I didn't realize that the U.S. Conference of Catholic Bishops was a political party with elected officials in Congress.

Does the bill provide abortion assistance in cases of rape, incest or to protect the life of a woman? or are we forced to carry the child of our rapist because???

I cannot wait for these Blue Dogs to start losing their seats and when they become unable to raise any money.

This is the biggest charade cluster---k I've ever seen in my lifetime.

Every day, as this thing gets whittled down more and more, I really do have to wonder about its overall worth.  The "we have to pass something" group takes greater control of this debate every day.

I know it is not politically feasible to get some things right up front.  But if the end result of all this paring and "compromise" is a tremendously marginalized bill that creates a whole new set of problems and roadblocks for the people who truly need health care, how much value, in the end, does it really have?

It is just supremely frustrating that all of the "give back" has to be from one side, the side that is trying to help real people with real needs.

It is just aggravating to watch.  The people in Washington just really don't give a shit about the most marginalized people in this debate.  

"Nothing in all the world is more dangerous than sincere ignorance and conscientious stupidity"

Roosevelt was right about fear, and it has been the fear of Democrats which has led us to this crappy bill.

A conservative is a man with two perfectly good legs who, however, has never learned how to walk forward. Franklin D. Roosevelt

Leaning pro - needs shoring up

Arcuri (D, NY-24)
Bean (D, IL-08)
Bishop, S. (D, GA-02)
Boswell (D, IA-03)
Butterfield (D, NC-01)
Cardoza (D, CA-18)

Costa (D, CA-20)

Doyle (D, PA-14)
Edwards, C. (D, TX-17)
Etheridge (D, NC-02)
Gordon (D, TN-06)
Kratovil (D, MD-01)
Langevin (D, RI-02)
McMahon (D, NY-13)
Michaud (D, ME-02)
Minnick (D, ID-01)

Nye (D, VA-02)

Obey (D, WI-07)
Owens (D, NY-23)
Ruppersberger (D, MD-02)
Ryan, T. (D, OH-17)
Salazar (D, CO-03)
Space (D, OH-18)

Undecided / Unknown
Biggert (R, IL-13)
Castle (R, DE-AL)

Chandler (D, KY-06)
Cooper (D, TN-05)

Cuellar (D, TX-28)

Davis, A. (D, AL-07)
Dent (R, PA-15)

Frelinghuysen (R, NJ-11)
Kirk (R, IL-10)
Neal (D, MA-02)

Pomeroy (D, ND-AL)
Snyder (D, AR-02)
Tanner (D, TN-08)
Visclosky (D, IN-01)

Leans anti-choice (probably gone, but if anyone has any relationship, worth pursuing, especially GOPers)

Altmire (D, PA-04)
Barrow (D, GA-12)
Berry (D, AR-01)
Boccieri (D, OH-16)
Bright (D, AL-02)
Capito (R, WV-02)

Carney (D, PA-10)
Donnelly (D, IN-02)
Ellsworth (D, IN-08)

Hill (D, IN-09)
Jenkins (R, KS-02)
Kildee (D, MI-05)
Lance (R, NJ-07)
Lee, C. (R, NY-26)

Lynch (D, MA-09)

Matheson (D, UT-02)
Mollohan (D, WV-01)
Ortiz (D, TX-27)
Paulsen (R, MN-03)
Perriello (D, VA-05)
Rahall (D, WV-03)
Ross (D, AR-04)
Spratt (D, SC-05)
Wilson, C. (D, OH-06)

To:                   House Offices
From:              Laurie Rubiner, Vice President of Public Policy and Advocacy
                        Planned Parenthood Federation of America
                        Planned Parenthood Action Fund

Date:               November 7, 2009

Re:                  INTENT TO SCORE:  Oppose Stupak-Pitts Amendment to the Affordable Health Care for America Act (H.R. 3962)

Today, the House is prepared to consider the Affordable Health Care for America Act (H.R. 3962), landmark legislation whose intent is to ensure that millions of Americans have accessible, affordable health care.  As a health care provider to millions of Americans, Planned Parenthood is keenly aware of how imperative it is that we reform our nation's health care system.  Unfortunately, women's health has been put on the line in the process.

Make no mistake about it - the Stupak-Pitts amendment, which will be made in order, is the most extreme of any anti-women's health amendment considered (all of which have been outright rejected) by the five committees of jurisdiction.  It is unquestionably a ban on abortion coverage under health care reform.

While Mr. Stupak claims that his amendment simply applies the Hyde amendment to health reform, nothing could be farther from the truth.  The Stupak-Pitts amendment would result in a dramatic new restriction on women's access to abortion coverage in the private health insurance market, undermining their ability to purchase a private health plan that covers abortion, even when they are paying for all or most of the premium with their own money. Planned Parenthood urges you to oppose the Stupak-Pitts amendment.  A NO vote on the Stupak-Pitts amendment will be considered a vote in support of women's health.

