Blogs Comment on Abortion Coverage, Abstinence-Only Funding in Senate Health Reform Bill, Other Topics

November 20, 2009 — The following summarizes selected women's health-related blog entries.

~ "Two New Analyses Show Women Have 'Much at Stake' Under Stupak Amendment," Jodi Jacobson, RH Reality Check: Jacobson explains how two new reports -- one from the Kaiser Family Foundation and one from the George Washington University School of Public Health -- "show just how much" the Stupak amendment to the House health reform bill (HR 3962) "would undermine women's basic human rights to exercise choice over childbearing, to access comprehensive reproductive health care, to access abortions (a legal procedure in the United States) and to ensure they are covered by insurance for unanticipated pregnancy-related conditions that could, absent coverage, leave them and their families with enormous debt." According to the KFF report, "The House bill places a number of restrictions on coverage of abortion, with the most direct impact on the plans that will be offered in the new health insurance exchange." It is unclear whether insurers would offer the "abortion riders" allowed under the Stupak amendment or how much such riders would cost, the report says. It adds, "This complex combination of restrictions means that many women who will obtain coverage under health reform either through Medicaid or the exchange would have to pay for an abortion out-of-pocket, the cost of which varies depending on factors such as location, facility, timing and type of procedure." Jacobson continues that the GWU report "focused on the implications of the Stupak amendment for the health benefits industry on the whole, the growth of the public market for supplemental coverage and the implications for covering abortions that are a consequence of an unexpected condition." The report concludes that the Stupak amendment "will have an industry-wide effect, eliminating coverage of medically indicated abortions over time for all women, not only those whose coverage is derived through a health insurance exchange" (Jacobson, RH Reality Check, 11/19).

~ "Senate Bill Restores Abstinence-Only Funding," Sarah Kliff, Newsweek's "The Gaggle": The Senate health reform bill includes a provision that would restore funding for the Title V abstinence-only sex education program, which was allowed to lapse in June. If the language in the bill survives, the Title V program, which allocates $50 million to states annually, would be extended through 2014. The provision was added in the Senate Finance Committee via an amendment by Sen. Orrin Hatch (R-Utah). Abstinence-only groups praised Senate Majority Leader Harry Reid (D-Nev.) for including the language, according to Kliff. Kliff writes that she expects the language to survive, arguing that the most ardent backers of health reform will not jeopardize the bill over abstinence-only education. The language also could help in swaying the vote of Sen. Blanche Lincoln (D-Ark.), who supported the amendment in the Finance Committee and is undecided on health reform. Meanwhile, abortion-rights groups that oppose abstinence-only education are too busy fighting the bill's abortion restrictions "and likely do not have the resources for a serious two-front battle," according to Kliff (Kliff, "The Gaggle," Newsweek, 11/19).

~ "Pew: Abortion Low on List of Concerns for Healthcare Reform Opponents," Dan Gilgoff, U.S. News & World Report's "God & Country": Gilgoff writes that a new survey from the Pew Forum for People and the Press finds that "[a]bortion coverage is way down on the list of concerns of those who oppose Democratic-led health care reform." He continues that the poll shows a "majority of Americans -- 55% -- oppose abortion coverage as a 'guaranteed medical benefit' in a government-run health insurance plan, but just 3% of those who oppose Democratic-led reform volunteer abortion as their top concern." According to Gilgoff, "This is welcome news to Democrats, since the debate over how a government-managed health care plan should treat abortion coverage threatens to derail the whole reform effort." He adds, "But it's important to note what the Pew survey didn't ask: What qualifies as government-funded abortion?" Gilgoff writes, "There's general agreement in Washington that health care reform should maintain the status quo of no federally funded abortion." He concludes, "The argument is over what that actually means," and it would "be interesting to hear what the American people think" (Gilgoff, "God & Country," U.S. News & World Report, 11/20).

