washingtonpost.com
Abortion and health-care reform: Explaining Stupak, what's next and more

Lori Montgomery
Washington Post staff writer
Thursday, November 12, 2009 11:00 AM

Confused about the Stupak amendment to the House health-care bill, its impact on funding for abortion, and what is likely to happen with the bill in the Senate? Post staff writer Lori Montgomery takes your questions.

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Lori Montgomery: Good afternoon, and welcome to today's chat about health care -- with a special focus on the abortion battle. I'll try to take as many questions as I can, so let's get started.....

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San Diego: Bottom line question: How does the Stupak amendment change conditions/circumstances from the current status quo with regard, for example, to the legality of abortion and who pays the cost?

Lori Montgomery: An excellent question to start. The Stupak amendment does nothing to change the legality of abortion. The procedure would remain legal, with whatever restrictions apply in your state, and insurance policies could continue to cover abortion. What the Stupak amendment would do is prohibit any government-run insurance plan created by health care legislation from covering abortion. And it would prohibit people who receive affordability credits under teh House health care bill from using those credits to purchase a policy with abortion coverage. Pro-lifers say it maintains the status quo on using federal funds for abortion. Pro-choicers say it would have the effect of preventing insurance companies from coverage the procedure for anyone.

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Oakton, VA: I know I had to read this wrong but when I read a story in the WP earlier this week about the abortion portion of the bill I had to get clarification. It says opposition is fighting the bill because it would not allow women to pay for abortions with their own funds? THEIR OWN FUNDS? How will the gov't know if a woman has had an abortion if she pays for it with her own funds? I'm totally confused about that one. Can you clarify?

Lori Montgomery: Most women -- whether they have insurnace or not -- choose to pay for an abortion with cash, and never make an insurance claim. The Stupak amendment would not affect them at all. What the prochoicers are complaining about is the possibility that, under health care reform, a woman who did not need a federal subsidy to purchase insurance could be precluded from purchasing a policy that coverage abortion simply because she wanted to use the new insurance exchange. Others make the same argument based on the fact that even people in the public plan would be paying SOME of their own money for the policy, and therefore should be free to purchase abortion coverage with their share of the premium.

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Madison, Wisconsin: As a physician, I find it abominable that something called "health reform" could withhold affordable medical care from patients. Abortion is a safe, legal procedure that one in three women has before age 40. These women and their families have done nothing wrong. What can the House and Senate do to ensure that my tax dollars support health care for all Americans, including women with unhealthy or unplanned pregnancies?

Lori Montgomery: Hire a lobbyist to repeal the Hyde Amendment. Because right now, federal funds cannot be used to pay for abortion.

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Alexandria, Va.: In 2009, certain medical expenses are deductible from income according to the IRS. These Schedule A medical expenses include abortion. Has Congress proposed to change the status quo on abortion being a deductible medical expense? (I am particularly interested because I can use my HSA funds for any such deductible expenses, although they may not be covered by the accompanying insurance.)

Lori Montgomery: Both the deductibility of medical expensese and the use of HSA funds could change under health care reform. The Senate, for example, wants to make you spend 10 percent of your income before you can deduct (instead of the current 7 percent) and wants to limit the size and the scope of your HSA.

However, neither of these changes has anything to do with abortion at this point.

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Burbank, Calif.: I'm a very liberal, pro-choice Democrat. Nevertheless, it does not bother me that the health-care reform bill won't cover abortions. Why do you think some Democrats are drawing this as a line in the sand?

Lori Montgomery: They're standing on principle. Their argument is made even more difficult by the fact that few women with insurance choose to file a claim when they have abortions. But there is a hard-core group of reproductive rights advocates who are outraged by the possibility that a legal medical procedure would be excluded under reform.

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Rochester, NY: I am an obstetrician/gynecologist, and the Stupak amendment worries me. Its premise is that abortion can be easily separated from the rest of health care. But I have a hard time accepting that this country wants to hurt pregnant woman.

