Tuesday, November 17, 2009

And now a message from the wonk portion of my brain

Over the past few months I have mostly had my fingers in my ears when health reform talk was in the air. This has been hard to do, as health insurance reform has been topic #1 for much of the past six months. It has been in the news for good reason. What other time in my lifetime has there actually been so much change actually likely to happen? Never. So, not a good time for me to be singing "la la la la" instead of listening to the news on this. Also, I am a health policy wonk, professionally, so I have a vested interest in health reform news. But for almost six months I've been a policy wonk on leave, so I have not really paid the attention I would have if I had been working the past six months.

(now that I know my mother reads the blog, I am a little embarrassed to admit this in front of her, policy/research wonk that she is. Oh well. It is still true.)

Even in my news gray zone, certain pieces of the reform process have gotten my attention. I can't help pay attention to news about a potential public plan, after all the discussions we have had here in Oregon on that topic. The idea of a health insurance exchange is also key for me. It looks like I will be doing some work on that when I return to my job in a couple of weeks. And the past week or two, I have been listening to the news about the Stupak Amendment, which would not allow insurers to offer abortion as a covered benefit in the insurance offered to people who access federal financial premium assistance.

This is a sneaky way to limit access to abortion, and not just for low and middle income Americans. Of course, it does limit access to abortion for people who will get federal subsidies for their insurance purchase (by refusing to allow it to be a covered service). But it actually goes further. As people who get help paying for insurance premiums will have to buy through a health insurance exchange, it effectively eliminates abortion as a covered service from any insurance purchased through exchanges, whether or not the purchaser uses a subsidy. Exchanges will be open to people buying coverage on their own, with no financial help from the government. But no insurance company is going to offer one package for people getting subsidies, and another almost-but-not-quite-identical-except-with-abortion-coverage to people paying on their own. Since insurers will have to exclude abortion for some, they aren't going to include abortion in an otherwise identical insurance package for others. It just doesn't make financial sense for the insurance companies.

Proponents of this amendment say that people could always buy a separate insurance rider for abortion. But who is going to do that? How many women think "gee, I'd better plan for the possibility of a catastrophic pregnancy that needs to be terminated at 22 weeks in order to avoid threatening my health or life!"? No one thinks that, and pretty much no one is going to buy this kind of special coverage. (Plus, people who - due to past health issues - know it is likely that they'd need this are going to be high risk, making premiums for such insurance costly, and further dissuading others from buying it.) This rule would shut down abortion coverage for a big chunk of Americans. Given that most Americans who purchase insurance in the individual market have abortion as a covered service, this will be a big change.

Yes, I am annoyed.

I expressed my annoyance by signing a petition sponsored by California Senator Barbara Boxer. Despite what the conservatives say, Boxer is a moderate, not a crazy flaming liberal (not that there is anything wrong with flaming liberals. I and some of my best friends are crazy liberals).

My fellow countrymen and women can sign a petition against the Stupak Amendment here. You can also write or call your legislators to let them know what you think about this. (Click these links for contact info for your senators and representatives.)

Maybe I am ready to go back to work after all.


  1. I haven't had the brain power for a lot of these details lately bit this one caught my attention right away. Sneaky is putting it nicely. I can't believe time has passed so quickly (says she who does not have twin babies) that you will be working again soon. On the other hand, it's great that you are working on such important change at such a pivotal time!

  2. Nora, I want to say a LOT on this, but most importantly, I want to say that I am glad you're going back to work. We need good peeps working on health care now, and you're one of them. (And I'm not just saying that as one of your crazy liberal friends.)

  3. this infuriorates me also. thanks for the info on how and where to complain.

    as Nancy Pelosi said, "being a woman is not a pre-existing condition". all women's services should be covered. period.

  4. Thanks for this. And I signed.

  5. If I was American, I'd sign. As it is, I'll just have to sigh and tut. The marriage of "church" and state in the US and its consequences, at home and abroad, continues to bemuse me.