Reproductive Health In The House Bill

Following up on an earlier item, Dana Goldstein takes a look at the House Tri-Committee health care bill, with respect to reproductive rights:

• An expert medical commission led by the surgeon general will decide what services must be covered by the public plan and all private plans operating within the new Health Insurance Exchanges. This is a victory for reproductive rights organizations, which were worried that if such decisions were left up to the Health and Human Services secretary, access to contraceptives and abortion would be limited under future anti-choice administrations.

• The bill mentions "family planning" coverage both in the context of Medicaid and the public plan, but uses a definition of "family planning" that excludes abortion. So it refers explicitly to contraceptive coverage, but not to abortion coverage.

• Yet according to Democrats' summary of the bill, the public plan will "meet the same benefit requirements and comply with the same insurance market reforms as private plans." This could be interpreted as friendly to contraception and even abortion coverage within the public plan, since 90 percent of all current private health plans cover abortion at least in some cases, and 89 percent cover contraception.

• Medicaid currently covers only very poor women and their kids. Under this plan, all individuals and families within 133 percent of poverty are eligible for the program, a huge expansion. But as expected, nothing in the bill appears to threaten the Hyde Amendment, which currently bans Medicaid from paying for abortions. So we could be looking at a public plan that has generous reproductive health coverage, alongside a Medicaid plan for the poorest Americans that continues to severely limit states when it comes to abortion and contraception benefits.

Goldstein has written about how Democrats don't have the votes to overturn the Hyde Amendment right now. The question is whether the other side has the votes to extend it. Just this morning I heard a Louisiana Congresscritter fulminating about "taxpayer-funded abortions," despite the fact that the public plan in the House bill is designed to be self-sustaining, meaning that not one dime of taxpayer funding would go to anything the public plan covers. I'm waiting for this to go full-blown and hear everyone in the conservative noise machine go to 11 on it. We'll have to be ready.