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Abortion Coverage Excluded from ‘High-Risk’ Pools

My inbox was flooded with emails from outraged readers this week from pro-choice and civil liberties groups demanding action on abortion coverage in health reform. It felt a little déjà-vu. After the healthcare reform process, which brought us Bart Stupak and months of controversy over whether abortion would be sidelined as a different kind of health procedure that shouldn’t be covered, I thought we’d reached an unpleasant, but complete compromise.

But this week the Obama administration, of its own accord, decided to honor the “spirit” of that compromise by banning abortion coverage in almost all cases (rape, incest, life-threatening situations excluded), from high-risk pools — that is, for people who probably need this coverage the most.

As the ACLU put it:

These high-risk pools, which are already in effect and which will exist until 2014, will allow people with pre-existing conditions who have been denied coverage on the individual market to purchase health insurance with a federal subsidy. But, they won’t be able to access abortion coverage except in the case of rape or incest or to save the pregnant woman’s life. There’s nothing in the new Health Care Reform law that requires this restriction and it is deeply disturbing that a pro-choice administration would voluntarily impose such an anti-choice measure.

In other words, the “high-risk” pools are an extension of the compromise — they are not equivalent to the state “exchanges” originally targeted by the Stupak and Nelson amendment and the subsequent executive order. For a more detailed explanation of the ins and outs of this move relative to health reform legislation see this story from Jessica Arons at Center for American Progress, an expert on domestic abortion policy.

What’s particularly disturbing about this week’s decision is its indication once more that the Obama administration embraces the sidelining of abortion as a “different” medical procedure, one that needs to be shepherded away from appendectomies and other, less commonplace surgeries. It’s worth reading Emily Bazelon’s recent cover story in last week’s Times magazine about the fact that pro-choice doctors, including obstetricians and gynecologists, and family practitioners, are trying to do exactly the opposite — to integrate early abortions into their regular care, to indicate that this procedure is a routine part of taking care of women.

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