Guttmacher Institute Analyzes Health Care Legislation's Implications for Reproductive Health

Guttmacher Institute news release: The New Health Care Reform Legislation: Pros and Cons for Reproductive Health:

For the nation’s consumers and providers of reproductive health care, and for advocates of reproductive health and rights, the health care reform legislation just enacted is something of a mixed bag. The bill’s onerous abortion restrictions have been rightly denounced by reproductive rights supporters. New funding for evidence-based sex education was regrettably paired with the retention of a failed and discredited abstinence-only program. But, taken together, a number of other provisions in this sweeping measure constitute a clear and significant step forward for the reproductive health of America’s women and men.

Abortion: Insurance Coverage Now an Endangered Species

The bill’s restrictive abortion provision is putatively designed to uphold the status quo on the question of federal funding. Accordingly, federal funds—in this case, subsidy dollars for individuals purchasing insurance plans on the new health care “exchanges” that are slated to become operational in 2014—may not be used to pay for abortion coverage (except in extreme cases), but individuals, at least in theory, may purchase a plan that includes abortion coverage so long as the abortion coverage itself is paid for with their own money. (This mirrors the Hyde Amendment, under which federal Medicaid dollars may not be used to pay for most abortions, but states may cover the procedure for their Medicaid recipients using their own funds.)

In practice, however, the complex, politicized arrangements the legislation necessitates militate heavily against the likelihood that many such plans will be purchased—or even offered. . . .