During Thursday’s mark-up session of the Kennedy health bill, Sen. Barbara Mikulski (D-MD) introduced Mikulsi 201, an amendment requiring health plans in the Exchange to cover — with no or limited cost sharing requirements — women’s preventive care and screenings provided for in guidelines supported by the Health Resources and Services Administration, such as contraception, Pap tests, breast cancer screenings, and STI testing and treatment.
The amendment passed, but several Republicans and Sen. Bob Casey (D-PA) objected to the measure because it did not explicitly exclude providers who happened to offer abortion services. Sen. Orrin Hatch (R-UT) specifically objected to language that would allow women who purchase coverage from the Exchange to also seek aid from “essential community providers,” such as Planned Parenthood: Watch it (via Karen Tumulty):
As Mikulski explained, the community-based clinics “would include women’s health clinics that provide comprehensive health services…it does not in any way expand a service, in other words it doesn’t expand or mandate an abortion service….it would provide for any service deemed medically necessary or medically appropriate.” These essential community providers serve low-income, medically-undeserved communities and are an important part of addressing the provider shortage. In other words, the amendment leaves medical decisions to the doctor, while preserving women’s access to legal medical services, an approach Hatch himself supports.
But here the issue is abortion, a red herring for Republicans looking to divide the Democratic party among social lines and derail the entire reform effort. Even amendments that serve only to ensure timely access to preventive care and make no explicit reference to abortion services are re-interpreted as implicitly guaranteeing that right. “To force private insurance companies to pay for abortions is unconscionable, and this President and his far left liberal allies in the Senate have no business foisting this on the private sector,” Hatch wrote in a statement regarding the Mukulski amendment, before introducing an amendment that would extend the Hyde Amendment restrictions — which denies federal Medicaid coverage of abortions except in the cases of rape, incest, or life endangerment — to coverage purchased within the Exchange. Medical decisions, in other words, are the purview of the medical professionals, so long as they don’t include abortion, at which point the tag team of Hatch and Coburn are qualified to deny coverage.
During today’s HELP mark-up hearing, the committee rejected two amendments targeting abortion but accepted Kennedy 205, which would ensure that providers that refuse to perform abortions are not excluded from contracting with a health insurance plan.