In July, following GOP allegations that states would be able to use federal dollars to cover none-Hyde abortions in the temporary high risk insurance pool program, HHS issued regulations prohibiting states from covering the procedure. “The (high-risk pool) program,” the regulation states, “is Federally-created, funded, and administered (whether directly or through contract); it is a temporary Federal insurance program in which the risk is borne by the Federal government up to a fixed appropriation. As such, the services covered by the PCIP program shall not include abortion services except in the case of rape or incest, or where the life of the woman would be endangered.”

Progressive pro-choice advocates felt betrayed. Since there is no over-arching law that prevents states from using federal dollars to fund abortion services, the administration was not required to alter the state’s proposals. Writing at RH Reality Check, CAP’s Jessica Arons accused the administration of applying the Stupak amendment to the high risk pools and going beyond the bargain it struck. Now, 19 national pro-choice groups have “signed on to public comment, submitted Monday, urging HHS to ‘revise this rule and remove the ban.’” The group, Raising Women’s Voices has released a video and letter writing campaign, “highlighting stories of women with pre-existing conditions who have had abortions,” urging Sebelius to “lift the harmful abortion restrictions”:

My doctor said my health is at risk. Here is a Catch-22. My insurance will pay for the pregnancy that can seriously injure me, but it won’t cover the abortion that can protect my health. I don’t get it.

Watch it:

It’s unclear if the group can change the rules after it’s been written, but it’s fairly obvious that the pro-choice community was outmaneuvered by the Right. Few realized that Nelson’s amendment did not apply to every federal dollar in the health care law, and the administration seemed unprepared to fight once conservatives organized around the issue. In fact, when I spoke to some state sources who were implementing the pools, they were surprised to learn that the Hyde restrictions did not apply to the federal funds earmarked for the program. But what’s disappointing is that the administration felt so compelled to issue its restrictive regulations so quickly and reactively. If it was hoping to appease conservatives, then it overestimated the GOP’s willingness to recognize its concessions and underestimated its supporters ability to just accept the slight (yet again).

Public comment on the high risk pools closed Tuesday at midnight.

This morning, while defending Sen. Mike Enzi’s (R-WY) resolution to eliminate regulations that would dissuade insurers and employers from shifting costs to plan beneficiaries, Republicans proudly regurgitated insurance industry talking points about premium increases and unfair mandates. Without probing the reasons behind the new premium requests, Republicans simply bought the insurers’ explanation that the health care law was primarily responsible for the recent increases and criticized the administration’s efforts to review their rates. Sen. Pat Roberts (R-KS) even accused the HHS Secretary Kathleen Sebelius — who asked the industry to stop misattributing the hikes to the law — of creating an “enemies list” of insurers and gagging the industry’s free speech rights:

ROBERTS: [Sebelius] is threatening to shut down private companies for exercising their First Amendment right to free speech and she’s keeping a list it reminds me of the days with a previous administration with an ‘enemies list’ … they’re more subtle than this in Caracas, Venezuela…Stop the gag orders and the administration…don’t tread on the First Amendment.

Roberts and his colleague Sen. John Ensign (R-NV) are repeating the talking points of the insurance industry. Watch a compilation:

To be clear, premiums do follow underlining health care costs, but the new health benefits are responsible for only a very small fraction of the increase. According to actuaries at Hewitt Associates, a global consulting firm, “the most immediate reforms under the law — including the new protections known collectively as the Patient’s Bill of Rights — will contribute ‘approximately 1 percent to 2 percent of the 8.8 percent projected increase for 2011′” — far less than what the insurers are claiming.

The Enzi resolution to eliminate the new grandfather regulations ultimately failed in a procedural vote of 40 to 59, but not before the GOP invented a new stat for attack. Enzi claimed that “there will be 100 pages of regulation for each page of that bill.” “There are 2,700 pages in that bill. That means there are going to be 270,000 pages of regulation,” he said. (Sen. McCain came up with a different estimate, 121 pages of regulation for every 2 pages in the bill.)

But as Sen. Tom Harkin (D-IA) asked, “where did that come from? It sounds like it came from the health insurance industry to me.”

Paul Bedard of U.S. News and World Report previews Former Senate Majority Leader Tom Daschle’s new book, Getting It Done: How Obama and Congress Finally Broke the Stalemate to Make Way for Health Care Reform. The book is due out October 12th, and if this excerpt about 10 Healthcare Reform Pitfalls is any indication, we’re in for a good dose of honesty about the future politics of reform:

1. Higher premiums. While he says that “there is little risk” that everyone’s health insurance premium will go up, “it is unrealistic to expect that none of us will see any increases.”

2. Preexisting condition gap. 2010 will see that children with preexisting conditions can’t be rejected by health insurance companies, but adults won’t get that benefit for another four years.

3. Shrinking Medicare payments to doctors. 2011 will see payments to Medicare Advantage plans frozen and payments to providers will increase at a slower rate as it becomes official policy to expect healthcare providers to become more efficient.

4. Increased senior premiums. In 2011 more high-income seniors will start paying higher premiums. They will also get less of a subsidy for prescription drug coverage.

5. Cuts in Medicare Advantage. In 2012, Obama’s reelection campaign year, Daschle says that “there will be some significant healthcare events this year that are not politically safe.” Such as: Payments to Medicare Advantage plans will now be cut, not just frozen.

6. Mediare-cutting panel. Also in 2012, Obama will have to appoint a board charged with “tightening Medicare spending even more.” Daschle concedes that “in an election year, the appointment of the board is sure to lead to a new round of overheated charges about what the board might to do seniors’ care.”

7. Medicare tax boost. Come 2013, Daschle reports that individuals earning more than $200,000 a year and couples earning $250,000 a year or more will see a boost in Medicare taxes, ironically called the “HI tax,” short for hospital insurance tax. s.

8. Change in healthcare deduction. Also in 2013, the healthcare spending deduction will change. Where you can now deduct anything spent over 7.5 percent of your income, the new base will be 10 percent of annual income. Seniors get an extension on the 7.5 percent rate until 2017.

9. Employer tax. If employers have more than 50 full-time workers and do not provide coverage, they will be fined $2,000 for each employee. If they provide “expensive” coverage, they’ll also pay a fine.

10. Individual penalty. In 2016, with most of the reforms, in place, individuals who don’t have health insurance will be fined $695 a year, or 2.5 percent of annual income, whichever is greater.

Talk about spilling cold water on the much touted Democratic belief that Americans will fully embrace health care reform once it becomes law. Daschle’s perspective offers a more realistic take on the long road to not just selling reform to the public, but also dealing with many of the challenges that it brings for different constituents. Universal coverage won’t be painless and the cost containment provisions — excise tax, medicare panel — will generate tougher headlines than anything we’re seeing today. The question for lawmakers will be: do we stick with these policies or abandon them for short-term political gain. The history on this is mixed — with Congress, patching one cut, but offsetting it with others — but it’s also worth arguing that many of these cuts (particularly the Medicare adjustments that will come from the board) are actually politically advantageous since they do not directly target benefits.