In Health Care Battle, a Truce on Abortion

President Obama is not merely willing to take single payer off the table and give up on the paltry substitute that goes by the name of public option. He is also determined not to allow abortion funding to be used as an issue to sink health reform. This story is from the New York Times

In Health Care Battle, a Truce on Abortion
September 12, 2009

“And one more misunderstanding I want to clear up: Under our plan, no federal dollars will be used to fund abortion, and federal conscience laws will remain in place.”

Did that apparently unqualified statement by President Obama to a joint session of Congress on Wednesday guarantee that health care overhaul, whatever its other travails, will not fall victim to the seemingly intractable moral battle over abortion?

Of course not. Administration foes, like the National Right to Life Committee or the Catholic League for Religious and Civil Rights, were quick to declare that the president could not possibly mean what he said.

But others, like officials of the United States Conference of Catholic Bishops and some religious leaders with concerns about abortion, welcomed his words. When it comes to health care overhaul, a surprising number of people on both sides of the abortion war have declared a limited truce.

The key words are “abortion neutral.”

What those two words mean is that neither abortion opponents nor abortion rights advocates would use the overhaul effort to advance their agendas. Most important, they would not try to change the legal status quo regarding federal financing of abortions.

That truce did not mean that those activists — or Americans generally — were themselves abortion neutral. Far from it.

When it comes to health care, abortion rights supporters strongly believe that abortion should be treated no differently than any other medical procedure to which Americans have a legal right. Abortion opponents say that a procedure they view as lethal to a distinct member of the human species, no matter how early in its development, hardly qualifies as health care.

Neither side is surrendering those fundamental beliefs or its long-term goals, but at least some influential players on both sides value health care overhaul enough that all they want is that it not change the abortion status quo.

If only they could agree on what the status quo is.

Currently the federal government does not pay for abortions under Medicaid, except in cases of rape, incest or physical threat to the pregnant woman’s life, although states can do so. Similar bans apply to other federal programs.

The Federal Employees Health Benefits program, for example, is often cited by advocates of health care overhaul as a model for extending insurance coverage. It gives millions of federal employees, including members of Congress, a choice of hundreds of private insurance plans and pays most of the premiums. But no plans can include abortion in its benefit package except, again, in cases of rape, incest, or physical threat to the woman’s life.

For abortion opponents, abortion neutral means maintaining these restrictions, whether in the private plans that might receive federal subsidies in a proposed insurance exchange or in any public plan competing in this exchange.

Abortion opponents also want these restrictions spelled out explicitly, not left to court decisions or to the appointees of a president who has repeatedly described himself as pro-choice.

Not surprisingly, defenders of legal access to abortion see the status quo differently. They recognize the reality of the near total ban on federal financing of abortion. But they emphasize that millions of women are covered by insurance plans, mostly through employers, that pay for abortions.

As low-income individuals or as employees of small businesses, many of these women may qualify either for the subsidized private plans or the public option offered in an exchange. If abortion could not be included in any of those benefits packages, these women would lose the kind of coverage they have now.

For abortion rights advocates, that would not only constitute an unacceptable departure from the status quo, it would also violate the president’s principle that under an overhaul, people not lose their current coverage.

An amendment by Representative Lois Capps, Democrat of California, to the leading House health care bill tried to bridge these differences. It authorized the public plan to cover abortions, beyond the instances of rape, incest, and threat to a woman’s life, while mandating that at least one private plan available in a national insurance exchange, and eligible for federal subsidies, include broad abortion coverage and at least one does not.

The Capps amendment tried to satisfy the current ban on direct federal financing of abortions by requiring that government contributions to either the public plan or the private plans be kept in separate accounts from premiums paid by individuals. Payments for abortions (beyond the current exceptions) would be attributed to the premium pool.

Groups like Planned Parenthood and Naral Pro-Choice America insist that this segregation of money means that abortion would be paid for with “private dollars,” not federal ones. Abortion opponents call this bookkeeping legerdemain.

With the large majorities currently enjoyed by Democrats, why are they so eager to disassociate health reform from abortion funding? After all the scare tactics Democrats have used about how threatening Republicans are to the right to choose abortion, one might have expected them to repeal the Hyde Amendment, passed in 1976 to exclude abortion from health services provided under Medicaid. Clearly Democrats have overriding priorities. This is nothing new, but for some reason, the mainstream pro-choice organizations are willing to play along with this charade. It is true health care is so messed up, almost anything would be an improvement, but is it really worthwhile for women to support this tinkering around the edges Democrats propose as health care reform, in light of how willing Democrats are to make concessions to placate opponents of abortion? Where will that end, with any subsidized insurance plan forbidden to pay for abortion? That seems to be the consequence of what Obama is saying. Perhaps abortion foes are correct, he cannot possibly mean what he says, but if that is true, why should any of his reassurances be believed?

