nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
See here for more discussion.

Monday, March 8, 2010

Is Abortion Funded in the Health Care Reform Bill Or Not?  I Think The Answer is "Yes."

From the Senate Health Care Reform Bill, page 2070.
(Sorry, but this is a rough "go."  The legislative language is Obfuscation Supreme)

(B) ABORTION SERVICES-
(i) ABORTIONS FOR WHICH PUBLIC FUNDING IS PROHIBITED- The services described in this clause are abortions for which the expenditure of Federal funds appropriated for the Department of Health and Human Services is not permitted, based on the law as in effect as of the date that is 6 months before the beginning of the plan year involved.

(ii) ABORTIONS FOR WHICH PUBLIC FUNDING IS ALLOWED- The services described in this clause are abortions for which the expenditure of Federal funds appropriated for the Department of Health and Human Services is permitted, based on the law as in effect as of the date that is 6 months before the beginning of the plan year involved.

That is, there are plans that prohibit, and plans that allow, abortion funding.

(i) IN GENERAL- The Secretary shall assure that with respect to qualified health plans offered in any Exchange established pursuant to this title--

(I) there is at least one such plan that provides coverage of services described in clauses (i) and (ii) of subparagraph (B); and
(II) there is at least one such plan that does not provide coverage of services described in subparagraph (B)(i).

 
That is, the Secretary makes sure there's at least one plan of each type in the state.
 
(A) IN GENERAL- If a qualified health plan provides coverage of services described in paragraph (1)(B)(i), the issuer of the plan shall not use any amount attributable to any of the following for purposes of paying for such services:
(i) The credit under section 36B of the Internal Revenue Code of 1986 (and the amount (if any) of the advance payment of the credit under section 1412 of the Patient Protection and Affordable Care Act).

(ii) Any cost-sharing reduction under section 1402 of thePatient Protection and Affordable Care Act (and the amount (if any) of the advance payment of the reduction under section 1412 of the Patient Protection and Affordable Care Act).

That is, any credits or discounts can't be used for abortion if the plan doesn't cover it.

(B) SEGREGATION OF FUNDS- In the case of a plan to which subparagraph (A) applies, the issuer of the plan shall, out of amounts not described in subparagraph (A), segregate an amount equal to the actuarial amounts determined under subparagraph (C) for all enrollees from the amounts described in subparagraph (A).
 
This is the funky part.  The insurance plan has to put any amounts that would pay for abortion in a separate pot that everybody contributes to (except for the discounts and credits).
 
(C) ACTUARIAL VALUE OF OPTIONAL SERVICE COVERAGE-
(i) IN GENERAL- The Secretary shall estimate the basic per enrollee, per month cost, determined on an average actuarial basis, for including coverage under a qualified health plan of the services described in paragraph (1)(B)(i).
(ii) CONSIDERATIONS- In making such estimate, the Secretary--
(I) may take into account the impact on overall costs of the inclusion of such coverage, but may not take into account any cost reduction estimated to result from such services, including prenatal care, delivery, or postnatal care;

(II) shall estimate such costs as if such coverage were included for the entire population covered; and
(III) may not estimate such a cost at less than $1 per enrollee, per month.

This is where the Secretary determines how much it costs for everybody to fund abortions, and therefore, how much to put into a pot that covers it.

(b) Application of State and Federal Laws Regarding Abortion-

(1) NO PREEMPTION OF STATE LAWS REGARDING ABORTION- Nothing in this Act shall be construed to preempt or otherwise have any effect on State laws regarding the prohibition of (or requirement of) coverage, funding, or procedural requirements on abortions, including parental notification or consent for the performance of an abortion on a minor.
(2) NO EFFECT ON FEDERAL LAWS REGARDING ABORTION-
(A) IN GENERAL- Nothing in this Act shall be construed to have any effect on Federal laws regarding--
(i) conscience protection;
(ii) willingness or refusal to provide abortion; and
(iii) discrimination on the basis of the willingness or refusal to provide, pay for, cover, or refer for abortion or to provide or participate in training to provide abortion.
(3) NO EFFECT ON FEDERAL CIVIL RIGHTS LAW- Nothing in this subsection shall alter the rights and obligations of employees and employers under title VII of the Civil Rights Act of 1964.

No laws get affected, or civil rights.  But, if abortion is ever determined to a civil right then the restrictions will be void.

As a corollary here's what the Secretary (of health and Human Services), Kathleen Sibelius, said back in December:  “And I would say that the Senate language, which was negotiated by Senators Barbara Boxer and Patty Murray, who are very strong defenders of women’s health services and choices for women, take a big step forward from where the House left it with the Stupak amendment, and I think do a good job making sure there are choices for women, making sure there are going to be some plan options [that pay for abortions],” .

In summary, I think what's happening here is the following:  people pay premiums and taxes, the govt takes the money and puts it into two piles--one goes to abortion plans and one goes to non-abortion plans.

An accounting gimmick.  But, I'm willing to listen to anyone who can decipher this gobbledygook better than I can.

Doc D

Opinions are entirely my own.

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