As we saw with 2011’s targeted regulation of abortion providers (TRAP) bill, the Republican-dominated Pennsylvania legislature routinely ignores protests from medical associations and professionals in passing bad-faith bills that politicize and endanger women’s health.
Now, Republican Gov. Tom Corbett, already suffering low approval ratings in large part because of a significant gender gap, is poised to sign HB 818. The bill intrudes on the free market by prohibiting private insurance companies that plan to sell health-care plans through Pennsylvania’s forthcoming state health insurance exchange from covering abortion, even in cases of medical emergency, health of the mother, and severe fetal anomaly.
Even more troubling, lawmakers supporting HB 818 are attempting to deceive the public by offering a non-solution: allowing Pennsylvania women to purchase abortion-specific riders from private companies not participating in the exchange.
The problem is that such abortion riders do not appear to exist.
Even though the state exchange, established by the Affordable Care Act (ACA), won’t be set up until next year, Pennsylvania lawmakers have been working on versions of the bill since Corbett’s first week in office back in 2011.
The bill’s sponsor, state Rep. Donna Oberlander (R-Clarion/Armstrong), insists HB 818 simply underscores existing policy that already prohibits tax dollars from funding abortion. There’s no reason for the “small government” party to propose redundant legislation—except, of course, as cover for something else.
HB 818 doesn’t address tax dollars, which are indeed not allowed to be used to fund abortions (except in cases of rape, incest, and endangerment to the life of the mother) under the Hyde Amendment, Pennsylvania state law, and terms set within the ACA. What it will do is require businesses participating in the health-care exchange to offer sub-standard insurance plans to women—which, in turn, means the hundreds of thousands of Pennsylvania women expected to purchase coverage through the exchange won’t be able to spend their own money to purchase industry-standard medical care through the exchange.
No Health Exceptions
Tinkering with the free market in order to bully insurance companies into economically hijacking working women’s constitutional right to abort an unwanted pregnancy is bad enough, but HB 818 goes even further, restricting physician-advised terminations of wanted pregnancies complicated by unexpected disease or accident.
Pennsylvania lawmakers explicitly rejected an amendment to add health of the woman as an exception to the narrow restrictions, which only allow abortion coverage “where necessary to avert the death of the woman” and in cases of incest and rape, providing the rape victim already reported the assault to the authorities. (The fact that many victims often don’t report aside, protocol of communication between police, insurers, doctors, and patients is unclear.)
When lawmakers voted against a medical emergency amendment offered by state Sen. Judy Schwank (D-Berks), they voted against insurers covering the expense of medically advised terminations in cases when a pregnant woman faces, for example, a cancer diagnosis, diabetes, a car accident, or discovers a severe fetal anomaly.
“Let’s say a woman was pregnant [and] her water broke prematurely and the baby would not survive. She would not be able to get an abortion,” Sen. Schwank told RH Reality Check. At least, not without paying out-of-pocket for the procedure, which could cost tens of thousands of dollars.
“These are already tragic situations,” said Schwank. “These are babies that are wanted, and to have to add this anguish on to the situation. … I can’t understand why we couldn’t get this through.”
“Certainly I understand that there are extenuating circumstances,” Oberlander said in a PCN interview defending the bill. “However, [a health exception is a] loophole wide enough you can ride a semi truck through. Women experience a lot of different issues and side effects from a pregnancy.”
Seemingly frustrated with questions about the bill, Oberlander added, “It’s not rocket science.” Well, it’s not medical science, either; it’s religion-based health care influenced by special interests. Specifically, the Pennsylvania Catholic Conference, the public affairs arm of Pennsylvania’s Catholic bishops, and the Catholic dioceses of Pennsylvania lobbied hard for HB 818 and against the health amendment.
“I hear it in my colleagues,” state Sen. Vincent Hughes (D-Philadelphia/Montgomery), who has spoken out against the bill, told RH Reality Check, “the frustration that they continue to get [calls from the Catholic Conference], especially since the Affordable Care Act took care of everything in terms of public funding. No matter where it comes from, no public funding can be utilized for abortion.”
Two Democrats, state Sens. Tim Solobay of Canonsburg and Richard Kasunic of Fayette and Somerset, voted against the health amendment, which lost by two votes.
Rep. Oberlander also insists the bill is “consistent with the will of the people.” But 2011 polling conducted by Susquehanna Polling & Research reveals otherwise. When asked whether or not they support insurance companies participating in the exchange covering abortion “to protect the health of the woman,” 79 percent of respondents said yes.
What Abortion Riders?
To compensate for the sub-standard care they’ve mandated with HB 818, lawmakers say that Pennsylvania women will be able to purchase abortion-specific riders from private companies not participating in the exchange.
“If someone wanted to buy abortion coverage, they could do that through a rider in a separate company,” said Oberlander in the same interview.
From the bill:
Nothing in this section shall prohibit an individual from purchasing optional supplemental abortion coverage provided the individual pays a separate premium for the coverage outside of the health insurance exchange.
Forget, for now, the logical absurdity of women purchasing abortion-specific insurance for an unplanned pregnancy. Given the lack of a health exception, it’d be prudent for women planning a pregnancy to purchase the rider, so they would not have to pay tens of thousands of dollars out-of-pocket in the event an unforeseen illness or complication.
So how much would an abortion-specific rider cost?
“It seems these riders don’t exist,” said Elizabeth Nash, state issues manager at the Guttmacher Institute. “Most of these states that have some kind of restriction on private health plans allow for these riders, but there’s no evidence they exist.”
“That suggestion by the proponents was a joke,” echoed Andy Hoover, legislative director of the American Civil Liberties Union of Pennsylvania. “That type of abortion-specific policy doesn’t exist, and the suggestion that it will come into existence once the exchange starts is ludicrous.”
“It doesn’t exist,” confirmed Sen. Schwank, who offered the defeated health amendment. “My staff made some calls to insurers, and realized that it’s not something that is available.”
With HB 818, Pennsylvania is trying to legislate the gender discrimination that the ACA was drafted in part to eradicate back into state law. Pennsylvania, after all, is one of the 37 states that currently allows gender rating, which means charging women more than men for identical coverage.
It’s no oversight. The same language—and fake solution to the problem of their own making—was in the version of HB 818 drafted back in 2011.
Photo by Alexandra Lee released under a Creative Commons license.