~ "Women in Their 40s Ponder Whether To Skip the Mammogram," Deborah Kotz, U.S. News & World Report's "On Women": Kotz writes, "I'm guessing that I'm not the only woman confused about" when to get a mammogram after the U.S. Preventive Services Task Force released new guidelines saying that most women should begin routine mammograms to screen for breast cancer at age 50, not 40 as previously recommended. She reports that she contacted Susan Love, a breast surgeon and clinical professor of surgery at the University of California-Los Angeles' medical school, who said Kotz should wait until she is 50, "provided I am not at a higher-than-average risk of getting the disease." Kotz writes that she then contacted Isaac Schiff, chief of obstetrics and gynecology at Massachusetts General Hospital, who said he is abiding by the old guidelines, as he "worries that the ... [new] recommendations are based on cost-effectiveness and the push to drive down health care costs." According to Kotz, Schiff said that getting diagnosed early "simply makes sense, since a smaller tumor often means a smaller biopsy, lumpectomy instead of mastectomy, less aggressive chemotherapy." Kotz adds, "Love would argue that while that may be true in some cases, it's not true all the time." Kotz writes, "Clearly, there's still a lot to be learned about breast cancer" (Kotz, "On Women," U.S. News & World Report, 11/20).

~ "Hold Off on That Mammogram," Mary Elizabeth Williams, Salon's "Broadsheet": Williams writes that while she is "skeptical of the new guidelines that have raised the suggested age to start getting mammograms to 50," there is also "plenty in the guidelines worth considering." She says that "the report does make a persuasive case that not all cancers are life-threatening and that 'over-detection' and 'over-treatment' pose their own -- often considerable -- health risks." However, the report also notes that false positives resulting from frequent mammography can cause anxiety for women. Williams writes that "given the choice between 'anxiety' or not living to see my children grow up, I'd go for the first one." Ultimately, after reviewing several factors in her own life that could put her at high risk for breast cancer, Williams says, "Every woman with an opinion about breast cancer has to figure out her own risks -- and share them with her doctors." She adds, "Blanket guidelines are just that -- they're fine for covering the many, and they are not laws we have to follow" (Williams, "Broadsheet," Salon, 11/18).

~ "Senate Health Bill Rejects Anti-Choice Extremes," John Nichols, The Nation's "The Beat": "The Senate health care bill unveiled Wednesday ... is not exactly the cure for all of what ails America," but "in many respects" the bill is "better" than the House version, Nichols writes. With regard to abortion coverage, the Senate bill is "dramatically better" because it omits the "draconian 'Stupak' language, which was written into the House bill with the intent of establishing radical new limits on access to reproductive health services," according to Nichols. While Senate Majority Leader Harry Reid's (D-Nev.) bill is hardly a "pro-choice bonanza" because "[i]t preserves existing limits on public funding of abortions," that concession could help Reid gain the votes needed to secure passage of the legislation, Nichols notes. "If the Senate passes the bill as written by the majority leader -- and that remains a big 'if' -- the Senate and House measures will then have to be reconciled in a conference committee," Nichols writes, adding that House Speaker Nancy Pelosi (D-Calif.) "will, unquestionably, need an assist from the White House" in order to gain sufficient support for the bill in the House (Nichols, "The Beat," The Nation, 11/19).

~ "Welcome to Abortion's Middle Ground," Tracy Clark-Flory, Salon's "Broadsheet": "There's nothing like an extreme assault on women's reproductive rights to make you truly appreciate moderation," Clark-Flory writes, referring to the abortion coverage restrictions in the Senate health reform bill, "which trades the House's stringent Stupak-Pitts language in favor of a limited ban on federal funding of abortions." The "key details" of the Senate bill are that both public and private insurance plans could offer abortion coverage, she writes, adding, "It empowers consumers to use government subsidies to purchase insurance that covers abortion, but requires that their premiums (and not federal funds) pay for the actual procedures." The bill is "a true compromise bill" because "now both sides have something to be unhappy about," Clark-Flory writes (Clark-Flory, "Broadsheet," Salon, 11/19).

~ "Health Care and Abortion Funding: Dealbreaker or No Big Deal?" David Gibson, Politics Daily's "Disputations": The "brain-twister for the day" comes from recent polls that "show that a majority of Americans do not want federal funds to subsidize abortion coverage," but "hardly anyone cites taxpayer funding of abortion as a reason they oppose health care reform packages under consideration in Congress," Gibson writes. He adds, "And yet abortion funding has become the make-or-break issue for health care reform." According to Gibson, a CNN poll released Wednesday found that 61% of respondents oppose federally subsidized abortion coverage, while a Pew Forum on Religion and Public Life poll released Thursday showed that 3% of respondents named the issue as their main reason for opposing health reform. "Either way, the overall numbers on health care reform are what count in the end, and on that score there was some good news for the reform camp," Gibson writes, adding that the Pew poll indicated that respondents favor current versions of health care reform legislation by a 42% to 39% margin (Gibson, "Disputations," Politics Daily, 11/20).