Newswise — The Stupak/Pitts Amendment was added to the Affordable Health Care for America Act (H.R. 3962), which passed the House on November 7th. The amendment bans federal funding for abortions and bars payment of federal subsidies to health insurance products sold in exchanges that cover most medically indicated abortions.
An analysis conducted by the GW School of Public Health and Health Services’ Department of Health Policy, concludes that the Amendment would produce industry-wide effects, leading to the elimination of health plan coverage for nearly all medically indicated abortions. Although the Amendment appears to address only plans that receive federal exchange subsidies, even health plans sold to private, large employers that purchase outside the exchange ultimately are likely to be affected, the analysis concludes. These findings are based on an assessment of the extent to which the health benefits services industry adjusts its products over time to conform to the regulatory environment in which it operates.
"Under national health reform, millions of women, including women who are covered by small employers (as employees or spouses or dependents of employees) as well as those who are currently uninsured, will receive their coverage through health insurance exchanges. By barring the sale of subsidized products that cover medically indicated abortions as part of a broader package of benefits, the Amendment can be expected to cause the industry to re-design its offerings in order to avoid violating the legal restrictions on abortion applicable to exchange products that receive subsidies," said Professor Sara Rosenbaum, JD, lead author and Chair of the Department of Health Policy. "The Amendment also can be expected to chill efforts to develop supplemental coverage for medically indicated abortions, because it appears to prohibit the joint administration of both a basic and supplemental product," Rosenbaum noted.
The analysis also concludes that, based on past experiences with claim administration decisions involving treatment exclusions, insurers can be expected to interpret the exclusion broadly, excluding coverage of not only most medically indicated abortion procedures but also treatments for serious illnesses, injuries, and medical conditions that include an abortion undertaken for health reasons.
The analysis is available at http://tiny.cc/nBuDv
About The George Washington University Medical CenterThe George Washington University Medical Center is an internationally recognized interdisciplinary academic health center that has consistently provided high-quality medical care in the Washington, DC metropolitan area, since 1824. The Medical Center comprises the School of Medicine and Health Sciences, the 11th oldest medical school in the country; the School of Public Health and Health Services, the only such school in the nation’s capital; GW Hospital, jointly owned and operated by a partnership between The George Washington University and a subsidiary of Universal Health Services, Inc.; and the GW Medical Faculty Associates, an independent faculty practice plan. For more information on GWUMC, visit www.gwumc.edu.
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