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House Passes Health Care Reform Bill

Close to midnight on Saturday, November 7, 2009, the House of Representatives passed a broad health care reform bill by a narrow vote of 220–215. Even with an overwhelming majority in the chamber, Democrats were barely able to rally enough support to pass H.R. 3962, the Affordable Health Care for America Act, and, in the process, made worrisome concessions to extremist elements that considerably undermine the legislation. Most notably, the final bill included a last minute amendment concerning payment for abortion that targets women’s constitutionally protected right to choose. There are, however, some significant inclusions in the bill that, were they to become law, advance the sexual and reproductive health of the American people.   

One of the most significant elements of the legislation for advocates of comprehensive sex education is the inclusion of the Healthy Teens Initiative. The Healthy Teen Initiative would dedicate $50 million in funding to states for evidence-based programs designed to prevent teen pregnancy and sexually transmitted infections, including HIV. The money would be administered by public health professionals at the Centers for Disease Control and Prevention (CDC) and given to states, which would be required to match every four federal dollars received with one state-raised dollar and then use the money or distribute it. 
“This provision finally addresses the challenges to the health and well being of young people with programs that comprehensively address sexual health and behavior instead of the ideologically based and narrowly focused abstinence-only-until-marriage programs that dominated the last decade,” said Joseph DiNorcia, Jr., president and CEO of SIECUS. “We are grateful to the members of the House who are dedicated to comprehensive sexuality education, especially Chairman Waxman (D-CA) and Representative Capps (D-CA) for introducing the amendment in the House Energy and Commerce Committee,” continued DiNorcia.
The House bill also includes several provisions that represent positive steps toward ending discrimination against lesbian, gay, bisexual, and transgender (LGBT) or HIV-positive individuals in the health care system. One section could serve to protect LGBT individuals from exclusion from health care coverage because of their sexual orientation, while another would end tax discrimination of health benefits for domestic partners. Furthermore, the bill contains the Early Treatment for HIV Act (ETHA), which could save many lives by allowing states to use Medicaid money to treat individuals in the early stages of HIV infection instead of waiting until they develop AIDS. 
However, an anti-abortion amendment offered by Representatives Bart Stupak (D-MI) and Joe Pitts (R-PA) was included in the final bill. This amendment would essentially prevent any private insurers that participate in a public exchange from paying for abortions, even if women pay for the insurance with their own private dollars. 
A broad group of advocacy organizations from the progressive and women’s health communities has joined together to form the Coalition to Pass Health Care Reform and Stop Stupak! According to the coalition’s website, “the coalition’s goal is to ensure that health care reform is passed and does not restrict women’s ability to purchase private health insurance that provides comprehensive reproductive health care, including abortion.” In addition to organizing advocacy days on Capitol Hill, the coalition is gathering signatures for a petition to Congress. The petition reads, in part: “The health care bill would make significant progress for women—ending gender inequalities in health care costs, halting discriminatory practices such as treating domestic violence as a “pre-existing condition,” and making coverage more affordable for American families— but its crucial this legislation does not include a provision that would set women back. I ask you to ensure that the final bill does not include the Stupak/Pitts Amendment language or any other measure that would make women less healthy, less safe and less able to exercise their constitutional rights.”
“We stand in solidarity with our colleagues in calling this amendment a gross perversion of the intent of this bill. Not only is the Stupak/Pitts amendment a direct attack against all women’s constitutionally protected right to choose, but it also targets the most poor and vulnerable women,” said DiNorcia. “We realize…that any bill that is signed by President Obama will contain myriad provisions that affect the lives of virtually every American,” continued DiNorcia in the statement, adding that, “Because of this complexity and significance, we strongly encourage both the House and the Senate to take the remaining opportunities they have left to strengthen the bill, remove extraordinarily harmful provisions like the Stupak/Pitts amendment, and finally put the health and future of America above political posturing.”
Final passage of health care reform legislation remains in limbo. As of this writing, the Senate is debating their version of the bill on the Senate floor and is hoping to vote on final passage before the Christmas holiday. . As expected, the Senate legislation includes a $75 million state grant program for comprehensive sex education and an extension of the Title V abstinence-only program. Advocates are working to ensure that the final health care reform legislation only funds a comprehensive approach to sex education and does not follow through with funding ineffective abstinence-only programs that leave young people at risk
On December 8th, Senators rejected an amendment offered by Senators Ben Nelson (D-NE) and Orin Hatch (R-UT) that put forward similar language to the Stupak/Pitts amendment that passed in the House. While advocates are pleased that they, have thus, far avoided the Senate bill including more restrictive abortion language, details and compromises on abortion are still being worked out in the final days of the legislation’s consideration on the Senate floor.