Abortion coverage unchanged in high-risk plans, White House clarifies

A federal research agency earlier had concluded that the new insurance program for the uninsured was not subject to previous limits on abortion coverage.

By Doug Trapp — Posted Aug. 9, 2010

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The Obama administration has swiftly closed another potential health reform law loophole that the Congressional Research Service said could have allowed federally sponsored elective abortion coverage. By doing so, the White House again assuaged concerns from anti-abortion lawmakers and disappointed abortion rights advocates.

New federal high-risk insurance pools will not offer expanded abortion coverage but will maintain the long-standing Hyde Amendment restrictions that allow federal support for abortions only in the cases of rape, incest or medical conditions that pose a danger to the woman's life, according to a July 29 statement by Nancy-Ann DeParle, director of the White House Office of Health Reform.

She said President Obama is committed to maintaining the Hyde Amendment, which Congress first enacted in 1976. A March 24 Obama executive order clarified that health reform law regulations will follow the Hyde standards, though the law's language does not explicitly do so. Maintaining the compromise was key to securing enough votes from anti-abortion Democrats for House adoption of health reform.

Concerns about abortion coverage most recently were sparked by a July 23 Congressional Research Service report that concluded that subscribers to new high-risk health plans might be able to use federal subsidies in the program to buy coverage allowing elective abortions. However, the report cited a July 14 Dept. of Health and Human Services news release stating that the agency intended to maintain the Hyde restrictions in the high-risk pools.

A group of 13 Republican senators on July 28 sent a letter asking HHS Secretary Kathleen Sebelius to uphold the Hyde standards for the high-risk program.

The state high-risk plans are federally subsidized coverage for uninsured people denied health coverage because of preexisting conditions. The temporary program is a bridge to coverage expansions and insurance reforms taking effect starting in 2014. The national health reform law provided $5 billion for the program.

Anti-abortion advocates said they would continue to scrutinize implementation of the national health reform law. "Unless Congress repeals the health care law or performs major corrective surgery on it, there will be years of battles, as each new program is implemented, over how elective abortion will be covered," said Douglas Johnson, the National Right to Life Committee's legislative director.

Although DeParle tried to head off concerns about the high-risk pool's abortion coverage, she said the "program's restriction on abortion coverage is not a precedent for other programs or policies given the unique, temporary nature of the program and the population it serves."

A representative for Sen. Mike Enzi (R, Wyo.), who signed the July 28 letter to Sebelius, said he hopes the administration will continue to enforce the Hyde standards.

Abortion rights advocates, meanwhile, said they were dismayed that the White House compromised so quickly on coverage for women with serious medical conditions.

"These are the very women who are more likely to be subject to medically complicated pregnancies and in need of the full range of reproductive care, including abortion coverage," said Cecile Richards, president of Planned Parenthood Federation of America.

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State abortion limits

Several states have adopted new restrictions on public and private abortion coverage this year in reaction to the national health reform law.

Banning abortion coverage in state health insurance exchanges: Arizona, Louisiana, Mississippi, Tennessee

Banning or limiting abortion coverage in state employee health plans: Arizona, South Carolina

Increasing standards for counseling, consent or waiting periods for women seeking abortions: Louisiana, Nebraska, Oklahoma, South Carolina, Utah, West Virginia

Source: "State Legislative Trends at Midyear," Guttmacher Institute, July

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