Hat Tip to mcjoan at Kos. From Jessica Arons, Director of the Women’s Health and Rights Program at the Center for American Progress Action Fund.

1. It effectively bans coverage for most abortions from all public and private health plans in the Exchange: In addition to prohibiting direct government funding for abortion, it also prohibits public money from being spent on any plan that covers abortion even if paid for entirely with private premiums. Therefore, no plan that covers abortion services can operate in the Exchange unless its subscribers can afford to pay 100% of their premiums with no assistance from government “affordability credits.” As the vast majority of Americans in the Exchange will need to use some of these credits, it is highly unlikely any plan will want to offer abortion coverage (unless they decide to use it as a convenient proxy to discriminate against low- and moderate-income Americans who tend to have more health care needs and incur higher costs).

2. It includes only extremely narrow exceptions: Plans in the Exchange can only cover abortions in the case of rape or incest or “where a woman suffers from a physical disorder, physical injury, or physical illness that would, as certified by a physician, place the woman in danger of death.” Given insurance companies’ dexterity in denying claims, we can predict what they’ll do with that language. Cases that are excluded: where the health but not the life of the woman is threatened by the pregnancy, severe fetal abnormalities, mental illness or anguish that will lead to suicide or self-harm, and the numerous other reasons women need to have an abortion.

3. It allows for a useless abortion “rider”: Stupak and his allies claim his Amendment doesn’t ban abortion from the Exchange because it allows plans to offer and women to purchase extra, stand-alone insurance known as a rider to cover abortion services. Hopefully the irony of this is immediately apparent: Stupak wants women to plan for a completely unexpected event.

4. It allows for discrimination against abortion providers: Previously, the health care bill included an evenhanded provision that prohibited discrimination against any health care provider or facility “because of its willingness or unwillingness to provide, pay for, provide coverage of, or refer for abortions.” Now, it only protects

From McJoan at Kos:

Once again, just like in the pre-Roe days, the wealthy will have access to abortion, those who can’t scrape several hundred dollars together won’t. Because of how the exchange is structured, most of people covered through it will be receiving credits or subsidies. Therefore, most of the participants will not have access to a legal medical procedure. Additionally, the reality, as Arons says, is that the insurers participating in the exchange won’t offer it at all, and the question remains whether they’ll continue to offer it for women in employer-based programs outside the exchange, or whether it would just be easier for administrative and overhead purposes to stop covering it at all. Right now, nearly 90 percent of private, employer-based plans cover abortion services. This legislation could result in many of those plans dropping it, to make administration of plans simpler and more cost-effective. We know how critical the bottom line is to them.

And take another look at those exclusions: “where the health but not the life of the woman is threatened by the pregnancy, severe fetal abnormalities, mental illness or anguish that will lead to suicide or self-harm, and the numerous other reasons women need to have an abortion.” Even planned pregnancies are regularly terminated–legally–because of the health of the mother or severe fetal abnormalities. Forcing women to carry these pregnancies to term is dangerous and cruel. Forcing low- and moderate-income women to have to make hard financial decisions to try to come up with the money for the procedure is cruel. It’s also diametrically opposed to the very principles of healthcare reform. This legislation is supposed to be freeing Americans from having to make horrible financial choices between basic necessities and medical care. [snip]

This is the most expansive restriction on access to abortion Congress has passed. It goes well beyond Hyde, which has never been codified and which only governs federal, public plans. It’s particularly galling that it comes under the umbrella of healthcare “reform.”

Remember the promises? Reform was about expanding choices, not allowing government to come between you and your doctor, no one will lose their coverage, and if you like your current plan you get to keep it. Apparently being female is a preexisting condition that exempts us from the promises, too.

Abortion is legal. It is a very real part of women’s lives. One in three American women will have an abortion at some point in her life. It’s a common procedure. It’s time Americans grow up and face reality about this issue.

If people really believe we need to reduce the number of abortions being performed then they need to provide actual effective policy proposals – simply making abortions difficult to obtain isn’t the answer and certainly isn’t in keeping with the reality of women’s lives. If we’re serious about reducing the number of abortions that’s fine, but we need to adopt a real world solution – one that empowers both men and women to take seriously their reproductive health, one that provides not only education about contraceptives but which makes them readily available, that provides low or no cost alternatives for accessing contraception and for making ob/gyn services readily available. If you want to reduce abortion, making it illegal and dangerous isn’t the answer.

I know women who have abortions, women who wanted to and couldn’t and women who have never had to make that choice. As a man, I will never need to make that decision; the least I can do is guarantee that those who will face that choice have a full range of options that are safe, legal, and readily available.