The language on abortion in the original version of House health care reform bill, before it was amended on the floor, and the Senate language on abortion are very similar. Both say that:

  • No federal funds will be used to pay for abortions, but as provided by the Hyde amendment, exceptions are made for rape, incest, and the life of the mother;
  • Any plan that covers abortion must use money from a special segregated account funded only with private premiums to pay for the procedure;
  • In every region, there must be at least one plan on the exchange that covers elective abortion (the so-called “pro-choice option”) and one plan that does not (the so-called “pro-life option”);
  • There could be no discrimination against an insurance plan that does not cover abortion;
  • Abortion could not be mandated as part of the minimum coverage requirements for an insurance plan.

The original House language and the Senate language did differ slightly on how the public option could cover abortion: While both would require that no federal funds are used by the public option to cover abortion beyond what is allowed in the Hyde amendment, the Senate bill does take additional steps to ensure that if elective abortion is covered by the public option, no federal funds are used and the government would bare no insurance risk.

The Stupak amendment, which was voted into the House bill, is a radical departure. It goes beyond original House and Senate language, mandating that no federal funds pay for an abortion (except those allowed by the Hyde amendment). It does not accept the idea that funds can be segregated. It prohibits federal funds from being used in any way to help operate an insurance plan that does cover abortion. If a plan uses even one federal dollar to help pay for any aspect of its overall operation, it can not cover abortion.

The Stupak amendment would technically allow for the sale of insurance plans or riders that cover abortion on the exchange–but only if no federal money even tangentially helped pay for their administrative functions. In effect, this restriction would make it practically impossible for any insurance provider to offer abortion coverage on the exchange for a variety of financial and legal reasons.

The broad language could also force many large employer-provided health insurance plans to drop the abortion coverage they already provide. The bills would provide a small amount of federal money to many large employer plans to help them pay for for things like wellness programs. Because of the Stupak amendment, this tiny drop of federal money could taint the entire insurance plan.