WASHINGTON —
The Senate health care bill contains sweeping new restrictions on abortion
coverage and defunds Planned Parenthood, setting up a complicated fight that
could potentially imperil its passage.
Under the
Better Care Reconciliation Act released by Republicans on Thursday, insurance
plans that customers can buy on the individual market with tax credits would be
banned from covering abortion services, with exceptions for rape, incest and
the health of the mother. The House bill contained a similar provision.
The Senate
bill also cuts off funding next year to Planned Parenthood, which is already
barred from receiving federal money for abortion but is reimbursed by Medicaid
for providing other health services.
The ongoing
policy standoff contains echoes of Obamacare’s passage in 2009 and 2010, which
featured a series of negotiations to bring pro-life Democrats on board who were
concerned that the bill’s new subsidies could be used to fund abortion.
“It was a
huge flashpoint which almost killed the bill in the House and Senate in 2010,”
John McDonough, a public health professor at Harvard who was a Senate aide at
the time, told NBC News. “That fight is erupting again.”
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Pro-choice
groups immediately condemned the bill, which would cause private insurers who
participate in the health care exchanges to drop abortion coverage en masse.
NARAL
Pro-Choice America President Ilyse Hogue decried the legislation as “a savage
attack on women’s healthcare.”
Making
matters more complicated, blue states like California and New York currently
require insurers to cover abortion. Unless the states changed their laws to
comply, the House and Senate bills would potentially block subsidies for all
insurance plans on the individual market.
IMAGE: Susan
Collins
Sen. Susan
Collins, R-Maine, speaks during a news conference on Capitol Hill in
Washington, Tuesday, June 21, 2016, to unveil a new gun legislation proposal.
Evan Vucci / AP
But there’s
a strong chance the abortion ban on private plans could be stripped by the
Senate parliamentarian for failing to meet reconciliation rules, which require
that legislative items directly impact the budget.
Key moderate
Republicans, including Sens. Susan Collins (R-Maine) and Lisa Murkowski
(R-Alaska), have also expressed opposition to the measure targeting Planned
Parenthood.
With these
challenges in mind, pro-life activists cautiously hailed the proposed
legislation on Friday.
“The Senate
discussion draft includes these pro-life priorities, but we remain very
concerned that either of these priorities could be removed from the bill for
procedural or political reasons,” Family Research Council President Tony
Perkins and Susan B. Anthony List President Marjorie Dannenfelser said in a
joint statement.
On Wednesday,
30 members of conservative House Republican Study Committee sent Senate
Majority Leader Mitch McConnell (R-Ky.) a set of four demands for any bill that
included defunding Planned Parenthood and the restriction on abortion coverage.
Leaving out the items “may jeopardize final passage” in the House, they warned.
Under the
longstanding Hyde Amendment, federal funding cannot go toward abortion.
President Barack Obama eventually worked out a compromise in which only money
from premiums could cover abortion through a separate fund, upsetting activists
on both sides of the issue, but securing enough key votes to enable the bill’s
passage.
Beyond the
abortion measures, reproductive health is emerging as a rallying cry for
Democrats and activists opposed to the bill.
Both the
House and Senate bills allow states to waive Obamacare’s requirements that
insurers cover items like maternity care, which was frequently left out of
private plans before Obamacare went into effect. According to the nonpartisan
Congressional Budget Office, the House’s changes could increase out of pocket
costs for pregnancy-related expenses by “thousands of dollars in a given year”
as a result.
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