The “compromise” allows states to block any insurance policy that offers abortion coverage to be offered on the insurance exchange in that state. Further, in all states if an individual receiving federal help to pay for insurance coverage chooses a policy that covers abortion, she’ll have to pay for the abortion coverage with a separate transaction. Brian Beutler explains,
Put another way: If you’re buying insurance with help from the government, and the policy you want to buy covers abortions, you have to write two checks (or authorize two credit card transactions, etc.) for your plan. If the plan costs $1000 a month, and the insurer plans to sequester $50 to put into a pool that covers abortions, you have to make one payment of $950 and a separate payment of $50.
One of the arguments made against Roe v. Wade over the years is that the decision to criminalize or legalize abortion should be made by states, not the federal government. Just let the states decide, they say, and we’ll abide by that. But does anyone honestly think the Fetus People would respect any state’s decision to legalize abortion?
Further, this morning the Right is still screaming that, somehow, the bill provides for “federal funding of abortion.” Exactly where they are seeing this federal funding is a mystery to me. It must be lurking behind the death panels.
As for the rest of the bill — Nate Silver thinks progressives really did have a positive impact on the bill, even though we may feel everything we wanted was traded away.
For instance: the CLASS Act has survived; the ban on lifetime coverage limits was restored; there was no tinkering with the Medicaid provisions; there’s some Ron Wyden like amendment to permit workers to opt out of their employer-provided coverage and purchase insurance on the exchanges instead; the abortion language in the Senate’s bill is milder than that which is already in the House’s (to an extent that may actually be a problem); a provision to allow people to purchase insurance through non-profit programs organized by the OPM was inserted, and some decent medical loss ratios were established. …
…From a policy standpoint, indeed, I think the kill-bill / public-option-or-bust strategy has helped to push the bill toward an optimal outcome. Certainly not optimal in the sense of “the best bill that the Senate could possibly have passed”, or “the best bill that progressives could have hoped for”. But in terms of the best bill that the Senate was actually going to pass, given the 60-vote requirement, an unpopular Congress, and an inexplicably lackluster performance from the White House, this is probably fairly close — especially if some further concessions can be realized in conference with respect to the magnitude of the subsidies.
Of course, the actual vote hasn’t been taken yet, and we still don’t now what will happen in reconciliation.
See also Eztra Klein, “The Congressional Budget Office scores the amended Senate bill“; Dan Wasserman, “Hey kids — What’s up with health reform?“