This article was originally published by ThinkProgress and is republished here with permission from the author and the Center for American Progress Action Fund.

If you thought that just because abortion is a constitutional right and
part of basic reproductive health care it would be available in the
reformed health insurance market known as the Exchange, think again.
The Stupak Amendment, passed Saturday night by the House of Representatives after a compromise deal fell apart, potentially goes farther than any other federal law to restrict women’s access to abortion.

The claim that it only bars federal funding for abortions is simply false. Here’s what the Stupak Amendment does:

1. It effectively bans coverage for most abortions from all public and private health plans in the Exchange:
In addition to prohibiting direct government funding for abortion, it
also prohibits public money from being spent on any plan that covers
abortion even if paid for entirely with private premiums. Therefore, no
plan that covers abortion services can operate in the Exchange unless
its subscribers can afford to pay 100% of their premiums with no
assistance from government “affordability credits.” As the vast
majority of Americans in the Exchange will need to use some of these
credits, it is highly unlikely any plan will want to offer abortion
coverage (unless they decide to use it as a convenient proxy to discriminate against low- and moderate-income Americans who tend to have more health care needs and incur higher costs).

2. It includes only extremely narrow exceptions:
Plans in the Exchange can only cover abortions in the case of rape or
incest or “where a woman suffers from a physical disorder, physical
injury, or physical illness that would, as certified by a physician,
place the woman in danger of death.” Given insurance companies’
dexterity in denying claims, we can predict what they’ll do with that
language. Cases that are excluded: where the health but not the life of
the woman is threatened by the pregnancy, severe fetal abnormalities,
mental illness or anguish that will lead to suicide or self-harm, and
the numerous other reasons women need to have an abortion.

3. It allows for a useless abortion “rider”: Stupak
and his allies claim his Amendment doesn’t ban abortion from the
Exchange because it allows plans to offer and women to purchase extra,
stand-alone insurance known as a rider to cover abortion services.
Hopefully the irony of this is immediately apparent: Stupak wants women
to plan for a completely unexpected event.

4. It allows for discrimination against abortion providers:
Previously, the health care bill included an evenhanded provision that
prohibited discrimination against any health care provider or facility
“because of its willingness or unwillingness to provide, pay for,
provide coverage of, or refer for abortions.” Now, it only protects
those who are unwilling to provide such services.

One in three women will have an abortion in their lifetime. Eighty-seven percent of employer plans offer abortion coverage.
None of that will matter if the Senate takes its cues from the House.
In every other way, this bill will expand access to health care. But
for millions of women, they are about to lose coverage they currently
have and often need.