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Have a Health Care Reform Headache?

Have a Health Care Reform Headache?


August 27, 2009

Q: Will the government start paying for abortions?

Neither the House nor Senate version of the legislation contains any requirement that federal funding be made available for abortions. (Federal law’s “Hyde Amendment” has since 1976 barred the government from paying for abortions through Medicaid, the federal- state program that provides health insurance for low-income individuals.)

Claims that tax dollars will be used for abortions are premature and misleading. But the legislation is still short on many details. Depending on how future regulations are written, it is possible that some women who get federally subsidized insurance could buy plans that cover abortions.

Under the most popular Democratic proposals, millions of Americans would buy insurance in a new, highly regulated marketplace in which private insurers and possibly the government would offer a choice of health plans. Many of those people would qualify for federal aid to defray the costs of at least part of their premiums.

It appears unlikely that the federal government would require the plans in this new marketplace to cover abortions. In fact, one version of the legislation explicitly prohibits such a requirement. But some private insurers in the exchange may well cover abortion services, and their customers could include women who receive public subsidies to help pay for their insurance.

Q: Will there be government rationing of health care under the bills being considered?

No. The new system would still rely on private health plans where patients and physicians make decisions on medical care.

Right now, there is a form of rationing based on cost. An individual or an employer may choose different coverage plans based on how much they want to pay. Less expensive plans with high deductibles, for instance, might lead some policyholders to defer medical care. That form of price-based rationing would continue under the pending health care reform bills.

How much will the government intrude?…

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