A Woman’s Guide to Proposed Health Care Reform

Photograph by George Doyle/Getty Images.

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This article is part of Double X's ongoing coverage of health insurance woes. Read Sarah Wildman's story about being denied coverage for her maternity care, readers' tales of health insurance woes, Diane McWhorter's troubles with condescending doctors, and Linda Hirshman's take on whether Sarah Palin could kill health care reform.

In Europe and Canada, governments subsidize everyone’s health care, and insurance covers controversial procedures like abortion and sex changes. At the end of the day, Western Civilization continues to trudge along just fine, thank you very much.

But this is America. Congress broke for summer recess with four out of five pieces of health reform legislation completed and passed out of committee—but with the crucial Senate Finance Committee continuing to dally. And according White House health policy czar Nancy-Ann DeParle, at the top of the list of disagreements among that committee’s bipartisan Gang of Six is abortion. Should health reform legislation refer to the procedure at all, and if so, by protecting access or denying it?

There are other issues at stake as well in the health reform debate specific to women. Here then, is your DoubleX guide to the potential benefits and pratfalls of the various proposals for the health care overhaul.

Abortion Access: During a July 23 webcast intended to mobilize anti-abortion activists against the health care overhaul, Focus on the Family founder James Dobson said, “The health care bill being advanced by Congress is the abortion advocates' dream come true.” A coalition of religious right organizations launched the website Stop The Abortion Mandate, which claims health reform would force all private insurers to cover abortions, and that doctors would lose their jobs if they refused to perform the procedure. After reform, “insurance companies will have to ensure there are abortionists readily accessible in every region,” the site threatens.

The truth is far more nuanced. The health reform bills in front of Congress do not include lists of medical procedures that insurance companies must cover. None of the legislation even mentions the word “abortion.” If reform passes, an independent council of medical experts, led by the surgeon general, will advise Health and Human Services Secretary Kathleen Sebelius on what basic services private and public insurance plans must cover. The much-feared “abortion on-demand” is unlikely to make the cut. Not only is the issue politically combustible, but most existing private plans cover abortion only in cases of risks to the mother’s health or severe developmental disabilities in the fetus.

What’s more, President Obama has already said he supports a “robust conscience clause” protecting the rights of doctors and nurses to refuse to offer abortions or sterilization, as long as they are willing to refer patients to providers who do offer those procedures.

Reproductive rights advocates are actually playing defense in the health reform battle. Right away, they agreed not to pressure Congress or the White House to overturn the Hyde Amendment as part of reform. This is the law that, since 1976, has prevented Medicaid from funding abortion. Additional bans against abortion coverage for federal employees, women in the military, Peace Corps volunteers, and female prisoners will also be left untouched by the health legislation emerging in the House and Senate.