This amendment would inflict special punishment on those who are ready to become mothers but whose pregnancies are making their medical conditions worse. A lot of damage can be done before a woman reaches the life-threatening stage when the Stupak amendment would relent and allow payment for abortion.

Because of their health problems, these women must have their abortions in the hospital, racking up thousands of dollars in bills that destroy their families' finances.

Is it true that the Stupak amendment would prohibit an insurance company in the exchange from covering my patient's abortion if her health is in danger or if the fetus is malformed?

Lori Montgomery: That is the fear, yes. Right now the language is the same as the Hyde amendment -- no abortion except in the case of rape, incest or to "save the life of the mother." I'm guessing that last category is open to wide interpretation, however.

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DC: As a life-long supporter of the pro-choice movement (I'm in my 60s, BTW, so I'm long past the sell-by date for pregnancy and choices thereupon), I find it fascinating that the anti-choice people "choose" not to recognize that if abortion is curtailed or otherwise remade illegal that women -- desperate women -- will do anything to abort, including perforating their uteri with coat hangers and the like, or drink exceedingly toxic substances to force the abortion. They will also visit the back alley butchers which used to be around before abortion was made legal and safe. Women will die in great numbers because of this, but apparently (according to the anti-choice movement) those women will deserve to die because of what they had done.

Abortion has been around forever, even when the Catholic Church voted for it before they voted against it. It will always be around. The price will be paid by everyone, as usual, no matter what the reform bill says.

Lori Montgomery: to be clear, no one is suggesting that abortion should again be made illegal, just that insurance obtained through the new exchanges should not cover it.

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Abortion, 4 years ago: What is going on with this? I had an abortion because I couldn't carry a baby to term at the time. It was sad, personally because I wanted that child, and also hurtful that there were people protesting when I went for it. I have stopped paying attention to abortion issues because of that experience even though I should be one of the people trying to help women have a choice.

Lori Montgomery: That is very sad, and does raise the most alarming thing about the Stupak amendment: While women with unwanted pregnancies are likely to be able to go on their own and pay the relatively small sum for a first trimester procedure, what about women like you, who want the baby and whose abortions could be more complicated and more expensive?

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Washington, D.C.: As a pro choice republican, I agree that abortion is a private decision for a woman to make.

If it is private, the government shouldn't fund it. I can't believe this is even a big deal. Just like something simple like if your 14-year-old daughter has an abortion the parents have to notified.

These are common sense things that I am shocked the abortion on-demand-crowed can't even understand.

Why?

Lori Montgomery: They argue that, because the public plan would be entirely financed by private premiums, the money spent is not actually federal funds. Ditto re: the private insurance plans that would be available through the exchanges: Because a portion of the premium would be paid with private money (rather than fedearl subsidies) they believe a ban on abortion coverage denies people the right to use PRIVATE FUNDS to purchase abortion coverage.

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NYC: The women that file with their insurance carriers for abortion coverage are often those women with catastrophic pregnancies -- those pregnancies with fetal abnormalities or women with type 1 diabetes or heart conditions or what have you. These abortions are necessary to save the woman's health and are very expensive. But these abortions wouldn't be permitted under the Stupak Amendment.

Lori Montgomery: I'm not sure that's true. As I mentioned earlier, Stupak would permit abortions to save the life of the mother, a caveat that I believe can be liberally interpreted by a doctor.

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California: It seems to me that excluding insurance companies who offer abortion coverage from the exchange would not be constitutional. And even if it was, saying that women have the option to buy a "rider" to gain coverage is placing a burden on one half of the population, for a medical procedure that is unquestionably legal. I think the stigma alone would prevent many woman from purchasing the coverage, even aside from the fact that no one plans an unplanned pregnancy.

I believe that there would be an uproar if men were required to purchase a separate rider for erectile dysfunction because it could lead to --and this is a bit tongue-in-cheek-- the sexual assault of women that could have been prevented if the men who needed Viagra were unable to perform.

