Stupak–Pitts Amendment
Encyclopedia
The Stupak–Pitts Amendment was a proposed amendment to the Affordable Health Care for America Act
Affordable Health Care for America Act
The Affordable Health Care for America Act was a bill that was crafted by the United States House of Representatives in November 2009. At the encouragement of the Obama administration, the 111th Congress devoted much of its time to enacting reform of the United States' health care system...

 of 2010 (AHCAA). It was submitted by Representatives
United States House of Representatives
The United States House of Representatives is one of the two Houses of the United States Congress, the bicameral legislature which also includes the Senate.The composition and powers of the House are established in Article One of the Constitution...

 Bart Stupak
Bart Stupak
Bartholomew Thomas "Bart" Stupak is a lobbyist and American politician of the Democratic Party. He served as the U.S. Representative from from 1993 to 2011....

 (Democrat
Democratic Party (United States)
The Democratic Party is one of two major contemporary political parties in the United States, along with the Republican Party. The party's socially liberal and progressive platform is largely considered center-left in the U.S. political spectrum. The party has the lengthiest record of continuous...

 of Michigan
Michigan
Michigan is a U.S. state located in the Great Lakes Region of the United States of America. The name Michigan is the French form of the Ojibwa word mishigamaa, meaning "large water" or "large lake"....

) and Joseph R. Pitts
Joseph R. Pitts
Joseph R. "Joe" Pitts is the U.S. Representative for , serving since 1997. He is a member of the Republican Party. The district is based in Lancaster and includes much of Amish country...

 (Republican
Republican Party (United States)
The Republican Party is one of the two major contemporary political parties in the United States, along with the Democratic Party. Founded by anti-slavery expansion activists in 1854, it is often called the GOP . The party's platform generally reflects American conservatism in the U.S...

 of Pennsylvania
Pennsylvania
The Commonwealth of Pennsylvania is a U.S. state that is located in the Northeastern and Mid-Atlantic regions of the United States. The state borders Delaware and Maryland to the south, West Virginia to the southwest, Ohio to the west, New York and Ontario, Canada, to the north, and New Jersey to...

). Its stated purpose was to prohibit the use of federal funds "to pay for any abortion or to cover any part of the costs of any health plan that includes coverage of abortion" except in cases of rape, incest or danger to the life of the mother. It was adopted by the House but not included in the Senate version, the Patient Protection and Affordable Care Act
Patient Protection and Affordable Care Act
The Patient Protection and Affordable Care Act is a United States federal statute signed into law by President Barack Obama on March 23, 2010. The law is the principal health care reform legislation of the 111th United States Congress...

 (PPACA). Many pro-choice representatives said they would oppose AHCAA with the Stupak-Pitts language and proposed to adopt PPACA. Stupak and several supporters said they would oppose PPACA without the amendment but withdrew their opposition after President Obama promised an executive order to bar such funding. Pro-life groups criticized this action, saying that the executive order would not be effective.

Introduction of the amendment

Under the Hyde Amendment
Hyde Amendment
In U.S. politics, the Hyde Amendment is a legislative provision barring the use of certain federal funds to pay for abortions. It is not a permanent law, rather it is a "rider" that, in various forms, has been routinely attached to annual appropriations bills since 1976...

, the federal government was prohibited from paying for abortion services. The AHCAA was to provide a "public option
Public health insurance option
The public health insurance option is a proposed government-run health insurance agency which competes with other health insurance companies. It is not the same as Publicly-funded health care. Called the public insurance option or public option, for short, it was a proposed health insurance plan...

", under which individuals could buy subsidized health insurance from a Federal agency, and also to set up health insurance exchange
Health insurance exchange
A health insurance exchange is a set of state-regulated and standardized health care plans in the United States, from which individuals may purchase health insurance that is eligible for Federal subsidies...

s through which individuals could buy health insurance from private companies, with federal financial assistance. Pro-life groups noted that both the public option and the exchanges allowed federal funds to pay for insurance which could pay for abortions, thus creating a loophole in the Hyde Amendment.

