More on Abortion in Health Insurance
This debate is moving into a rather fascinating area. Until this debate, I knew nothing about the extent to which private insurance companies paid for abortion. I admit it. If you told me it was never covered, I would have believed it. And the vehemence of the opposition to abortion coverage in plans in the exchange suggested that it was rare, if not non-existent, in the private sector.
Except that it isn’t. We have entered a phase in the debate whereby people are arguing over private coverage of abortion. The source of the data is the Guttmacher Institute. They claim that 87 percent of employer-based insurance plans cover some form of abortion, and they say specifically that plans that restrict their coverage to the hard cases (rape, incest, life of mother) are rare. On the other hand, Guttmacher says that only 13 percent of abortions are directly billed by abortion providers to private insurance companies. There could be many reasons for the difference, including restrictions in the plan, the private nature of abortion, and seeking reimbursement directlty.
All sides are seizing on it. Guttmacher, who wants to argue that abortion is a normal health service, is saying that it underestimates the amount of abortions paid for by insurance as it excludes those who obtain reimbursement from their insurance company themselves (and I certainly do this all of the time in my health care plan). They also note that 13 percent of abortions are paid for by Medicaid – despite the Federal ban, the government has winked at state wiggle room for years.
At the same time, many on the right are saying that the 13 percent numbers shows that abortion is not an important aspect of health insurance. This line of reasoning surprises me, as they are shooting themselves in the foot. If we can dismiss concerns about abortion funding private insurance so blithely, then we can dismiss concerns about the plans in the exchange, as they will only follow the industry standard. Conversely, if there is a problem with abortion coverage in the exchange, there is a problem with private insurance. It’s two sides of the same coin.
This is obvious. Why do so many miss it? What explains the great willingness to remove the splinter from the government’s eye while ignoring the plank in the eye of private enterprise? Is it the dominant laissez-faire ideology of individualism? Notice how many people on the right who chew out the health care plan for covering abortion make references (sometimes inadvertently) to phrases like “socialized medicine” and “government take-over of medicine” phrases with no relationship to reality. Does this guide their approach?
The reality is, private insurance has its hands dirty with the abortion industry. We can debate how dirty, but we cannot skirt over this basic fact. We recently learned that the Republican National Committee (RNC) has covered abortion since 1991. Why did we not know this for 18 years? (Ironically, the RNC policy also covers consultations on end-of-life issues – something that Sarah Palin once referred to as death panels!) Of course, Michael Steele immediately moved to end the abortion coverage, but what does this prove? You can be sure that if this insurer is covering abortion for the RNC, it is covering abortion for a lot more people too. The RNC’s premiums are still going into the same corporate pot that is paying for abortion. That is what happens when you have a few large insurers that dominate the industry. We are all tainted by that association.
Don’t get me wrong, I think the Stupak amendment is great. It’s great precisely because it does not keep the status quo, but pushes the insurance industry in pro-life direction. But this is far bigger than healthcare reform. To me, this is the great lesson of this peculiar debate. Shouldn’t we start applying pressure on the private insurers directly? Are there any grassroots campaigns out there to boycott offending insurers - or will be pro-life movement continue to focus only on “socialized” medicine?
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Shouldn’t we start applying pressure on the private insurers directly?
That would be interfering in the private market.
Good point. This blog should lead the pro-life fight on this.
Actually I would see this as an argument in favor of “socialized” or government-run health care, in that it has allowed us to raise the standards on how pro-life things need to be. It brings light to these practices, and a place on which to focus the pressure.
This raising of standards is a case in the point that we cannot rely on the market to bring about virtuous behavior.
I think probably part of the problem is that like you, most people had no idea that their insurance covered abortion. Determining coverage is a frustrating and elusive task for most people, and so determining what their plan says, much less other plans, is extraordinarily difficult. The reform plan is in the news, is a single plan, and there are smart people who can go through and tell you in simple form what exactly it says, allowing for a response.
I do think there should be pro-life plan, though trying to buck the established system will be a difficult task particularly in this economy. I agree with you though; this is a fascinating outshoot of the abortion debate. Perhaps this will give us a new area of the abortion politics: going after the money, specifically attacking private insurers who fund abortion.
I know there is a pro-life mutual fund company (Ave Maria Funds, I believe?) that doesn’t invest in companies that donate to Planned Parenthood. A pro-life health insurance company would seem to be a project that’s crying out for a hardy young Catholic entrepreneur.
During the Bush Admin, OSF Health, a unit of the Sisters of the Third Order of St. Francis, set up a health plan in IL that would accord with church teaching. It’s open to federal employees:
http://www.nytimes.com/2004/09/25/business/25care.html?_r=1&th
Some interesting details:
Currently, 23 states require contraceptive coverage, although 14 states provide for an exemption for employers or insurers that object on religious grounds.
A number of Catholic health plans have covered reproductive services including contraception; vasectomies; tubal ligation, which prevents pregnancy; and sometimes abortion, often under Medicaid laws and typically through a non-Catholic partner like a Blue Cross plan.
Indeed, members of other OSF Health plans in Peoria, including one with 4,067 federal employees, have access to contraceptive coverage, although not abortion coverage, through a separate third-party payer.
If Wyden-Bennett were passed as health reform, any citizen could sign up for the plan. It has a relatively high deductable (although lower than what I have from work) and a health savings account.
A pro-life health insurance company would seem to be a project that’s crying out for a hardy young Catholic entrepreneur.
There might be general agreement among “conservative” Catholics about what a pro-life insurance plan would and would not cover. But is there unanimity among “pro-lifers” in general? NRLC does not take a position on contraception. I would imagine many who are pro-life would have no problem at all with artificial insemination. A purely Catholic plan might be more restrictive than non-Catholic pro-lifers would be happy with.
If you can put pretax earnings in Flexible Spending Account (FSA) and withdraw them later to pay for an abortion (which you can), is the government giving a tax break to abortions by allowing this?
Determining coverage is a frustrating and elusive task for most people, and so determining what their plan says, much less other plans, is extraordinarily difficult.
Michael,
If you can’t find out by checking your benefits on the insurance company web site, all you need to do is call the phone number on the back of your insurance card and say, “Do you cover elective abortion?” It really isn’t difficult at all.
“The RNC’s premiums are still going into the same corporate pot that is paying for abortion. That is what happens when you have a few large insurers that dominate the industry. We are all tainted by that association.”
Yup.
Zak Says:
During the Bush Admin, OSF Health, a unit of the Sisters of the Third Order of St. Francis, set up a health plan in IL that would accord with church teaching. It’s open to federal employees
Actually, this plan opened up abortion coverage to federal employees, without a wimper of objection from the NRTL Committee.
The Christus Medicus Foundation is a pro-life group that has been urging insurance reform in the pro-life direction for many years. I think if you look at it you might have some principles in common.
I think I could live with their proposed amendment.
Actually, just asking whether your plan covers “elective abortions” will probably not give you the right answer. With coverage questions you are dealing with a complicated set of medical, insurance, and legal definitions.
Some policies, for example, do not specify “abortion” as a covered procedure, but include it under “maternity care.” (Ironic, I know.)
In my state, policies can only cover abortions necessary to save the life of the mother. However, the largest insurer calls those “therapeutic” abortions. In other contexts, and maybe even by other insurers, “therapeutic” means for elective reasons or for any “health” reason.
This is one reason why the reports on how many policies cover abortion have been inconsistent.