Is it possible that the "no abortion coverage on the exchange" could be constitutionally or otherwise legally challenged?

Lori Montgomery: I am sure it would be challenged in court.

and re: viagra -- i, for one, was glad to see our story about BPA affecting male sexual function, because now you KNOW somebody will do some serious research on the matter.

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Washington, DC: Lori - your point about the Hyde amendment: I AM a lobbyist trying to repeal the Hyde amendment. But Stupak/Pitts goes far beyond Hyde, burdening women's private funding and private choices. The Capps amendment would have tied health care reform to Hyde, but Stupak/Pitts deleted this compromise. In fact, Stupak/Pitts even deleted the portion of Capps that would have made it illegal to discriminate against providers of abortion.

Lori Montgomery: That's one interpretation.

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"no abortion except in the case of rape, incest ": I don't understand the "no abortion except in the case of rape, incest"...if the moral grounds is protecting the life of the fetus, how are these less important because the method of conception?

Lori Montgomery: That question is beyond my pay grade. Those standards have been in the law for years.

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Baltimore: With regard to the doctor in the previous question to whom you recommended a lobbyist. I'd argue more attention needs to be paid to Title X. A paltry $300ish million per year on a program that serves millions and PREVENTS unwanted pregnancy. What is Stupak doing to raise Title X funds?

Also, not all of us upset over the Stupak amendments are "hard core." We are appalled that yet again women's health is being used as the sacrificial lamb. From the global gag rule to Hyde to exclusions of maternity care, if seems we are always getting the very short end of the stick.

Lori Montgomery: I was not referring to you as "hard-core." I was referring to Democrats who might be willing to vote down health care reform because of this issue as hard-core. Not clear how many of them there are, or whether their ranks may swell as the implications of the Stupak amendment become clearer.

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San Francisco: I find it galling that insurance and Medicare will pay for Viagra but now we are about to blow it on heath-insurance Reform because of controversy over what is a legal procedure? As a woman, I certainly don't want my tax dollars spent on some old man's $300 a month Viagra habit. Can I get an amendment please?

Lori Montgomery: I think you should call up your congressperson and suggest it. No Viagra in the public option.

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Abortion funds: So hiring a lobbyist will be cheaper than getting the abortion you need to have? I don't think it can wait that long. What a messed up system of "healthcare."

Lori Montgomery: yep

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Arlington, Va.: Are there any statistics about how often abortions are covered by insurance now and how often women who have them take advantage of this coverage? I'm wondering how serious of a practical effect this would have.

Lori Montgomery: I've seen statistics, from Guttmacher, I believe, that only about 13 percent of abortions are actually paid for by insurance. So we are, in fact, not talking about a huge universe. But as previous writers made clear, that group probably includes some pretty hard cases, i.e. women who want the baby but can't carry it for some reason.

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Arlington, Va: Can you clear up for me whether this Stupak amendment does more than the law that was already in place saying that federal funds can't be used to pay for abortion?

I'm seeing action alerts from pro-choice groups that claim that this amendment will make it the case that no insurance providers will even provide abortion coverage at all. From what I gather, this isn't because the amendment forbids it, but because it will put pressure on insurance companies to stop offering coverage even in private plans, since insurance companies will want to attract subsidized customers but can't serve them if they offer abortion coverage.

Is a complete or near-complete disappearance of coverage for abortion likely to result from this, or is this a case of a lobby presenting what for them is the worst-case scenario as if it were obviously inevitable?

Lori Montgomery: You have it exactly right, and no one can answer your question about what the insurance companies would actually do in practice if the House bill were implemented. A right-to-life advocate told me this morning that abortion riders do exist in Missouri, for example, and that people do use them.

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Wheaton, Md.: Well, isn't this just ducky? We finally get close to getting some kind of help for people to get health insurance, and the whole thing is going to be blown up by abortion rights/anti abortionists! As a 50-something diabetic who is about to lose her job, I'd like to thank those who think abortion is necessary as a health care option (how about birth control) and the anti abortionists - who would love nothing more than to scuttle the whole thing for those of us who aren't wealthy and connected to get good jobs with benefits whenever we need one. Great job, everybody, Thanks!!

