It appears that the Senate version of the health-care bill won’t include the Stupak Amendment. But assume for a moment that Pelosi decides the votes aren’t there in the House to pass a Stupak-less bill. How bad is that?
As I try to game the situation out, it seems to me that the answer is “Maybe not bad at all.”
Imagine that you’re running a health insurance company that offers individual policies through the exchanges. (Recall that group policies aren’t covered by Stupak.) You’re not allowed to cover abortion under your regular plan, but you’re allowed to offer a supplementary policy – a “rider” – to cover abortion services.
At first blush, this seems stupid; since no one plans to need an abortion, very few people will buy the rider.
But what happens when some of the women you insure get pregnant and wants to terminate? Since perinatal care plus delivery would probably cost you $2500, while a first-trimester abortion costs about $200, you’d be happy to provide the abortion coverage gratis if you thought that otherwise even as many as one in twelve of those women would choose to carry to term. You can’t provide it gratis; that’s what Stupak provides. But you could provide it cheap, even to someone who’s already pregnant. Charge $50 for the abortion-coverage rider, effective immediately.
Now I don’t know that the companies would do this, but it seems to me that doing it would be very much in their best interests. That makes the idea of threatening to scuttle the whole bill if Stupak stays in even more far-fetched than it would otherwise be.
Whether Stupak passes or not, the pro-choice forces ought to make a concerted move to challenge the Hyde Amendment status quo. Restoring Medicaid coverage may be a bridge too far, but it seems to me that getting rid of the ban on abortion coverage for women in the armed services and the female family members of those in uniform ought to be a fairly easy sell, with the Secretary of Defense and the service secretaries testifying that the current policy is bad for recruitment and morale and the brass hats testifying that it’s bad for readiness.