Boehner Attacks Fee Provision, But Claim Comes Up Short

by Kasie Hunt
Friday, Nov. 20, 2009

House Minority Leader Boehner claimed Thursday that the Senate Democrats’ health bill would make Americans who buy public insurance coverage pay a fee to help the plan cover abortion. The problem? The provision he’s attacking won’t dictate premium costs at all.

“Senate Majority Leader Harry Reid’s … massive, 2,074-page bill would levy a new ‘abortion premium’ fee on Americans in the government-run plan,” said a post on Boehner’s leadership blog said under the headline: “Sen. Reid’s Government-Run Health Plan Requires a Monthly Abortion Fee.”

Boehner attacked a Senate provision that outlines how insurance companies and any public option are required to separate federal money from private premium contributions, a measure aimed at making sure government money doesn’t cover abortions. Under the long-standing Hyde Amendment, federal money can only pay for abortion services in the event of rape, incest or to save the life of the mother.

The provision requires that companies calculate the actuarial value of a plan’s abortion coverage and put at least that much private money — collected from individual premiums instead of government subsidies or tax credits — into a separate account. Abortion claims must be paid from this separate account, and companies “may not estimate such a cost at less than $1 per enrollee, per month.”

Boehner pointed to that section as proof of the fee. But the provision doesn’t dictate coverage requirements, which would affect premiums. It just tells plans how much money needs to be set aside in the separate account to ensure there are enough strictly private funds to pay for abortion services — and the money in the account can be used to cover the full range of healthcare services in addition to abortion.

“In no way do these funds have to be used for abortion services, but this is to ensure that in case an individual elects to have an abortion, it will be paid for with the private funds and not the federal funds,” a Democratic aide said.

Under the Senate bill, the HHS secretary would decide whether the public plan would cover abortions prohibited by the Hyde Amendment. The actuarial value of the plan, and therefore its premiums, would be determined without regard to these separate accounting rules, a Democratic aide said.

Abortion-rights supporters say the section is actually a safeguard that makes sure that an insurance company always has enough strictly private money to cover any abortion services its enrollees claim.

“This was something that was meant to meet the concerns of the pro-life groups,” said Emily Kryder, spokeswoman for Rep. Lois Capps, D-Calif. Capps was the primary author of the language the Senate ultimately accepted.

Republican leadership aides argue the structure means every person enrolled in the plan would end up contributing to the account and therefore paying for abortion. “They’re directed at a very minimum to put in a dollar, per enrollee, in a separate account for the purpose of abortion services. Where would that dollar come from if not from the premium?” a leadership aide said.

The provisions related to the accounts are part of a structure to handle abortion that anti-abortion advocates dismiss as an “accounting gimmick.” In his post, Boehner said that if the public plan covers abortion, “the premium will be paid into a U.S. Treasury account — and these federal funds will be used to pay for the abortion services.”

Anti-abortion rights groups argue private money becomes government money as soon as an individual pays a premium to the public plan. “It is literally impossible for the public option to pay for abortions without using public funds, because all of the funds spent by the public option will be federal funds,” said Douglas Johnson, the legislative director for the National Right to Life Committee. “The ‘abortion surcharge’ is part of this hoax,” he said.

Rep. Bart Stupak, D-Mich., whose more restrictive abortion amendment was adopted by the House in its overhaul, dismissed the Senate language. “This language is a significant departure from current law in several ways, including the fact that it would mandate abortion coverage for the first time in history,” he said, referring to the Senate bill’s requirement that at least one plan offered in the new exchanges offer abortion coverage.

Abortion-rights supporters say the strict separation of private premiums from federal dollars meets the Hyde Amendment’s test and that the Stupak amendment would fundamentally change the status quo.

by Kasie Hunt