to dispute this basic reality.
posted by saulgoodman at 8:47 AM on July 16, 2010 [1 favorite]

Fair enough.
posted by LogicalDash at 9:00 AM on July 16, 2010

The last sentence on RH Reality Check's article is particularly poignant:

"It is never ok to trade women’s rights for political reasons, but in this case the calculus seems to be particularly bankrupt.
posted by fontophilic at 9:03 AM on July 16, 2010

"It is never ok to trade women’s rights for political reasons, but in this case the calculus seems to be particularly bankrupt.

No one's rights are being denied, though. Remember, the people in the temporary high risk pools couldn't even get insurance--and weren't considered to have any right to it--before the new legislation. Women in the high risk pool are still able to get abortions. The abortions just won't be paid for by their high-risk pool insurance plans (which they wouldn't have even had to start with before the health care reform created them).

Most people's insurance plans don't cover abortions accept in the case of risk to the life of the woman. My own family's insurance doesn't. This clarification doesn't represent any worsening in the status quo, much less a trading away or reduction of rights.
posted by saulgoodman at 9:17 AM on July 16, 2010

A bit more on this topic: Remember, despite all the media focus, the Stupak amendment arguably wouldn't have actually changed the current federal law, which already prohibits government funding for abortion under the renewable Hyde Amendment, as Slate discusses below:

As I've explained before, the Hyde Amendment is not a permanent ban on government (actually, just Health and Human Services) funding of abortions. It's a ban that gets attached to appropriations bills and therefore must be renewed year after year. In the Senate bill, the ban on government funding of abortions through the new health insurance exchanges is dependent on the Hyde Amendment's renewal. The word "abortion" is defined "based on the law [governing HHS appropriations] as in effect as of the date that is six months before the beginning of the plan year involved." (This is on Page 119.) If Congress fails to renew the Hyde Amendment in any given year, the abortion ban in the health care reform bill will vanish.

Stupak, as a condition of supporting Health Care Reform, extracted a promise from the administration to issue an executive order clarifying the fact that the federal government wouldn't begin the practice of providing federal funding to pay for abortion services. That's all that happened.

Under existing law as it has stood for some time, the federal government is prohibited from directly funding abortion services except in cases of medical necessity. This clarification only affirms the commitment agreed to in the compromise with Stupak, which in essence, basically just says that the existing law still applies.

In other words, this whole thing really amounts to nothing at all in practice, except to those who'd like to see the administration pushing more aggressively to change the existing prohibitions on federal funding for non-medically necessary abortions. If that's your position, okay, you're free to hold it, but not even everyone who believes in the right to choose necessarily wants to see federal funding used to provide abortions. Certainly many on the pro-choice side do want that, but it's far from the consensus view, from what I can tell.
posted by saulgoodman at 9:31 AM on July 16, 2010

Most people's insurance plans don't cover abortions accept in the case of risk to the life of the woman.

Not entirely true. Most major private insurers will include coverage for elective abortions in a policy (abortion is much cheaper birth, so this has the potential to save the insurer money). However, many employers choose not to include this coverage in their policies. I have seen in both ways at different employers.
posted by jeoc at 9:53 AM on July 16, 2010

Well, none of the insurance plans I know of cover it.

And it's certainly true that people who don't qualify for insurance due to preexisting conditions have never at any previous time in history enjoyed insurance coverage for elective abortion.
posted by saulgoodman at 10:27 AM on July 16, 2010

No one's rights are being denied, though.

A right isn't something the government affords or grants, as rights are indelible to human beings, it is something it protects and allows no laws or practices to infringe upon them.

Saying these women still have the right to have an abortion is different from saying they have access to abortion. Imagine if we had not established strong laws, and strong actions to end segregation.* Saying African American kids had the right to go to an equal school is different from saying they have access to an equal school. You might as well say you have the right to own a unicorn, or a flying pig.

Already 87% of counties in the US do not have an abortion provider. Yes most women already pay for their own abortions out of pocket, and not through their insurance. Making less incentives for insurance to pay for abortions, and less incentives for doctors to provide and learn to perform abortions sure as heck isn't helping. And yes, Obama was supposed to be the pro-choice candidate. Painting abortion with shame for political points isn't what I expected from him.

Well, none of the insurance plans I know of cover it.

And it's certainly true that people who don't qualify for insurance due to preexisting conditions have never at any previous time in history enjoyed insurance coverage for elective abortion.

I've read this several times and still have no idea what you mean. Do you not think it is possible for a woman to have been healthy, had an abortion covered by insurance, get sick, get dropped from insurance and then need a high-risk insurance pool?

(*as passionate as I am about abortion, I do think civil rights was a much more important cause, and don't mean to put the two issues on the same level, just drawing comparisons between rights and access. No offense intended. And no, I don't think an abortion equivalent to bussing would be a great idea)
posted by fontophilic at 11:41 AM on July 16, 2010

I've read this several times and still have no idea what you mean. Do you not think it is possible for a woman to have been healthy, had an abortion covered by insurance, get sick, get dropped from insurance and then need a high-risk insurance pool?

Yes, and in the past, they would have simply not had insurance, so they would have had to pay for any elective abortion out-of-pocket. Which is all that's happening now, with the exception that now, they can still get coverage for life-threatening problems through the brand new high risk pools that did not exist before.

Even in the carefully constructed hypothetical scenario you presented, our hypothetical ingenue hasn't lost anything that she actually had before, which to my mind means she hasn't lost anything. And I'm struggling to understand how you can see the situation as being otherwise.
posted by saulgoodman at 11:46 AM on July 16, 2010

In case there's some really basic misapprehension going on here, the rule isn't that women who've ever had or are having an abortion will get dropped from the high risk pool.

A woman insured through the new high risk pools (in other words, a woman who can't get insurance coverage at all otherwise) can still have an abortion, pay for it out of pocket, and keep the coverage she gets through the high risk pool.
posted by saulgoodman at 11:56 AM on July 16, 2010

Oddly enough, saulgoodman, we seem to be on the same page, i.e. Obama is arguably departing from a campaign promise here, but it was a bargain he had to make, and he's basically done what he said he would most of the time, so dammit, cut the man some slack.
posted by valkyryn at 12:08 PM on July 16, 2010

What Everyone Needs to Know About Later Abortions
posted by homunculus at 4:15 PM on July 30, 2010