The Pittsburgh Post Gazette is reporting that Sen. Bob Casey (D-PA), a pro-life leader in the Senate, will likely oppose the Stupak abortion amendment. Casey’s office issued a press statement clarifying that the Senator supports preserving the status quo on abortion coverage:

Senator Casey has been a vocal supporter of health care reform and voted for the HELP Committee bill in July. He supports the public option to increase competition and reduce costs. And he is offering amendments to improve health care for children. Senator Casey thinks that health care reform should not be used to change longstanding policies regarding federal financing of abortion which has been in place since 1976.

He continues to work with his colleagues in the Senate and with the White House to ensure that the Senate health care reform bill protects existing federal and state conscience protections, existing state abortion laws and contains strong language to prohibit federal funds from being used to fund abortions. He voted for amendments in the HELP Committee that would maintain neutrality on abortion. Until Senate bill language is released it is premature to discuss next steps.

The existing abortion language in the Senate bill maintains the status quo by ensuring that federal dollars can only be used to pay for abortions when the pregnancy threatens life of mother or results from rape or incest. Only private premiums could be used to pay for so-called ‘elective’ abortions.

Democrats believe that pro-life advocates would not be able to muster the requisite 60 votes to pass a more restrictive amendment that would make it difficult for many private plans to provide abortion coverage. “If someone wants to offer this very radical amendment, which would really tear apart [a decades-long] compromise, then I think at that point they would need to have 60 votes to do it,” Sen. Barbara Boxer (D-CA) said during a recent interview with the Huffington Post. “And I believe in our Senate we can hold it.” On Monday, President Obama also indicated that he wanted to preserve the status quo on abortion coverage.

Casey’s statement, while promising, does not guarantee that the Senator won’t vote for a bill that includes stricter abortion restrictions. During the Health, Labor, Education and Pensions Committee’s (HELP)’s mark-up, Casey provided the only Democratic vote to at least four anti-choice amendments, all of which ultimately failed. One such amendment — offered by Sen. Orrin Hatch (R-UT) — closely resembled the Stupak provision.

If the Senate bill retains its current abortion compromise, it’s likely that the conference report will include similar language. Already, 41 House Democrats have sent a letter to Speaker Nancy Pelosi (D-CA), vowing to vote against the final conference report if it contains the Stupak amendment.

Yesterday, America’s Health Insurance Plans (AHIP) — the health insurance lobby — held a press conference focusing on “the need for major change, and for keeping costs in check.” AHIP President and CEO Karen Ignagni warned that “the bill the House passed could thrust too much of the cost of health care onto the shoulders of younger people because it lets insurers charge older people – who typically incur much higher medical bills and whose incomes are generally higher – just twice as much as younger people.”

The lobby has long argued that if insurers can’t set premiums for older adults “as much as 5 times as high as those for younger adults for identical coverage,” then they would have to shift costs to younger applicants. Coverage would become “unaffordable,” “resulting in a smaller and less stable pool, and higher premiums for everyone.”

But a recent report from the Urban Institute disputes these claims. The report, which models premiums under 5:1, 2:1, and 1:1 age bands, concludes that “overall, there is almost no difference across the premium rating options in the share of the total population that would be left uninsured.” Similarly, the various age bands would be very little effect “on aggregate health spending of government, employers, and household.”

However, the report concluded that the insurers’ preferred rating of 5:1 would “significantly alter health care financing burdens for the youngest and oldest adults and families” who don’t qualify for government subsidies (for those who do qualify, the difference would be absorbed by the subsidy.) As the chart below demonstrates, “the affordability concerns are substantially more pronounced” for older single adults (55-64yo) under the 5:1 rating than for younger single adults (18-24yo) under the 2:1 rating”:

A 5:1 rating would significantly burden 55-64 year olds purchasing non-group coverage and actually increase subsidy costs. An earlier version of the Senate Finance Committee bill adopted the industry’s 5:1 recommendation, but changed the rating during mark-up. The insurers, however, insist on the 5:1, noting that the government could provide seniors with an “external” subsidy outside of the exchange to help them afford coverage.

Generally, the industry is concerned that a tighter age band would jeopardize the industry’s ability to attract a significant number of young people into high deductible policies outside of the exchange (in the remaining individual market). A 4:1 or 2:1 community rating would force insurers to charge younger people higher premiums and would presumably attract fewer enrollees; a 5:1 community rating would allow insurers to charge older people more and market more “affordable” (read: high deductible) policies to young and healthy applicants who pay more in premiums than they file in claims.