Lori Montgomery: I think we're a long way from scuttling health care reform over this issue. Abortion is not a big deal in the Senate, and folks on both sides are already looking for a compromise in the House.

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Arlington, Va.: Can you clarify something? You say above, "What the Stupak amendment would do is prohibit any government-run insurance plan created by health care legislation from covering abortion."

Does this mean that only a new insurance plan would be restricted from covering it? The messages I have seen from pro-choice groups have claimed that this amendment would discourage any insurance provider from offering coverage of abortion (as I understand it, because they want to attract customers who may be partially subsidized.) I thought that meant that existing plans would be revised not to cover it. Am I understanding correctly? Are they wrong?

Lori Montgomery: The Stupak amendment is very limited: it applies only to a newly created public plan or to people who purchase insurance through the exchanges with a federal subsidy. The pro-choice groups are extrapolating from that, saying it would lead insurance companies to stop coverage abortion so they can offer policies through the exchanges. I've also heard a version of the argument that gets to every insurance plan in America dropping abortion coverage, but I frankly can't even remember the somewhat apocolyptic rationale.

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Private choices: "As a pro choice republican, I agree that abortion is a private decision for a woman to make. If it is private, the government shouldn't fund it. I can't believe this is even a big deal."

Getting unnecessary knee surgery when you should really lose 50 lbs to take off the pressure is also a "private" choice. Can the taxpayers not pay for that as well?

Lori Montgomery: pro-choice republican?

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Brooklyn, NY: You are incorrect about "life of the mother" being interpreted "liberally" under the Hyde amendment as it is enforced by Medicaid. A woman's physician must prove that she would have died if her pregnancy continued. Women on Medicaid who are unlucky enough to have medical conditions that only get much worse but not quite lethal have their Medicaid claims routinely denied. The Stupak amendment extends this punishment to millions more women. Does this change your interpretation of the amendment?

Lori Montgomery: Yeah, I'm not so sure you're right about that. But I'd welcome some actual data.

In addition, several states use their own funds to make abortion available without restriction to Medicaid recipients.

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Silver Spring, Md.: I'm a long time pro-choicer who has joined in more marches and rallies than I can count on one hand. I have to say however that I'm dismayed that my compatriots would be willing to throw away the chance to have 96 percent of Americans covered - over the small number of abortions that are typically paid through insurance. Isn't anyone in the pro-choice leadership considering how much harm will be done to the millions of women who are currently without any health insurance at all, if they insist on making the perfect the enemy of the good?

Lori Montgomery: An excellent question. I'm sure the pro-choice groups do not want health care reform to die because of this and will do whatever they can to find a compromise.

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Alexandria, Va.: There is no reason for this to be any issue. In almost every aspect of their lives, people are given a choice. Religion beliefs should have no bearing, period, on health care reform. This is the real world with real world issues. It's complex and complicated and a rigid, black and white moral code does nothing to help society as a whole. If you don't want to have an abortion, don't have one. I don't like my tax dollars going to things I don't support but sometimes that's just the way it is.

Lori Montgomery: Again, maybe you can band together with the guy who wants to hire an anti-Hyde lobbyist.

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a caveat that I believe can be liberally interpreted by a doctor. : Look, you already had an OB/GYN write in to say there are clear cases when the condition is not life threatening, but will impact the woman's health e.g. she may not ever be able to have children if she doesn't get the abortion.

In addition, he points out that an early abortion is far better than waiting until the condition becomes life threatening.

Do we expect physicians to lie and risk their careers?

Lori Montgomery: I'm not sure they have to lie. Readers?

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Re public funds: With all due respect, if a medical procedure is legal, what business is it of anyone's whether that procedure is paid for by public funds?

Lori Montgomery: The national debate is so far past this question, I'm not sure how to respond.

