Should health care reform pass, it seems, from what some are saying, that pregnant women across the country will be running out to get abortions. It will be as if abortion became legal all over again!

While there's been a lot of speculation about the effect of health care reform on abortion, until now, I've had no idea what the Senate bill actually says about it. Take it with a grain of salt if you will--it comes from Catholics who support reform because in this country the best (and most cost effective) way to access the human right to health care is through having insurance--but here are the abortion-related provisions in the Senate-approved health care reform bill: (Here's the full letter to Senate leaders from Catholic and Evangelical leaders.)

• Prohibits the Secretary of HHS from requiring the coverage of any abortion services as part of the essential health benefits for any qualified health plan offered in a state insurance Exchange (pg. 2070);
• Allows the insurance company to decide whether or not to include coverage of abortion services, including the Hyde abortion exceptions, in a qualified health insurance plan offered in a state insurance Exchange (pg. 2070);
• Prohibits insurance companies from using federal funds, including federal tax credits and cost-sharing assistance, to pay for abortion services except for those services allowable under the Hyde amendment (pg. 2071);
• Requires an insurance company that chooses to offer a plan in a State Exchange with abortion coverage, beyond the Hyde abortion exceptions, to collect a separate second premium payment from each enrollee for the cost of the abortion coverage (pgs. 2071-2072 & 2074-2075);
• Requires the insurance company to deposit all separate payments into a separate account that consists solely of abortion premium payments and that it is used exclusively to pay for such services (pgs. 2072-2074);
• Requires the state health insurance commissioners to ensure that insurance companies comply with these requirements in accordance with guidance and accounting standards set by the Office of Management and Budget and the Government Accountability Office (pg. 2075)
• Requires insurance companies that offer general abortion coverage as part of a qualified health plan to provide a notice of coverage in the summary of benefits and coverage explanation (pg. 2076);
• Allows states to pass a law prohibiting the inclusion of abortion coverage in plans offered in a state health insurance Exchange (pg. 2069);
• Requires the director of the Office of Public Management to ensure that there is at least one private, multi-state qualified health plan offered in each state insurance Exchange that does not provide coverage of abortion services beyond the Hyde exceptions (pgs. 2087-2088);
• Prohibits insurance companies offering qualified health plans from discriminating against any individual health care provider or health care facility because of its unwillingness to provide, pay for, provide coverage of, or refer for abortions (pg. 2076);
• Prohibits the preemption of state laws regarding abortion (pg. 2077); 
• Maintains current Federal laws relative to conscience protection; willingness or refusal to provide abortion; and discrimination on the basis of the willingness or refusal to provide, pay for, cover, or refer for abortion or to provide or participate in training to provide abortion (pg. 2077); 
• Establishes and provides $250 million for programs to support vulnerable pregnant women (pgs. 2170-2173); and
• Increases the adoption tax credit and makes it refundable so that lower income families can access the tax credit (pgs 2400-2407).

From what I see, I don't understand why this doesn't match the scrutiny of the requirements to uphold the Hyde Amendment (which the bishops support though it does make exceptions for rape, incest, and the life of the mother).

In fact, one element--the requirement for insurance companies to provide notice of coverage for abortion--would help all who want to avoid "complicity" with abortion out. I bet most, unless you have insurance through a Catholic organization, pay for insurance that includes abortion coverage. Having the option to buy insurance that doesn't have abortion coverage is a plus to this plan.

Despite our best efforts to keep federal funds away from abortion, the fact remains that we live in a country where abortion is legal. Until it becomes illegal (and as a pragmatist I doubt it will), having insurance in which pregnancy isn't a pre-existing condition and having $250 million in programs to support vulnerable pregnant women will do a lot of good for the unborn.