The amendment to close this apparent loophole was submitted in late 2009 by Stupak and Pitts. Other prominent supporters of the amendment included were Resentatives Brad Ellsworth
Brad Ellsworth
John Bradley "Brad" Ellsworth is the former U.S. Representative for , serving from 2007 until 2011, and was the unsuccessful 2010 Democratic nominee for the United States Senate seat currently held by Dan Coats...

, Marcy Kaptur
Marcy Kaptur
Marcia Carolyn "Marcy" Kaptur is the U.S. Representative for , serving since 1983. She is a member of the Democratic Party. The district, anchored by the city of Toledo, includes all of Ottawa and Erie counties, and part of Lucas and Lorain counties.Serving her fourteenth term in the House of...

, Kathy Dahlkemper
Kathy Dahlkemper
Kathleen Ann "Kathy" Dahlkemper is the former U.S. Representative for , serving from 2009 until 2011. She is a member of the Democratic Party.The district is based in Erie and includes most of the northwestern portion of the state....

, Daniel Lipinski, and Chris Smith. The amendment was adopted by the House on November 7, 2009, by a vote of 240-194.

The stated purpose of the amendment was to prohibit the use of federal funds "to pay for any abortion or to cover any part of the costs of any health plan that includes coverage of abortion" except in cases of rape, incest or danger to the life of the mother. This was been interpreted by some to mean that abortions not included in the exceptions may not be covered in the public option or in any exchange's private plans that accepted subsidized customers. The exceptions are similar to those included in the Hyde Amendment
Hyde Amendment
In U.S. politics, the Hyde Amendment is a legislative provision barring the use of certain federal funds to pay for abortions. It is not a permanent law, rather it is a "rider" that, in various forms, has been routinely attached to annual appropriations bills since 1976...

; it also specifically allows individuals to purchase supplementary insurance that covers other abortions.

Opposition

NARAL Pro-Choice America
NARAL Pro-Choice America
NARAL Pro-Choice America , formerly the National Association for the Repeal of Abortion Laws, then National Abortion Rights Action League, and later National Abortion and Reproductive Rights Action League, is an organization in the United States that engages in political action to oppose...

 criticized the amendment, stating it could mean that people whose health insurance currently covers abortions will lose that service.
Those who voted against the amendment argued that since premiums of private individuals would pay for the abortions, they are distinguished from situations covered by the Hyde Amendment.

The American Civil Liberties Union
American Civil Liberties Union
The American Civil Liberties Union is a U.S. non-profit organization whose stated mission is "to defend and preserve the individual rights and liberties guaranteed to every person in this country by the Constitution and laws of the United States." It works through litigation, legislation, and...

 joined the opposition to the amendment, saying it "jeopardizes the abortion coverage that millions of women currently have".

According to the Guttmacher Institute
Guttmacher Institute
The Guttmacher Institute is a non-profit organization which works to advance sexual and reproductive health. The institute operates in the United States and globally "through an interrelated program of social science research, policy analysis and public education." According to their mission...

, 13% of all abortions in 2001 were directly billed to private insurance companies. Some in the debate used this statistic to argue that, because relatively few women seem to use private insurance coverage to pay for abortion services, absence of coverage would have minimal impact. The Institute responded that arguments based on the statistic alone misrepresented the situation since it omits women who pay for the procedure out of pocket, later seeking reimbursement from their insurance company and those who have coverage, but chose not to use it because they want their employer, insurer or primary policyholder (spouse, parent) not to know that they obtained an abortion.

An analysis published by policy researchers at the George Washington University Medical School
George Washington University Medical School
The George Washington University School of Medicine and Health Sciences was established in 1824 due to the need for doctors in the District of Columbia but formally opened its doors a year later in 1825. It is the eleventh oldest medical school in the country and the first medical school...