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Concord, N.H.: Also disturbing is that women who want to have abortion coverage will be financially punished just for having the option. Can they recoup their annual tax credit if they don't get an abortion, or is the mere expression of wanting coverage enough to rule that out. This is quite the slippery slope . . . .

Lori Montgomery: You could see it that way.

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Washington DC: No contraceptive is 100% effective - while we need to do more for pregnancy prevention we can't prevent them all. Abortion is a safe and legal option for everyone - those who use contraception and those who don't for whatever reason. Let's not point fingers at people who genuinely make an effort to prevent pregnancy.

Lori Montgomery: I don't think anybody is pointing fingers. I think the question is whether those accidental pregnancies should be financed -- however tenuously -- with federal funds.

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Princeton, NJ: Why should a rich woman be able to get an abortion while it is impossible for a poor one to do so?

Why should my tax dollars go to support the tax exempt status of the Church when they are a political power which tries to prevent my daughters from getting possibly needed medical care?

Lori Montgomery: I'm not sure it's impossible for a poor woman to get an abortion. But, again, I'm open to data.

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Terminology: I am pro-choice, pro-life, and anti-abortion. Those who want to make abortions illegal are pro-death since study after study show that the only effect of outlawing abortion is to kill women who get back alley abortions. It does not reduce the abortion rate.

I think abortions are horrible, but there are situation when the alternative is also horrible. Who am I or who are you to tell a woman which dreadful choice she must pick.

The anti-choice people generally oppose all the methods that have been shown to really reduce the abortion rate like free availibilty of contrceptives and planned parenthood. They are not against abortions. What they want to do to impose their medieval sectarian ideas upon the rest of us.

I think it is important to get the terminolgy correct.

Lori Montgomery: Hokay.

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Burnsville, N.C.: How will the amendment affect women who find that their fetus is severely malformed or compromised in some way but are not at risk to miscarry?

Lori Montgomery: This is another excellent question. There is no caveat in Stupak for malformation of the fetus, so presumably the public option and any policy sold to a person with an affordability credit would be barred from covering it.

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Setauket, N.Y.: Under the Stupak amendment, will a woman still be able to have an abortion if the baby has spina bifida, downs syndrome or other genetic abnormality?

Lori Montgomery: See above. I don't think so. Though, obviously, she could choose to pay for the abortion herself, outside the insurance process.

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Sterling, VA: Under the bill itself, there is no requirement that gynecological visits be covered. Pap smears, yes. Pelvic exams, no.

The entire bill does not cover 51% of the US adult population. It should be scrapped.

Lori Montgomery: Um, Sterling, I'm not sure where you're getting your facts. The benefits that would be provided by the public option or by private insurance plans in the exchange are not specified in the House bill. That decision would be left to federal health officials, who, I would argue, are unlikely to neglect pelvic exams.

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Washington DC: Wheaton, Md. "I'd like to thank those who think abortion is necessary as a health care option (how about birth control)"

was pointing fingers

Lori Montgomery: Ok. Read right past that.

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DC lobbyist, again: Here's the problem with Stupak: everyone who wants abortion coverage would have to get an abortion rider. I've heard different things about these riders, but I'm not certain how they'd work. Most women don't intend to have an unplanned or catastrophic pregnancy, so women won't purchase riders (if, indeed, these are offered). But, when the need arises for an abortion to end a pregnancy for health reasons, then it will be too late to purchase the rider. The surgery will need to be paid out-of-pocket.

So there is a question of access. But there's also a question of justice here: why is women's healthcare being treated differently from any other kind of healthcare?

Lori Montgomery: Yes, yes. As a woman, I, too, am offended on principle.

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To the pro-choice Republican above: "Just like something simple like if your 14-year-old daughter has an abortion the parents have to notified."

I hope you recognize that there are many cases where this is really risky. I hope you at the very least support it being easy to be able to keep this private if not doing so would be dangerous for the girl. Say, for example, her parents are abusive. Or even worse: say her dad is the father of the child.

