The Abortion Deal That Saved Health Care: What's in It

After two days of back and forth, we finally have a definitive word on Bart Stupak: he's a yes and the final votes for health-care reform have been clinched.

Stupak announced at a press conference moments ago that he will support the health-care-reform bill after working with the White House on an executive order that bars the use of federal funding in abortion coverage.

I just read through the agreement (available here) and, from what I can tell, it's basically a guarantee that the Nelson language passed by the Senate will be really well enforced.

Here's a basic summary of what the Nelson language does and how it's different from Stupak's: 

[Under the Nelson plan] insurers that wanted to cover abortion would be required to collect two payments from every enrollee. One would go into a general fund, one would go into a fund that exclusively covers abortion. Every enrollee in a plan covering abortion—male or female, regardless of whether they wanted abortion coverage—would need to pay into both funds, the idea being the separate payment is not a rider but rather a standard part of the premium that must be paid separately. Insurers would be barred from advertising the breakdown of payments: in promotional materials, one would only see the lump sum premium payment advertised. Enrollees would learn of the breakdown after they signed up "as part the summary of benefits ... at the time of enrollment," according to the amendment.

What the executive order adds to these provisions is a guarantee that they will be taken seriously in terms of enforcement. The president's order directs the Office of Management and Budget to, within six months, create

Make no mistake, Stupak did not get the original abortion restrictions for which he had pushed. Those who want abortion coverage on the newly created exchanges will not have to purchase it specifically as a rider, as his law would have required.

The executive order reiterates a current law, called the Hyde Amendment, that has been at the focus of much of this debate. It was passed in 1976 in the wake of 1973's Roe v. Wade that bars federal funding of abortions except for cases of rape, incest, or the life of the mother. The restriction, arguably, weighs most heavily on the availability of abortion coverage in Medicaid, although 23 states allow state funding of Medicaid abortions in more expansive circumstances.

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