 Department of Health Policy concluded the Stupak–Pitts Amendment would have the effect of eliminating coverage of medically indicated abortions for all women, not just those receiving subsidies or participating in the exchange. The analysis also said the Amendment's restrictions would hinder the insurance industry's ability to market supplemental coverage for abortions, and impact the current ability of individual states to provide such supplemental coverage to Medicaid
Medicaid
Medicaid is the United States health program for certain people and families with low incomes and resources. It is a means-tested program that is jointly funded by the state and federal governments, and is managed by the states. People served by Medicaid are U.S. citizens or legal permanent...

 recipients. Another issue raised was the possibility of private insurance companies denying coverage for other procedures if a relationship between those procedures and an abortion exists, especially in cases where an abortion is the result of other serious health conditions.

Catholic lay pro-life activist Judie Brown
Judie Brown
Judith Ann Limbourne "Judie" Brown is the president and co-founder of the American Life League, reportedly the largest Catholic pro-life organization in the United States...

 of the American Life League
American Life League
The American Life League is one of the largest pro-life organizations in the United States. The organization opposes abortion under any circumstance, contraception, embryonic stem cell research, and euthanasia...

 criticized the Stupak–Pitts Amendment for being insufficiently pro-life. She said without the amendment, AHCAA would not have passed in the House, but United States Conference of Catholic Bishops
United States Conference of Catholic Bishops
The United States Conference of Catholic Bishops is the episcopal conference of the Catholic Church in the United States. Founded in 1966 as the joint National Conference of Catholic Bishops and United States Catholic Conference, it is composed of all active and retired members of the Catholic...

' (USCCB) support for the amended bill "gave cover for approximately 40 supposedly pro-life representatives to seemingly support the pro-life cause while also supporting all of the Pelosi bill’s major components." Brown said the bill as passed contained "anti-life" "provisions for abortion, contraception, medical 'care' that allows euthanasia, promiscuity-promoting sex education, 'family planning services' provided by organizations such as Planned Parenthood, contradictory and inconsistent language regarding conscience protection and other loopholes." She added, "USCCB made it possible for Catholic Democrats in the House to pay lip service to Church teaching on abortion while voting for a bill that violates Church teachings in several ways, including abortion."

House action

The House approved the Stupak–Pitts amendment on November 7, 2009, by a vote of 240–194. Stupak, the lead sponsor, had stated in late September that he wanted a full vote on the House floor on the amendment. After the amendment was adopted, Stupak voted in favor of the amended bill.

Even though the Stupak–Pitts Amendment was part of AHCAA as enacted by the House, its fate remained uncertain in early 2010. In mid-November 2009, it was reported that 40 House Democrats said they would not support a final bill containing the Amendment's provisions. Subsequently, Stupak said that 15– to 20 Democrats will not support adoption of the Senate bill because of objections to its abortion provisions as well as its tax on high-value health insurance plans.

In March 2010, Stupak revealed that he will vote for the Senate legislation without the Stupak language, drawing criticism from pro-life activists.

Senate action

The Patient Protection and Affordable Care Act
Patient Protection and Affordable Care Act
The Patient Protection and Affordable Care Act is a United States federal statute signed into law by President Barack Obama on March 23, 2010. The law is the principal health care reform legislation of the 111th United States Congress...

, presented by Senate leader Harry Reid
Harry Reid
Harry Mason Reid is the senior United States Senator from Nevada, serving since 1987. A member of the Democratic Party, he has been the Senate Majority Leader since January 2007, having previously served as Minority Leader and Minority and Majority Whip.Previously, Reid was a member of the U.S...

, did not include the language of the Stupak–Pitts Amendment. Instead, it contained provisions similar to the Capps Amendment
Capps Amendment
The Capps Amendment was a provision sponsored in the House by Rep. Lois Capps and included in America's Affordable Health Choices Act of 2009 The Capps Amendment was a provision sponsored in the House by Rep. Lois Capps and included in America's Affordable Health Choices Act of 2009 The Capps...