You say "have to" as if it's obvious that notification is the right thing to do in all cases. I think it's obvious that it's the wrong thing to do in at least some. Not every case of a young person getting pregnant is "sowing wild oats..."

Lori Montgomery: good points.

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Washington, DC: Won't affordability credits be offered to small businesses? And won't that mean that the employees of these businesses who receive health care through their employers be prohibited from purchasing a plan with abortion coverage? Furthermore, won't the mandate require that these women buy their insurance through the exchange (with the credits) meaning they'd have to pay twice for abortion coverage?

This would seem to impact millions of women and is not as limited as you make it seem.

Lori Montgomery: No. The Stupak amendment does not apply to the small business tax credits (which would not help as many businesses as you seem to think, by the way). And there is no mandate anywhere that would require people to buy insurance through the exchanges. The bottom line is that Stupak only applies to the 21 million or so people who would either be getting federal subsidies to buy insurance or who would be buying insurance through a public option. Whether or not it affects more people than that depends on the future -- and somewhat unknowable -- actions of the insurance industry.

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Boston, MA: I don't understand why receiving affordibility credits from the government should control whether or not an individual can buy private insurance that provides abortion care with their own separate money.

I just bought a house and got the $8,000 tax credit for first-time buyers. Could Congress decide I can't buy certain types of insurance because I took this federal funding? Capps was a neutral solution, Stupak is far too overreaching. Just because someone takes federal funds somewhere at some point in time doesn't mean they should never be able to buy abortion coverage with their own private funds from a private insurer.

Lori Montgomery: Readers?

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Washington, D.C.: Guttmacher put out a press release yesterday saying the 13% figure on insurance use has been widely misinterpreted:Misuse of Guttmacher Statistic on Insurance Coverage of Abortion

Lori Montgomery: Oh, good. Thank you for this!

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Washington DC: Well looks like I'm going to have to get a rider - I use contraception but apparently on the off chance that fails and I'm faced with a fetus which can't live outside the womb for any period of time I'm on my own. And wouldn't those be the most expensive cases - where paying cash might be prohibitively expensive? Guess it comes to a financial decision. How sad.

Lori Montgomery: The danger, according to some pro-choice advocates, is that the rider would not be there for you to purchase. But if you're not planning on taking a federal subsidy or buying into the public option, you don't need to worry about it.

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Abortion Riders: I haven't heard that individuals are able to access riders in Missouri. And in North Dakota (another state with abortion coverage only available through purchase of a rider), the private plan that holds 91 percent of the health insurance market does not offer a rider at all!

Lori Montgomery: OK. Readers?

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Austin, TX: Just wanted to chime in and say "great chat" on a difficult and divisive issue. Well handled, Lori.

Lori Montgomery: Thanks, Austin! And might I say, given the crappy weather in DC today, I'd love to be on Sixth Street.

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I'm with Alexandria!: As a member of an historic peace church (The Religious Society of Friends, or Quakers), I don't want my tax dollars going to pay for armaments or war. I don't get that choice, however, and I'd prefer that those who find abortion to be at odds with their religious beliefs didn't either.

Lori Montgomery: Touche

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Washington, D.C. : I think the major issue individuals are concerned about is that women whose plans currently cover abortions will no longer provide them. Currently a self-employed individual is like to have abortion coverage under her plan, but if her same plan enters into the exchange she will not have abortion coverage. Also, where is the line drawn? What if a woman has a fetal abnormality?

Lori Montgomery: Yes, this is what people are worried about. But I'm not sure the fear that all private insurance companies would simply stop covering abortion is justified. I mean, isn't it cheaper to pay for abortion in the case of fetal abnormality than the alternative?

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DC: Could this be challenged in court as discriminatory, since it is written for a procedure that by definition only affects one sex?

