PolitiFact Smacks Down Rep. Boehner's "Abortion Premium" Claim

November 21, 2009 3:29 pm ET

PolitiFact.com Destroys Rep. Boehner's Claim That The Senate Bill Includes An "Abortion Premium"

As the Senate moves to take up its version of the health care reform bill, Rep. Boehner alleged that the bill levied a new "abortion premium." PolitiFact.com reviewed his statement:

Boehner's claim that the Senate bill includes a monthly "abortion fee" was new to us. Intrigued, we went directly to Page 122 of Section 1303 of the bill, the language Boehner is concerned about.

That section deals with measures the government will take to ensure that no plan offered through the exchange will use federal dollars to cover abortion procedures.

If a plan through the exchange does offer abortion coverage, "the issuer of the plan shall ... segregate an amount equal to the actuarial amounts determined under subparagraph for all enrollees," the language says. The Health and Human Services Secretary "shall estimate the basic per enrollee, per month cost, determined on an average actuarial basis, for including coverage under a qualified health plan." Finally, the secretary "shall estimate such costs as if such coverage were included for the entire population covered; and may not estimate such a cost at less than $1 per enrollee per month."

All that legalese means this: Because insurance companies participating in the exchange may not use tax dollars to pay for abortion procedures, they must ensure that an adequate amount of private funding -- which will come from private premiums -- is set aside. Per premium, that funding can be no less than $1 dollar a month; otherwise, it's up to the insurance company. All this is to ensure that there's enough private premiums to pay for abortions should participants need them.

So, the bill does require that abortion coverage through the exchange be paid for with private premiums.

But does the bill language dictate an abortion fee as Boehner says?

Usha Ranji, a policy analyst for the Kaiser Family Foundation, says no.

"I don't understand what [Boehner's] reference is to," she said. The provision simply "outlines some technical direction of how you would establish cost of an abortion benefit."

Lara Cartwright-Smith of George Washington University's public health school concurred, adding that everyone participating in the exchange would have the option of choosing a plan that does not include abortion.

So, back to Boehner's claim. The bill does not require a fee, or a charge above and beyond the premium cost specifically to cover abortions. And technically speaking, we don't know whether the public option will offer abortion coverage or not. Instead, it gives the Health and Human Services secretary a minimum for estimating the cost of covering abortions. So we give Boehner a False.