When the House of Representatives agreed to adopt tight restrictions on the ability of lower- and middle-class consumers to purchase insurance that covers abortions, a team of researchers at George Washington University concluded that the legislation–the so-called Stupak amendment to the House health care bill–could have far-reaching consequences, including potentially eliminating abortion coverage in the insurance market completely, over time.
Now, the report’s lead author says that a new compromise in the Senate–adopted in a bid to secure the support of Sen. Ben Nelson (D-NE)–could have similarly significant ramifications.
“Taken together, the provisions of the amendment can be expected to have a significant impact on the ability or willingness of insurance issuers to offer Exchange products that cover a full range of medically indicated abortions,” writes Sara Rosenbaum, Chair of the Department of Health Policy at GWU, in a memo obtained by TPMDC.
Furthermore, as with insurance laws generally, and for the reasons stated in our earlier analysis, the amendment could be anticipated to have considerable spillover effects. This is because companies that issue insurance products (or administered products in the case of sales to self-insured plans) obviously desire to sell these products in as many markets as possible. If one purchaser market places significant restrictions on one or more aspects of product design, it is likely that sellers will attempt to design their products to a common denominator, so that the product can be sold across all markets in which the company desires to do business. This is particularly true with modern health insurance coverage products, where the concern is not only the coverage but the provider network through which coverage will be obtained. Negotiating the elements of such a product is extremely difficult, and it is just as difficult to have to explain to providers that some of their patients will be insured for certain medical procedures while others will not.
Pro-choice leaders in the House have already announced that they have grave reservations about the Nelson compromise. This finding is likely to heighten the reluctance of pro-choice activists and Democrats to accept the Nelson compromise, when the Senate and House meet to resolve the differences between their bills, and adopt a single piece of legislation.
You can read the entire memo here.