Stupak Gets 30 pieces of silver…Game Over!
STATEMENT FROM COMMUNICATIONS DIRECTOR DAN PFEIFFER
Today, the President announced that he will be issuing an executive order after the passage of the health insurance reform law that will reaffirm its consistency with longstanding restrictions on the use of federal funds for abortion.
While the legislation as written maintains current law, the executive order provides additional safeguards to ensure that the status quo is upheld and enforced, and that the health care legislation’s restrictions against the public funding of abortions cannot be circumvented.
The President has said from the start that this health insurance reform should not be the forum to upset longstanding precedent. The health care legislation and this executive order are consistent with this principle.
The President is grateful for the tireless efforts of leaders on both sides of this issue to craft a consensus approach that allows the bill to move forward.
A text of the pending executive order follows:
Executive Order ensuring enforcement and implementation of abortion restrictions in the patient protection and affordable care act
By the authority vested in me as President by the Constitution and the laws of the United States of America, including the “Patient Protection and Affordable Care Act” (approved March __, 2010), I hereby order as follows:
Section 1. Policy.
Following the recent passage of the Patient Protection and Affordable Care Act (“the Act”), it is necessary to establish an adequate enforcement mechanism to ensure that Federal funds are not used for abortion services (except in cases of rape or incest, or when the life of the woman would be endangered), consistent with a longstanding Federal statutory restriction that is commonly known as the Hyde Amendment. The purpose of this Executive Order is to establish a comprehensive, government-wide set of policies and procedures to achieve this goal and to make certain that all relevant actors—Federal officials, state officials (including insurance regulators) and health care providers—are aware of their responsibilities, new and old.
The Act maintains current Hyde Amendment restrictions governing abortion policy and extends those restrictions to the newly-created health insurance exchanges. Under the Act, longstanding Federal laws to protect conscience (such as the Church Amendment, 42 U.S.C. §300a-7, and the Weldon Amendment, Pub. L. No. 111-8, §508(d)(1) (2009)) remain intact and new protections prohibit discrimination against health care facilities and health care providers because of an unwillingness to provide, pay for, provide coverage of, or refer for abortions.
Numerous executive agencies have a role in ensuring that these restrictions are enforced, including the Department of Health and Human Services (HHS), the Office of Management and Budget (OMB), and the Office of Personnel Management (OPM).
Section 2. Strict Compliance with Prohibitions on Abortion Funding in Health Insurance Exchanges. The Act specifically prohibits the use of tax credits and cost-sharing reduction payments to pay for abortion services (except in cases of rape or incest, or when the life of the woman would be endangered) in the health insurance exchanges that will be operational in 2014. The Act also imposes strict payment and accounting requirements to ensure that Federal funds are not used for abortion services in exchange plans (except in cases of rape or incest, or when the life of the woman would be endangered) and requires state health insurance commissioners to ensure that exchange plan funds are segregated by insurance companies in accordance with generally accepted accounting principles, OMB funds management circulars, and accounting guidance provided by the Government Accountability Office.
I hereby direct the Director of OMB and the Secretary of HHS to develop, within 180 days of the date of this Executive Order, a model set of segregation guidelines for state health insurance commissioners to use when determining whether exchange plans are complying with the Act’s segregation requirements, established in Section 1303 of the Act, for enrollees receiving Federal financial assistance. The guidelines shall also offer technical information that states should follow to conduct independent regular audits of insurance companies that participate in the health insurance exchanges. In developing these model guidelines, the Director of OMB and the Secretary of HHS shall consult with executive agencies and offices that have relevant expertise in accounting principles, including, but not limited to, the Department of the Treasury, and with the Government Accountability Office. Upon completion of those model guidelines, the Secretary of HHS should promptly initiate a rulemaking to issue regulations, which will have the force of law, to interpret the Act’s segregation requirements, and shall provide guidance to state health insurance commissioners on how to comply with the model guidelines.
Section 3. Community Health Center Program.
The Act establishes a new Community Health Center (CHC) Fund within HHS, which provides additional Federal funds for the community health center program. Existing law prohibits these centers from using federal funds to provide abortion services (except in cases of rape or incest, or when the life of the woman would be endangered), as a result of both the Hyde Amendment and longstanding regulations containing the Hyde language. Under the Act, the Hyde language shall apply to the authorization and appropriations of funds for Community Health Centers under section 10503 and all other relevant provisions. I hereby direct the Secretary of HHS to ensure that program administrators and recipients of Federal funds are aware of and comply with the limitations on abortion services imposed on CHCs by existing law. Such actions should include, but are not limited to, updating Grant Policy Statements that accompany CHC grants and issuing new interpretive rules.
Section 4. General Provisions.
(a) Nothing in this Executive Order shall be construed to impair or otherwise affect: (i) authority granted by law or presidential directive to an agency, or the head thereof; or (ii) functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.
(b) This Executive Order shall be implemented consistent with applicable law and subject to the availability of appropriations.