When I had insurance on the independent market, I had to pay double for maternity coverage (which you had to add before becoming pregnant, and had to add at the start of the policy, not when you decided to try to conceive), which I also thought was discriminatory - there was no double pay for the eventuality of prostate cancer or impotency. But that at least was a private company. The fact that the FEDERAL GOVERNMENT is legislating discriminatory care based on sex seems pretty reprehensible to me, whether pro-life or pro-choice.

Lori Montgomery: There's actually some good news here: Health reform would bar insurance companies from charging you more because you are a woman of child-bearing years. And it would limit the extra amount companies could charge if you're old.

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Alexandria, VA: Lori, in your first answer, you indicate that "(p)ro-choicers say it (the Stupak amendment) would have the effect of preventing insurance companies from coverage the procedure for anyone."

Are the pro-choicers incorrect? I thought that the Stupak amendment allowed for all private plans participating in the Exchange to cover abortions through "riders," and that insurance companies not participating in the Exchange could cover abortion services with their typical premiums.

Lori Montgomery: You are correct. But pro-choice advocates argue that insurance companines would choose not to offer the riders, an argument that is apparently based on experience in some states.

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Baltimore: I believe Brooklyn is correct about the less-than-liberal interpretatino of the Hyde Amendment. There are many instances that could arise during a pregnancy where the health of a mother is certaily jepoardized, while she could certainly "survive" I have heard of pregnancies where carried to term a woman could certainly "live" but could wind up infertile afterwards.

Have our members of Congress suddently all gone to medical school?

Lori Montgomery: I assure you that many members of Congress have trouble discussing their own health care bills, much less the intricacies of maternal survivability.

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Washington DC: "isn't it cheaper to pay for abortion in the case of fetal abnormality than the alternative? "

for years insurance companies didn't cover contraception - even though clearly it was cheaper than having a baby. not until Congress stepped in and mandated it. Cost is not always a consideration for insurance companies - surprisingly.

Lori Montgomery: good point.

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Falls Church, VA: You're only half-right on the small business question. While small businesses may not get the affordability credits, they do have the option of buying through the exchange. Stupak-Pitts applies to anything offered through the exchange and not just to those that receive affordability credits. So it is a very real possibility that many small businesses will cover their employees through the exchange and that millions of women who currently have abortion services covered will lose them - through no actions of their own.

Lori Montgomery: No. Your facts are wrong. Read the amendment. Stupak would bar people who receive affordability credits from buying insurance that includes abortion coverage. The argument -- which may be accurate, but who knows? -- is that all private plans offered on the exchanges would therefore choose not to cover abortion.

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You wanted some data: "Many women struggle to raise the money for an abortion as their pregnancy progresses. Sixty-seven percent of poor women having an abortion report that they would have preferred to have an earlier procedure."

(Abortion Access Project and the National Latina Institute for Reproductive Health.)

Lori Montgomery: OK.

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Pennsylvania : How much do abortions cost on average? Does it differ from state to state?

Lori Montgomery: This is a good question. I'm thinking around $400. Readers?

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Sterling, VA: Here's where I got the info. Where's the Birth Control?

Now, granted, it's the Nation. But they tend to be right about this sort of detail.

Lori Montgomery: Here you go.

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Life Exception: The life exception has NOT been broadly interpreted by courts. Neither has health exceptions. In the Stenberg cases, the health exception was limited to "substantial and irreversible impairment of a major bodily function." Similar statutory lang exists in OH and FL.

Lori Montgomery: I'm curious how this stacks up in real life.

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Atlanta: We are bound to have disputes (on Stupak Amendment) like this until ROE v WADE is gone and each state is allowed to decide what their policy should be on abortion availability and funding. By taking abortion out of the political process (as the court did with Roe), that guaranteed decades more of "culture war," whereas if that issue had played out among the states, it probably would have been largely resolved by now.

Lori Montgomery: Many people would agree with you. On the other hand, many more women would probably be dead from botched abortions if not for Roe v. Wade.

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Lori Montgomery: Well, time is up and I am out of questions. Thanks so much to the folks who provided us with abortion data. And thanks to everyone for reading/chatting with the WaPo!

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