NARAL PREZ NANCY KEENAN ON HEALTH REFORM AND ABORTION RIGHTS.

As Congress marks up the House and Senate health reform proposals, reproductive rights organizations are lobbying in overdrive, responding to a spate of amendments that seek to prevent even private insurers from offering abortion services in the new health insurance exchanges. Here I speak to NARAL: Pro-Choice America president Nancy Keenan about the threats -- and opportunities -- that health reform presents when it comes to women's reproductive care.

NARAL is asking its supporters to write to their Senators in opposition to a specific anti-choice amendment from Sen. Tom Coburn, which would establish an Office of Unborn Children's Health. That seems patently absurd. But other senators and House members are proposing, very seriously, that both private and public health care plans, after health reform, be prevented from covering abortion services.

You haven’t seen reproductive health care be a big topic within the debate until some of the anti-choice members of Congress poised to offer these amendments. They’re wanting to rattle their sabers here. They are the ones that are trying to make this political, versus keeping the divisiveness out of the debate.

Are there specific services women currently have from employer-based health coverage that are under threat right now?

Obviously, many of the private insurers do provide care for reproductive health, including abortion care. And I think that would be under threat if you saw these anti-choice amendments succeed. The potential there is that many, many women could lose the coverage they presently have.

Read the rest of the interview after the jump.

--Dana Goldstein

Who should have discretion to define services covered by plans in the new health insurance exchanges? The HHS secretary, or an independent expert commission?

We would advocate that experts make those determinations and those decisions, not politicians. And if you were to have a special committee, benefits as a broad discussion would be determined in that venue, versus in this kind of realm of politicians with their amendments trying to make determinations on their own. That’s the mistake we see when the politicians are trying to get involved versus experts making those decisions and determinations. ...

I don’t think the issue of reproductive health care services should be treated differently from any other kind of benefit. It should all be treated under this umbrella of benefits by a professional committee. Don’t separate it out to begin with. And have the professionals determine what should be allowed, not necessarily the secretary of HHS.

Medicaid will likely be expanded as part of health reform, meaning single adults could be eligible for the program for the first time. The House tri-committee bill even expands eligibility to 300 percent of poverty. But no one is talking about taking this opportunity to repeal the Hyde Amendment, which currently prevents Medicaid from covering abortion. Why not?

You know, obviously, in the long term we’d like to see the Hyde Amendment removed. But you have to look at the number of votes. There’s not enough pro-choice members of Congress to make that happen. Even though it’s a goal, when we lobby and count votes around here, we still don’t have the have the votes to repeal Hyde. Right now, we’re working on a little piece of that, and that’s the D.C. abortion ban that is also on the books. That is a possibility that we could actually remove that ban. Being pragmatic, strategic, making sure we actually have the votes. So even though overturning Hyde is a long term goal, we can have some wins on some other areas earlier.

How seriously do you take the 19 anti-choice House Democrats who vowed to oppose any health reform plan that covers abortion services? The language in their statement was so broad, it seemed to apply to both public and private insurers that will participate in the new health insurance exchanges.

It’s a not a surprise to us, but their demands are pretty extreme. This is again why we would advocate for a commission or a panel of experts. Because this is exactly what the American public does not want. They don’t want the divisiveness and the continued attacks on reproductive health care issues. The panel serves that purpose.

What’s your vision of who would sit on a panel like that?

Obviously it could be physicians, it could be insurance representatives -- because they’re the ones that obviously write the plans. I think it’s public health people. And you’ve got some folks who are consumer advocates -- you find that particularly in the mental health area. Folks who believe that if we had coverage for mental health issues, it would better serve the public.

At this point in time, are you confident health reform will be a step forward for women’s access to reproductive health care, or are you concerned it will actually be a step back?

If, indeed, it is depoliticized and if, indeed, we can advance a panel or commission, then I am very optimistic about reproductive health care being part of this entire package. The other side are the ones that are preemptively trying to stop any coverage of reproductive care, including abortion care. We don’t take anything for granted, and we don’t want to lose any ground for the women of this country.

So the main risk you see is for women who are already on employer-provided health care.

That’s right, and what they might lose in this process.