(c) This Executive Order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity against the United States, its departments, agencies, entities, officers, employees or agents, or any other person.
THE WHITE HOUSE
Proposed Executive Order Language
1. The Executive Order directs that the Hyde language found in sections 507 and 508 of the Labor HHH Appropriations Bill shall apply to the HR 3590.
(a) None of the funds appropriated in this Act, and none of the funds in any trust fund to which funds are appropriated in this Act, shall be expended for any abortion.
(b) None of the funds appropriated in this Act, and none of the funds in any trust fund to which funds are appropriated in this Act, shall be expended for health benefits coverage that includes coverage of abortion.
(c) The term ‘‘health benefits coverage’’ means the package of services covered by a managed care provider or organization pursuant to a contract or other arrangement.
(a) The limitations established in the preceding section shall not apply to an abortion —
(1) if the pregnancy is the result of an act of rape or incest; or
(2) in the case where a woman suffers from a physical disorder, physical injury, or physical illness, including a life-endangering physical condition caused by or arising from the pregnancy itself, that would, as certified by a physician, place the woman in danger of death unless an abortion is performed.
(b) Nothing in the preceding section shall be construed as prohibiting the expenditure by a State, locality, entity, or private person of State, local, or private funds (other than a State’s or locality’s contribution to Medicaid matching funds.)
(c) Nothing in the preceding section shall be construed as restricting the ability of any managed care provider from offering abortion coverage or the ability of a State or locality to contract separately with such a provider for such coverage with State funds (other than a State’s or locality’s contribution of Medicaid matching funds.)
2. Under this Act, Hyde language shall apply to the authorization and appropriations of funds under section 10503 of the Community Health Centers.
SEC. 10503. COMMUNITY HEALTH CENTERS AND THE NATIONAL HEALTH SERVICE CORPS FUND. Pages 2355-2357 of H.R. 3590.
3. Under this Act, the Hyde language shall apply to the section 1303 of the HR 3590.
SEC. 1303. SPECIAL RULES. Pages 2069-2079 of H.R. 3590.
4. Under this Act, the Accommodation of Conscious is recognized.
(a) NONDISCRIMINATION.—A Federal agency or program, and any State or local government that receives Federal financial assistance under this Act (or an amendment made by this Act), may not—
(1) subject any individual or institutional health care entity to discrimination; or
(2) require any health plan created or regulated under this Act (or an amendment made by this Act) to subject any individual or institutional health care entity to discrimination, on the basis that the health care entity does not provide, pay for, provide coverage of, or refer for abortions.
(b) DEFINITION.—In this section, the term ‘‘healthcare entity’’ includes an individual physician or other health care professional, a hospital, a provider-sponsored organization, a health maintenance organization, a health insurance plan, or any other kind of health care facility, organization, or plan.
(c) ADMINISTRATION.—The Office for Civil Rights of the Department of Health and Human Services is designated to receive complaints of discrimination based on this section, and coordinate the investigation of such complaints.
5. Addition Conscious Provisions
“(1) Nothing in this Act shall require an otherwise qualified health plan, including an Exchange-participating plan, to cover any items or services to which the issuer, plan sponsor, or purchaser has a moral or religious objection, provided the plan is at least actuarially equivalent to a qualified health plan that covers the essential health benefits.
“(2) If a health plan is permitted not to cover items or services under paragraph (1), then the issuer, plan sponsor, or purchaser shall not be required to include such items or services in such plan as a condition of (A) being eligible for a premium tax credit or cost-sharing reduction, or (B) avoiding any assessable payment or any other tax, assessment or penalty under this Act.
“(3) Nothing in this Act shall prohibit a qualified health plan, including an Exchange-participating plan, from contracting with an individual or institutional health care provider that declines to provide, participate in, or refer for an item or service to which the provider has a moral or religious objection.
“(4) Nothing in this Subsection shall be construed to deny, alter, or modify any right or duty any person may have under state or local law, or under federal laws other than this Act.”
“(5) Nothing in this Subsection shall be construed to authorize a health plan to deny coverage for all medical care, or for life-preserving care, to an individual based on a view that treats extending the life or preserving the health of the individual as of lower value than extending the life or preserving the health of others because of the individual’s disability or other characteristic.”
Rough estimate of the timing for Sunday’s votes:
2 p.m.: The House will debate for one hour the rules of debate for the reconciliation bill and the Senate bill.
3 p.m.: The House will vote to end debate and vote on the rules of the debate.
3:15 p.m.: The House will debate the reconciliation package for two hours.
5:15 p.m.: The House will vote on the reconciliation package.
5:30 p.m.: The House will debate for 15 minutes on a Republican substitute and then vote on the substitute.
6 p.m.: The House will vote on the final reconciliation package.
6:15 p.m.: If the reconciliation bill passes, the House will immediately vote on the Senate bill, without debate.
NRO UPDATE: A senior Republican House staffer e-mails: “I saw your timeline per the Dems. The timing is probably optimistic. I’d say the vote will be much later than 6:15. Definitely after 7.”
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