The Stupak-Pitts amendment will ban abortion coverage in the health care exchange.
The amendment offered by Reps. Stupak (D, MI-01) and Pitts (R, PA-16) would prohibit federal subsidies from going to any private plan in the health care exchange that covers abortion care.  This goes beyond current federal policy on abortion care - which is maintained by the current compromise that makes clear that no federal funds can be used to pay for abortion.  (See information further below on the language in the current bill.)

Not only does this amendment limit coverage of abortion to an unworkable, single-service rider, it imposes further barriers for health plans to offer such a rider.  This is unquestionably a ban on abortion coverage under health care reform.

Such an "abortion rider," whereby abortion care could only be covered by a single-service plan in the exchange, is discriminatory and illogical.  Women do not plan to have unintended pregnancies (or pregnancies in which a complication will arise that will require ending the pregnancy).  In fact, about half of all pregnancies are unintended.  Abortion is simply not something that women plan to insure against. An abortion rider policy also raises serious privacy concerns, as it fundamentally undermines the spirit of existing privacy law.  In addition, the barriers this amendment proposes for health plans that want to offer such a rider will ensure that few, if any, are offered.  Proposing a separate "abortion rider" represents exactly the type of government interference in the health care marketplace that conservatives purport to vehemently oppose.

This amendment would mark an unprecedented restriction on people who pay for their own health insurance.
Millions of Americans will be purchasing health insurance through the health care exchange without any federal subsidies, and millions more will be paying for the majority of the cost of coverage.  With an individual mandate in place, an effective ban on abortion coverage in the exchange would amount to the government forcing people to use their own money to purchase health insurance that does not meet their health care needs.

The Stupak-Pitts amendment represents a dramatic shift from the status quo on federal abortion policy.
The current abortion compromise applies the Hyde amendment so that it has the same effect as it currently does in Medicaid - ensuring that no federal funding may be used to cover abortion care while still allowing for coverage (17 states offer all medically necessary abortion coverage in Medicaid).   At the same time, it's important to note that the health insurance exchange is not comparable to Medicaid.  This is fundamentally a private health care system whereby individuals will be purchasing plans from private insurance companies, in large part with their own money. The Stupak-Pitts amendment dramatically changes federal policies related to abortion coverage and undermines the principle of abortion neutrality in health care reform.

Furthermore, the Stupak-Pitts amendment goes beyond its stated purpose of restricting abortion coverage in health care reform and targets access to abortion as well, by gutting the neutrality of existing conscience protections, which currently protect both those who refuse to provide and those who choose to provide abortion care.

We're extremely disappointed that some members have decided to turn the health care reform debate into an abortion debate, and we take very seriously all efforts to impose a ban on abortion coverage in the health care exchange - which would mark a dramatic departure from current coverage in the private marketplace and therefore violate the first tenet of health care reform that no one lose the coverage they currently have.  Women won't stand for this.

Below is more information about the overall bill and the current abortion compromise language.  Please don't hesitate to contact me or any of PPFA's legislative representatives (Jacqueline.Ayers@ppfa.org / 202-973-4976; Alicia.Dupre@ppfa.org; 202-973-4832; and Emily.Stewart@ppfa.org / 202-973-4839) with any questions.

*******

Background and Talking Points on H.R. 3962

The current abortion compromise language ensures that neither pro-life nor pro-choice agendas are advanced in this bill.
The status quo on federal abortion policy is maintained.  (A detailed summary of the abortion compromise language in H.R. 3962 is attached).

Health care reform is about increasing access to quality, affordable care.  It should not be a platform for resolving or litigating issues like abortion.  It assures that access to abortion is neither mandated nor prohibited, and it clearly states that no federal funds - neither tax nor cost-sharing credits - can be used to pay for abortion care.  It also sets up a stringent process to ensure segregation of funds, whereby health plans must demonstrate that federal funds are not used to pay for abortions using an actuarial value process set up by the Secretary.  In fact, this process is more stringent than in Medicaid, where there are no federal rules around how states must demonstrate separation of funds if they cover abortion under the state Medicaid programs.

If the language in H.R. 3962 makes any concessions, it is to pro-life Americans, who - for the first time - will be guaranteed access to health plans that do not include abortion coverage, unlike in the current marketplace.  In the current marketplace, the majority of private health insurance plans cover abortion care, and some consumers only have access to plans that offer abortion coverage.  It is important to note that under no instance can health insurance companies be forced to provide coverage of abortions.

In addition, the compromise language also provides new protections for facilities that refuse to provide abortion care by stipulating that health plans participating in the exchange cannot discriminate based on a provider or facility's unwillingness to provide, pay for, provide coverage of, or refer for abortions.  Because it is "abortion neutral," the language also provides similar protections for abortion providers.  The Stupak-Pitts amendment strips the protection for providers who are willing to provide abortion care but maintains the protection for providers who are unwilling to provide abortion care.

