Monday July 19, 2010

Maryland Plan Indicates HHS Approved High Risk Pools With No Abortion Requirements

By Peter J. Smith

WASHINGTON, D.C., July 19, 2010 ( – Was the U.S. Department of Health and Human Services (HHS) approving state applications for running federal high-risk insurance pools without a second thought to abortion? That is how it seems to the National Right to Life Committee, which discovered that Maryland’s plan to cover individuals with pre-existing conditions also had no restrictions on abortion coverage until media attention and public controversy propelled the HHS to clarify the matter.

In an email sent Friday to, NRLC Legislative Director Douglas Johnson said that Maryland was “on the way to providing federally funded abortion coverage in the new federal Pre-existing Condition Insurance Plan (PCIP)” until the HHS declared that Hyde amendment restrictions on abortion funding – allowing abortion only for rape, incest, or to save the life of the mother – would apply to the federal high risk pools.

The federal PCIPs are a $5 billion HHS program to help give coverage to individuals with pre-existing medical conditions unable to afford health insurance, until the health care reform law takes full effect in 2014. The HHS is directly administering the program in 21 states, while 29 states and the District of Columbia will administer the PCIPs through their own programs.

Johnson pointed out a press release from Maryland Governor Martin O’Malley, which explained that the Maryland Health Insurance Plan (MHIP) would be administering the PCIP for that state. But the release also directed readers to a “Frequently Asked Questions” page which explained that the “MHIP Federal Plan offers the same benefit package as other MHIP plan options.”

But the MHIP also provides coverage for abortion, a fact Johnson said could be seen for itself on page 53 of MHIP’s “2010 Plan Year Certificate of Coverage.” In the “Covered Services” section, under the heading “Maternity Services,” is listed abortion. For individuals with an HMO plan – one of five plans available – inpatient abortion surgery has a “$250 co-pay per admission,” while outpatient abortion surgery has “No Facility Copay.”

“Each day brings more evidence that federal DHHS was merrily approving abortion-funding plans without a second thought,” observed Johnson. “There is no evidence that DHHS either conveyed to the states that abortion could not be included, or that DHHS had any intent of imposing such a policy, until NRLC put the spotlight on the issue.”

Johnson’s theory that the federal government was approving plans without abortion guidelines has already been bolstered by the plans in two other states.

Betina Gonzales McCracken, spokeswoman for New Mexico Human Services Department, told in an e-mail that the inclusion of “elective abortion” in New Mexico’s federal high risk pool was a “simple mistake,” and that state officials “knew from the very beginning that elective abortion is not a covered service.”

“The ‘draft’ summary of benefits submitted to the HHS mistakenly included ‘elective abortion,’” McCracken stated. “The way that occurred was we had a short time frame to turn in our application to the feds, so we turned in a ‘mirror’ version of the NM high-risk pool. We should have had a qualifier that stated ‘pending rules and guidance’ from the federal government.”

McCracken’s statement did not indicate that the HHS had given application requirements to states submitting such proposals. LSN twice requested McCracken Friday to provide any HHS directives regarding abortion coverage in the application process, but received no response as of press time Monday.

HHS spokeswoman Jenny Backus also indicated to the AP that HHS issued no abortion restrictions – but were “working on” it – even as some state-run PCIPs, such as Maryland’s, began going into effect as of July 1. Backus told the AP last Wednesday, “The department is working on guidance to make those restrictions explicit to states and insurance plans.”

The controversy impelled HHS to clarify in a statement last week that Hyde-amendment restrictions would apply to all PCIPs – both state and federal. The declaration drew howls of outrage from NARAL Pro-Choice America, and praise from the US Catholic Conference of Bishops, which had lobbied heavily for a broad ban on federal funds for elective abortion and failed. (see coverage here)

But the matter has also put President Obama’s executive order back in the spotlight. Rep. Bart Stupak (D-Mich.) stated on Friday that the executive order made clear “that federal funds may not be used for abortion under the Affordable Care Act – including the pre-existing condition insurance pools currently being implemented in Pennsylvania, New Mexico and other states across the country.”

Yet top pro-life analysts have noted that the text of the executive order only concerns the state-run exchanges (sec. 1 & 2), and the Community Health Center (CHC) program. No mention is made regarding the PCIPs.

Citing such flaws on abortion funding, pro-life organizations including the USCCB, NRLC, and others, have called for the adoption of the Protect Life Act (HR 5111) to clearly apply Hyde-amendment restrictions to the federal health care law. The bill, offered by Rep. Joe Pitts (R-Penn.), has the same legislative language that Rep. Stupak fought for during the health care debate but no longer supports.

See related coverage by

HHS Moves to Block Abortion Funding in High-Risk Pools Following Controversy

NARAL Enraged, USCCB Cautiously Pleased with HHS ‘Clarification’ on High-Risk Pool Abortion Funding

President Signs Stupak’s Executive Order in Private Ceremony

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