Slate: Why Stupak is Wrong

Slate: Why Stupak is Wrong
Because this keeps coming up and needs addressed, Slate's Timothy Noah explains:

"If you go to Page 2069 through Page 2078 [of the Senate bill]," Stupak told George Stephanopoulos on March 4 on Good Morning America, "you will find in there the federal government would directly subsidize abortions, plus every enrollee in the Office of Personnel Management-enrolled plan, every enrollee has to pay a minimum of one dollar per month toward reproductive rights, which includes abortions." Stupak is here referring to the exchanges created under health reform and to a nonprofit plan managed by the Office of Personnel Management that would be sold through the exchanges. The latter was a consolation prize to supporters of a public-option government health insurance program that didn't make it into the bill.
Let's go to Page 2069 through Page 2078 of the Senate-passed bill. It says, "If a qualified plan provides [abortion] coverage … the issuer of the plan shall not use any amount attributable to [health reform's government-funding mechanisms] for purposes of paying for such services." (This is on Page 2072.) That seems pretty straightforward. No government funding for abortions. (Except in the case of rape, incest, or a threat to the mother's life—the same exceptions granted under current law.) If a health insurer selling through the exchanges wishes to offer abortion coverage—the federal government may not require it to do so, and the state where the exchange is located may (the bill states) pass a law forbidding it to do so—then the insurer must collect from each enrollee (regardless of sex or age) a separate payment to cover abortion.
The insurer must keep this pool of money separate to ensure it won't be commingled with so much as a nickel of government subsidy. (This is on Pages 2072-2074.) Stupak is right that anyone who enrolls through the exchange in a health plan that covers abortions must pay a nominal sum (defined on Page 125 of the bill as not less than "$1 per enrollee, per month") into the specially segregated abortion fund. But Stupak is wrong to say this applies to "every
enrollee." If an enrollee objects morally to spending one un-government-subsidized dollar to cover abortion, then he or she can simply choose a different health plan offered through the exchange, one that doesn't cover abortions. (Under the Senate bill, every insurance exchange must offer at least one abortion-free health plan.)
One dollar exceeds health insurers' actual cost in providing abortion coverage. In fact, it's entirely symbolic. The law stipulates that in calculating abortions' cost, insurers may consider how much they spend to finance abortions but not how much they save in foregone prenatal care, delivery, or postnatal care. (This is on Pages 2074-2075.) This is to keep insurers from pondering the gruesome reality—one they surely know already—that covering abortions actually saves them money. For health insurers, the true cost of abortion coverage is less than zero, because hospitals and doctors charge less to perform abortions than they do to tend pregnant women before, during, and after childbirth. (Ironically, only the Senate bill—not the House bill—provides some small counterweight to this calculus by increasing aid for adoption assistance.)
What really rankles Stupak (and the bishops) isn't that the Senate bill commits taxpayer dollars to funding abortion. Rather, it's that the Senate bill commits taxpayer dollars to people
who buy private insurance policies that happen to cover abortion at nominal cost to the purchaser (even the poorest of the poor can spare $1 a month) and no cost at all to the insurer. Stupak and the bishops don't have a beef with government spending. They have a beef with market economics.

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