Opponents have also consistently failed to highlight that the current compromise stipulates that state laws regarding abortion coverage are not pre-empted.  Therefore, if citizens of any given state do not want abortion covered at all through private health insurance plans, they have the option of pushing for further restrictions in their state.

The compromise in the bill does more to ensure separation of federal funds from private dollars than any other existing policy, including those that are not related to abortion.  For instance, in their zeal to undermine this bill, opponents have conveniently overlooked the precedent established through Charitable Choice policies.  These policies very clearly accept similar separation requirements as legitimate--otherwise, thousands of religious charities that receive federal financial assistance would be in violation of the Establishment Clause of the United States Constitution.  In fact, existing Charitable Choice law stipulates that federal funds that indirectly go to religious organizations (through a genuine and independent private choice of a beneficiary via a voucher, certificate, coupon, or similar mechanism) do not need to be separated at all.   (See 69 Federal Register 42586; 45 CFR Parts 74, 87, 92, and 96).  While the same could have held true under health care reform (where individuals are receiving a subsidy), the compromise requires strict separation between private premiums and the federal funds beneficiaries receive under health care reform.  In short, opponents are pushing for a double standard.

Recent polling by the Mellman Group confirms that there is widespread public support for this compromise - particularly among traditionally moderate and conservative groups of voters.  The language is supported by 64% of anti-abortion voters, 61% of Republicans, and 58% of Catholics.  This is greater than support among pro-choice voters (47%) and Democrats (47%), who are concerned it already goes too far.

The bottom line is that women must not lose benefits under health care reform, and the current compromise language ensures that women can access the care they need without undermining current abortion restrictions in federal law.

PLANNED PARENTHOOD URGES YOU TO OPPOSE THE STUPAK-PITTS AMENDMENT.

*******

Leading Editorials Have Opposed the Stupak-Pitts Amendment and Similar Proposals
An editorial in USA Today said(11/2/09):
"[The Stupak amendment] goes too far. It would mark a broad new expansion in the effort to restrict access to abortion. Nearly 90% of private health insurance policies now offer abortion coverage, and almost half of women with private insurance have it. But women covered under the new system would have to find supplemental insurance or pay out of pocket for an unanticipated procedure that can cost from hundreds to tens of thousands of dollars, depending on complexity. For anyone unable to afford it, this would amount to a de facto ban."
[http://blogs.usatoday.com/oped/2009/11/debate-on-reproductive-rights-our-view-abortion-foes-seek-to- use-health-plan-to-curb-access.html]

An editorial in the New York Times said (10/1/09):
"Conservative critics of pending reform bills want to prohibit the use of tax subsidies to buy any health insurance policy that covers abortion. Some want to require women to buy an extra insurance "rider" if they want abortion coverage, an unworkable approach given that almost no one expects to need an abortion, few women would buy the rider and, therefore, few insurance companies would even offer it."
[http://www.nytimes.com/2009/10/01/opinion/01thu1.html?ref=opinion]

An editorial in the LA Times said (11/6/09):
 "The real goal of abortion opponents isn't to maintain the status quo. It's to extend federal prohibitions into private pocketbooks. By restricting coverage offered through the exchange, they hope to make abortion coverage so unattractive that insurers eventually stop offering it in the market for individual and small-group policies."
[http://www.latimes.com/features/health/la-ed-health6-2009nov06,0,1334958.story]

An editorial in The St. Petersburg Times said (11/5/09):
"Contrary to the claims of Rep. Bart Stupak, D-Mich., who has been leading the antiabortion effort, the Capps amendment would not expand federal funding for abortion. Instead it would establish some basic principles to reflect the current health insurance landscape in which nearly 90 percent of private plans offer abortion coverage."
[http://www.tampabay.com/opinion/editorials/preserving-abortion-coverage/1049437]

An opinion editorial by Kathleen Kennedy Townsend in Newsweek said (11/6/09):
"Unfortunately, this reasonable approach is under attack from some Roman Catholic bishops who object even to the use of private dollars for women to exercise their conscience. They are determined to make abortion illegal, even if it derails health-care reform entirely--no matter the cost to women and children--and regardless of whether it would actually have any impact on the number of abortions in this country. (In fact, comprehensive health care could well reduce the number of unintended pregnancies and subsequent abortions.) In politics, this is called using abortion as a "wedge" issue. And it's simply not right."
[http://www.newsweek.com/id/221551]

and again, I told you so.  I told you since DAY 1 and all anyone said was "brendan's a cynic."

I wasn't a cynic. I was a REALIST.

John Mccain Called his wife WHAT??

Of course we're far from there, but things could be worse, which is about the best you can say for it.

________
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