Franzonello: Abortion Was Always Heart of Health Care Overhaul

Posted April 18, 2012 at 4:57pm

In 2008, candidate Barack Obama made a campaign promise to put abortion at “the heart” of any health care plan his administration would propose. President Barack Obama is making good on this promise.

Through a mandate issued by the Department of Health and Human Services, nearly all private insurance plans must fully cover the abortion-inducing drug ella.

But instead of listening to the people (or the Constitution) and abandoning the ill-advised mandate, the Obama administration and HHS seek to blunt the criticism, in part by claiming they are merely following the “marching orders” given by the “independent Institute of Medicine”  — the organization tasked with advising HHS on what should be included as “preventive services” in the mandate. In other words, HHS is claiming the allegedly independent and unbiased IOM made it include life-ending drugs in the mandate.

Considering the breadth of this anti-life mandate, which applies to nearly all insurance plans and eliminates life-affirming choices from the market, it is important to examine the IOM panel, whose recommendation HHS feels so obliged to follow.

Independent? Maybe.

Unbiased? Hardly.

The biographies of the committee members convened by the IOM to make a recommendation to HHS on what constitutes “preventive services” reads like a “who’s who” of the abortion lobby. While perhaps independent from HHS, the IOM panel has deep connections to the abortion industry and its anti-life ideology.

The groups that the IOM panel invited to present testimony to help the IOM make its “evidence-based” determination likewise had a clear abortion bias.

At the first IOM meeting, Planned Parenthood, the nation’s largest abortion provider, represented “women’s issues,” along with other abortion-advocacy groups. As a distributor of contraceptives and life-ending drugs, Planned Parenthood stands to gain if insurance plans are required to fully cover the drugs and devices it dispenses. Of course, that financial stake was never disclosed as a conflict of interest. Rather, Planned Parenthood’s Dr. Carolyn Westhoff bluntly started her presentation by saying: “I’m just going to jump ahead — pregnancy is dangerous.”

Though the deck seemed stacked from the beginning, pro-life groups still mounted an effort to keep coverage for life-ending drugs and devices from being forced on nearly all Americans perversely under the guise of necessary “preventive” health care for women.

Never formally invited by the IOM to present, pro-life organizations — including Americans United for Life — attended and spoke up during the public comments portion of every open IOM committee meeting to urge the panel against including life-ending drugs and devices in the mandate.

At every meeting, the IOM panel was reminded by AUL and others that the “preventive services” provision was, as its author Sen. Barbara Mikulski (D-Md.) stated, “strictly concerned” with “preventing diseases.”

Further, the IOM panel was reminded that Mikulski made assurances on the Senate floor that, under her provision, abortion would not be covered “in any way.”

And at every meeting it was explained to the IOM panel that ella, newly approved by the Food and Drug Administration as a “emergency contraceptive,” is — just like the abortion drug RU-486 — a selective progesterone receptor modulator. By blocking progesterone, ella, like RU-486, can end even an “established” pregnancy. Thus the IOM committee was well-aware of the facts: Ella does not prevent disease. Its mandated coverage not only fails to “fit” with the stated intent of the law, but, as an abortion-inducing drug, its inclusion directly violates Mikulski’s assurances.

Despite this knowledge, in July 2011, during the IOM committee’s press conference announcing the release of its report, Chairwoman Dr. Linda Rosenstock explained, unequivocally, that the drug ella was included in her committee’s recommendation. Though Rosenstock stated her committee considered “every” comment that was presented before it, the IOM report utterly failed to address the serious concerns repeatedly presented at the meetings about ella’s abortion-inducing quality. Nowhere in its 250-page report did the committee even mention ella’s mechanisms of action.

Also absent from the 250-page report was any mention that other FDA-labeled “contraceptives,” including intrauterine devices and Plan B, can work to prevent implantation of an already developing embryo — another fact presented at every meeting, a fact the FDA notes in its labeling of the drugs and a fact that even HHS has included in its information on birth control methods.

Still not convinced that the IOM’s recommendation was based on an agenda, rather than an independent, evidence-based review? Dr. Anthony Lo Sasso, a member of the IOM panel, dissented from the recommendation because of its lack of transparency and subjective advocacy.

In addition, the IOM’s own report acknowledged that the panel would have considered surgical abortion as a “preventive service” even had it not felt otherwise constrained by the Affordable Care Act.

Certainly, HHS can cite the IOM panel as recommending including ella and other life-ending drugs and devices in the HHS mandate that is being forced on nearly all Americans. However, it is indefensible to omit the important fact that the anti-life recommendation was, as Lo Sasso describes, “filtered through a lens of advocacy” — a lens so warped, it would equate destruction of human life with disease prevention.

Rather than support its creation, the evidence demands that HHS repeal its mandate.

Attorney Anna Franzonello is staff counsel with Americans United for Life.