As former health insurance executive Wendell Potter explained in an interview with ThinkProress, insurers would “like to move us all into high deductible plans.” “[The would like to] have high deductibles that we would all have to meet and or [move us] into these limited benefit plans that are very skimpy and don’t cover you, don’t cover what you need. That way, when you do get sick, they’re not on the hook to pay you anything. They would love to have you enrolled in these.”

Politico is reporting that “the Republican National Committee will no longer offer employees an insurance plan that covers abortion after POLITICO reported Thursday that the anti-abortion RNC’s policy has covered the procedure since 1991″:

“Money from our loyal donors should not be used for this purpose,” Chairman Michael Steele said in a statement. “I don’t know why this policy existed in the past, but it will not exist under my administration. Consider this issue settled.” Steele has told the committee’s director of administration to opt out of coverage for elective abortion in the policy it uses from Cigna. Federal Election Commission Records show the RNC purchases its insurance from Cigna, and two sales agents for the company said that the RNC’s policy covers elective abortion.

Of course Steele doesn’t know why “this policy existed in the past” for the same reason why Focus on the Family, one of the nation’s largest religious right organizations, didn’t know that it paid premiums to an insurance company that also offered abortion coverage: they don’t care. They’re using ‘abortion’ to manufacturing outrage, derail health reform and energize the pro-life base.

Even they don’t believe that purchasing insurance coverage that includes abortion is an abomination. Nor do they believe the argument made in the Stupak-Pitts amendment — that paying premiums to an insurance policy that offers abortion coverage is indirectly subsidizing abortion. As Steven Benen points out, while the RNC may have opted-out of the abortion benefit, it is still “taking Republican money and giving it to an insurance company through premiums. That company will then use its pool of money to pay for abortion services, not for RNC employees, but for other customers.”

The Republican Party does not believe in the Stupak Amendment; it believes in opt-outs…

The Huffington Post’s Sam Stein has obtained a Goldman Sachs report analyzing the impact of health reform on Cigna, Aetna, WellPoint, UnitedHealth and Humana. The report, conducted sometime in mid-October, concludes that a more moderate version of the Senate Finance Committee (SFC) legislation would lead to the highest “aggregate revenue growth” for the insurance industry, but that “no reform” would also result in substantial growth.

“At this point, we assign a 75% probability to health reform becoming law under the current effort,” the report notes and assumes that the current SFC proposal would likely become law. Under that plan, “we forecast sector earnings growth would be cut by 50% over the next decade as a result of health reform implementation”:

The reform measures that would most negatively impact earnings growth are funding cuts to Medicare Advantage and strict new regulations for the individual and small group business. These would be partly offset by the positive impact of expanded insurance coverage under reform….However, we believe final legislation is unlikely to get much worse for the industry than the current SFC reform plan and we do not believe a government-run public plan will be included in final legislation…To be clear, we expect the stocks would go down if the current SFC reform plan is made law, but we think that is mostly priced-in and the magnitude of further downside would be limited. By contrast, we see higher probability for scenarios that would lead to significant stock upside (i.e., no reform, or scaled-down reform under our “bull” case) than for the “bear” case scenario that would drive severe stock downside.

Should lawmakers further water-down the SFC bill, the industry will stand to profit, the report implies, suggesting that the “bull” case scenario is a reform package that brings in millions of new government-subsidized customers but does not require the industry to pay any new taxes.

“While more investors had already assume[d] the SFC plan would exclude a public option but include severe MA [Medicare Advantage] funding cuts, other aspects of the SFC plan have emerged more negatively than hoped,” the report says. “In particular, the provision to impose a $6.7 billion annual industry ‘fee’ starting as soon as next year, coupled with the weakening of mandates on individuals to maintain coverage.”

The worst case scenario — “where we introduce a government-run public plan that we assume would capture the majority of coverage expansion under reform as well as some of the industry’s current market-share in the [Middle market large employer] segment” — would produce revenue growth of just 2.4%, compared to 5.9% growth under the SFC and 6.2% growth without reform. Industry revenue would grow 6.9% from “more moderation of provisions in the current SFC plan or as a result of changes prior to the major implementation in 2013“:

The report estimates that there is a 25% chance that no reform will pass, 55% chance of the SFC-like legislation becoming law and just a 10% chance of a more moderate SFC alternative.

Meanwhile, UnitedHealth is urging its employees “to lobby the Senate against reform proposals that would hurt the firm’s bottom line.” The sample letters urge lawmakers to to “build upon what is currently working in the Medicare system and not limit the ability of seniors to access the [Medicare Advantage program]” and argue that “government-run health care will result in millions of Americans not being able to keep their current coverage and will lead to unintended consequences of higher premiums and less choice.” “In addition, I am disturbed by proposed legislation that will lead to increased taxes, less affordable coverage, and reduced benefits,” the sample letter says.