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Coverage Of Abortion Services In Federal Health Plan Remains Controversial
Advocates on both sides of the abortion-rights debate are "preparing for a renewed battle" over insurance coverage of abortion services in health care reform efforts, the AP/Atlanta Journal-Constitution reports. Abortion-rights opponents say that current restrictions on federal funding for abortion services should carry over to any insurance sold under new health insurance exchanges proposed under reform legislation. However, abortion-rights supporters say that carrying over the restrictions would deny abortion coverage to millions of women who currently have it through employer-sponsored coverage and are likely to join the exchanges.A variation in how the questions were asked yielded different results but significant proportions of private plans were found to cover abortion services. A Guttmacher Institute study found that 87% of typical employer-sponsored health plans covered abortion services in 2002, and a 2003 Kaiser Family Foundation study found that 46% of workers covered by employer-sponsored plans had coverage for abortion services.A Congressionally imposed provision of law known as the Hyde Amendment currently prevents the use of federal Medicaid funds for abortion services except in cases of rape, incest or life endangerment. States that choose to cover abortion services for low-income women through Medicaid must use their own funding to do so. Other Congressionally imposed restrictions prohibit abortion coverage for federal employees, women in the military and other women who rely on the federal government for their health care coverage. An overhaul of the health care system would "create a stream of federal funding not covered by the restrictions," including federal subsidies to offset the cost of health insurance for low- and middle-income people purchasing public or private health insurance though an exchange, the AP/Journal-Constitution reports.Congressional Proposals The plan passed by the Senate Health, Education, Labor and Pensions Committee is "still largely silent" on the issue of coverage for abortion services, the AP/Journal-Constitution reports. Both the House and Senate bills leave the decision on whether the public plan would include abortion coverage to the HHS secretary.In the House Energy and Commerce Committee, members approved an amendment that would allow the public plan to cover abortion services through the use of beneficiary premiums but not federal funds. In addition, the amendment says that private plans in the insurance exchanges could choose whether to cover abortion services, but no federal subsidies could be used to pay for the procedure. The amendment -- proposed by Rep. Lois Capps (D-Calif.), who supports abortion rights -- also would allow plans that do not cover abortions under any circumstances to be offered through insurance exchanges. Capps said that her amendment aims to appease both sides of the abortion-rights debate, adding, "Our country allows for both sides, and our health plan should reflect that as well."Comments Abortion-rights opponents say that they cannot accept a public insurance plan that would cover abortion services and that private plans in insurance exchanges should offer coverage for abortion services as a separate option, the AP/Journal-Constitution reports. Richard Doerflinger, associate director of antiabortion activities for the U.S. Conference of Catholic Bishops, said the group "want[s] to see people who have no health insurance get it," but coverage for abortion is "a sticking point." He said that there can be a "result where nobody has to pay for other people"s abortions," adding, "We don"t want health care reform to be the vehicle for mandating abortion."However, abortion-rights supporters argue that prohibiting coverage for abortion services would deny health care to women who have abortion services coverage through their private plans. Heidi Hartmann, president of the Institute for Women"s Policy Research, said that applying current restrictions for low-income women and federal employees to a program meant for the middle cla

Environmental Health Biostatistician Whose Work Has Impacted Air Pollution Regulation Joins Harvard School Of Public Health
Francesca Dominici, PhD, a biostatistican whose work has affected air pollution regulation, has joined the faculty of the Harvard School of Public Health (HSPH) as professor of biostatistics.
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Washington Post Examines Focus On Abortions Later In Pregnancy After Tiller Murder
The Washington Post on Friday examined the renewed attention on abortion procedures performed later in pregnancy following Kansas provider George Tiller"s shooting death on Sunday. Tiller was one of the few physicians in the U.S. who performed late abortions. The Post reports that these abortions make up a small portion of the 1.2 million abortions performed each year -- more than 88% of abortions are performed in the first trimester and less than 1% are performed after 21 weeks" gestation. Data published in 2001 from 15 states and New York City show that as many as 2,400 abortions after 24 weeks" gestation were performed in the U.S. that year, according to Stanley Henshaw, a senior fellow at the Guttmacher Institute. He added that most of those abortions likely were performed in the 25th or 26th week.Henshaw said that little is known about the circumstances surrounding third trimester abortion procedures and that "information just isn"t available." The government does not collect detailed data regarding the number of such procedures, who is performing them and under what circumstances. In addition, abortion providers who perform the procedure later in pregnancy supply very little published information, the Post reports. According to the Post, most abortion providers will not perform the procedure after 22 or 24 weeks" gestation because of legal and other concerns, social stigma, or inadequate training and lack of experience. A 2001 survey of 1,819 abortion providers indicated that 18 clinics and 12 hospitals performed abortions at 26 weeks" gestation. However, the Post reports that the number of providers offering abortions later in pregnancy likely has declined in correlation with the decreasing number of overall providers. Henshaw said the number of providers offering the procedure later in pregnancy also likely has declined.Abortion-rights supporters say that third-trimester abortions are performed only when medically necessary, such as when a fatal abnormality is detected in the fetus or a life-threatening complication in the woman is discovered. Other circumstances include cases when the woman suffers serious emotional issues or is undergoing cancer treatment, the Post reports. Vicki Saporta, president of the National Abortion Federation, said that women who experience such pregnancies have "no good choice" and "nee[d] to terminate their pregnancies to protect their own health." Tiller "provided both the emotional and physical care for women in that situation," she said (Stein, Washington Post, 6/5).Los Angeles Times Profiles Abortion Provider Hern The Los Angeles Times on Friday profiled Warren Hern, a Colorado-based abortion provider who performs the procedure later in pregnancy and was a close friend of Tiller"s. Hern has provided abortions since 1973 when the Supreme Court legalized the procedure with Roe v. Wade. He said he "felt doing abortions was the most important thing I could do with my life." Hern opened the Boulder Abortion Clinic in 1975, and in the 1980s authored and self-published a textbook, Abortion Practice. He said that he eventually began to focus on abortion procedures later in pregnancy, which currently make up the majority of his practice. Such abortions usually are performed because of medical complications in the woman or abnormalities in the fetus. Patients at Hern"s clinic receive counseling to explain the procedure and to ensure the woman wants it, although he said many women have already made their decision with their own physician. Hern said that although Tiller"s death has been an emotional situation, his clinic is "pretty busy taking care of people who said they couldn"t find anyone else" to perform abortions later in pregnancy (Correll, Los Angeles Times, 6/5).Bond Set for Tiller Shooting Suspect Sedgwick County, Kan., District Judge Warren Wilbert on Thursday set a $5 million bond for Scott Roeder, the man charged with shooting and killing Tiller, the AP/Yahoo! News reports. A preliminary hearing for Roeder is scheduled for June 16. If convicted, Roeder face
Endocrinology

RCN Statement On Lord Ara Darzi

Commenting on news that Lord Ara Darzi will stand down as a government minister, Dr Peter Carter, Chief Executive of the Royal College of Nursing (RCN), paid tribute to his contribution to the health service. He said: "Lord Darzi has been instrumental in shifting the focus of health reforms to where they should be, which is on providing quality care. We want to pay tribute to Lord Darzi, especially for putting clinical staff at the centre of this vision. He leaves a lasting legacy on the health service and it will be important to continue to focus on quality and safety and not to let financial pressures take centre-stage over the coming months and years. "Lord Darzi"s commitment has stemmed from his front-line experience in the NHS which is welcome as it shows how a focus on quality over targets will ultimately help to improve care for all." Royal College of Nursing (RCN)


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