The XX Factor

Choose Between Health Care and Abortion

Remember those conservatives who don’t want the government interfering in health care plans? Right, well, it turns out what they meant was they don’t want the government interfering in health care plans, except when it comes to abortion. At that point, the government can interfere to its heart’s content.

And it looks the government will, in fact, interfere, because in a bid to win pro-life Democrats’ votes for the health care reform bill, Democratic leaders have agreed to allow a vote on an amendment that would ban both the public plan and private insurance plans that receive federal subsidies from covering abortions. With the support of all the House’s Republicans and dozens of its Democrats, the amendment is expected to pass .

That means low- and middle-income women who qualify for government subsidies, along with the legions of women who will buy insurance on the exchange because they are either self-employed or employed by small businesses, won’t be able to get plans that automatically include abortion coverage.

They could, in theory, pay out of pocket for a “rider” that would extend their coverage to include abortion. But Stupak-Pitt foes say the rider option is a charade , because most insurance companies won’t even offer it. Businesses don’t like to sell products that don’t have a market, and the market for something like an abortion rider-essentially a plan for an unplanned pregnancy-is notoriously slim.

All of this congressional wrangling won’t change the coverage of women who already have employer-based insurance plans. The Stupak-Pitt amendment doesn’t affect corporate plans, so women who have abortion coverage will continue to have it, as long as their employers stick with the same insurance provider.

And most employer-based plans-87 percent, according to a 2002 Guttmacher survey -do cover abortions. That’s not rape-and-incest-only coverage; it’s for the intentionally broad category of “medically necessary and appropriate” abortions.