. The failure of the Reid bill to incorporate the additional restrictions included in Stupak–Pitts was criticized by pro-life organizations, and Democratic Senator Ben Nelson
Ben Nelson
Earl Benjamin "Ben" Nelson is the senior U.S. Senator from Nebraska. He is a member of the Democratic Party and was elected to the U.S. Senate in 2000....

 said he would not support a bill that "doesn't make it clear that it does not fund abortion with government money"., resulting in inclusion of the Nelson Amendment
Nelson Amendment
The Nelson Amendment is the name given to an amendment to restrict federal funding of elective abortions in the Senate version of America's Affordable Health Choices Act of 2009.-No abortions funded with government money:...

 in the bill passed by the Senate.

Public opinion

A poll from November 10–11 by Angus Reid Global Monitor found that 54% of Americans supported "prohibiting the use of federal funding for insurance that covers elective abortions". Among self-identified Democrats, 46% expressed support. The poll results had a 3.1% margin of error.

In a November 12–15 Washington Post
The Washington Post
The Washington Post is Washington, D.C.'s largest newspaper and its oldest still-existing paper, founded in 1877. Located in the capital of the United States, The Post has a particular emphasis on national politics. D.C., Maryland, and Virginia editions are printed for daily circulation...

 – ABC News
ABC News
ABC News is the news gathering and broadcasting division of American broadcast television network ABC, a subsidiary of The Walt Disney Company...

 poll, 61% responded they "support barring coverage for abortions for those receiving public subsidies"; asked whether "with segregated private money used to cover abortion procedures", as provided by the earlier Capps Amendment, 56% said "insurance offered to those using government assistance should be able to include such coverage".

A November 13–15 CNN
CNN
Cable News Network is a U.S. cable news channel founded in 1980 by Ted Turner. Upon its launch, CNN was the first channel to provide 24-hour television news coverage, and the first all-news television channel in the United States...

Opinion Research Corporation
Opinion Research Corporation
Opinion Research Corporation, based in Princeton, New Jersey, is a demographic, health, and market research company. It was founded in 1938 by Claude Robinson and George Gallup, although Gallup quickly left the firm in 1939....

 poll found that 60% of the respondents oppose public funding of abortion. When asked whether private and employer-sponsored insurance plans should cover any costs of abortion or whether women should have to pay the entire cost themselves, a 51–45% majority said women should have to pay the full costs themselves. CNN said the 6% difference is within the poll's sampling error.

A poll taken by Quinnipiac University
Quinnipiac University
Quinnipiac University is a private, nonsectarian, coeducational university located in Hamden, Connecticut, United States at the foot of Sleeping Giant State Park...

 showed that voters opposed public money in the health care bill to pay for abortions by 72% to 23%.

Outcome

On March 21, 2010, Stupak made a deal with Obama whereby he and his bloc of Democrats would vote for the final bill if Obama signed an executive order barring federal funding of abortion under the bill. The deal resulted in the final bill being passed in the House by a vote of 219-212. The deal was condemned by both pro-life and pro-choice groups.

External links

  • GPO
    United States Government Printing Office
    The United States Government Printing Office is an agency of the legislative branch of the United States federal government. The office prints documents produced by and for the federal government, including the Supreme Court, the Congress, the Executive Office of the President, executive...

    text of H. R. 3962/ as introduced, (for reference to portions changed by the Stupak–Pitts Amendment)
  • Stupak of Michigan Amendment to H.R. 3962 (PDF), as reported by the House Committee on Rules, November 6, 2009.
    • Amended (in part) Division A, Title II, Subtitle F, Sections 258 & 259 and inserted, new, Section 265.
  • Patient Protection and Affordable Care Act amendment to H.R. 3590 in the nature of a substitute proposed by Sen. Harry Reid, et al.
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