Bottom line, this concession is unnecessary, unwarranted, and unfair to women, but none of that appears to bother the President, since getting a health care reform bill passed is so much more important to him than whether more low-income women will have to find some way to pay for abortions. Abortion is not a luxury item. If abortion services are not to be covered by health insurance plans available for poor women, there should be no pretense that women are getting a fair shake. Women need comprehensive reproductive health care services. It appears that according to the President, abortion is too controversial to be included in that. Is this what he calls bipartisanship, or just more evidence that the rights of women are secondary considerations in his bigger scheme of things?

5 Responses to “In Health Care Battle, a Truce on Abortion”

  1. Aletha Says:

    This is how the Feminist Majority, which last Friday sent out bulletins entitled “Women gain big time with health insurance reform,” lets the President off the hook, from the bottom of this page explaining how REPRODUCTIVE HEALTH SERVICES MUST BE PROTECTED

    This insurance reform package cannot be the vehicle for overturning the Hyde Amendment because there are simply not the votes to defeat the Hyde Amendment now. The women’s movement must change the political climate to defeat the Hyde Amendment in the future.

    Sorry, Feminist Majority, though the proposed health insurance reform plans may be an improvement over the current system, which is broken and corrupted from top to bottom, it is not this great boon to women you portray it to be, and reproductive health services will not be protected. The Free Soil Party is not about to let President Obama or his party off the hook for this betrayal. How is the political climate to be changed, by electing more Democrats? This brings to mind one definition of insanity, to do the same thing over and over expecting a different result.

  2. Aletha Says:

    The House Democrats have passed their version of health insurance reform, barely, basically by placating the abortion opponents within their ranks. If the bill passes in its current form, it will mean poorer women who need a subsidy to buy health insurance will not be able to get a policy that covers elective abortion. There may be supplemental insurance such women could buy with their own money, but how many women plan on an unplanned pregnancy? Some in Congress are furious at this betrayal of women and threaten to vote against the bill if the restriction survives. This story is from the Baltimore Sun

    Abortion fight looms large in debate over health bill
    By James Oliphant and Kim Geiger

    WASHINGTON BUREAU – Furious liberals on Monday threatened to derail the massive healthcare overhaul bill to protest a last-minute deal over insurance coverage of abortions that had secured passage of the legislation in the House.

    At least 40 House members pledged not to vote for a final healthcare bill if the abortion provision survives–endangering the exceptionally fragile Democratic coalition that has kept the bill afloat.

    At issue are the insurance policies offered in a new “exchange,” or insurance marketplace, that the legislation would create to help consumers purchase health plans, many using newly created federal subsidies.

    The House measure says the federal subsidies cannot be used to buy health policies that cover elective abortion. Abortion rights supporters say this would affect a broad set of consumers, because insurers would likely abandon abortion coverage in all policies offered in the exchange.

    The provision “represents an unprecedented and unacceptable restriction on women’s ability to access the full range of reproductive health services to which they are lawfully entitled,” the House members wrote to House Speaker Nancy Pelosi.

    It was a tougher line than they had adopted less than 48 hours earlier, when they had, almost to a member, voted to pass the health legislation. The bill cleared the chamber late Saturday by a mere five votes.

    The tumult over abortion now travels to the Senate, where it promises to cause headaches for Democrats still wrestling with fundamental issues of cost, coverage, and revenues in its version of the health bill.

    The Senate legislation contains looser restrictions on abortion coverage than were approved by the House. But, already, at least one Democrat, Sen. Ben Nelson of Nebraska, has signaled that he may be willing to work with abortion rights opponents on language similar to that from the House.

    “He wants to make sure the intent is the same” as the House amendment, said Jake Thompson, a spokesman for Nelson. “The final bill has to satisfy him that it doesn’t support federal funding of abortions.”

    Abortion rights opponents were also focusing on Sen. Robert Casey (D-Pa.), who opposes abortion rights. Because Democrats will likely need the vote of every member of their caucus to pass the health bill, Nelson and Casey might have significant leverage in demanding tough language on abortion coverage.

    President Obama suggested Monday that the House measure might be altered as the legislation moves through Congress, though he did not say that he would push for changes himself.

    Obama told ABC News that the bill should uphold the principle that federal money may not be used to subsidize abortions.

    “And I want to make sure that the provision that emerges meets that test–that we are not in some way sneaking in funding for abortions, but, on the other hand, that we’re not restricting women’s insurance choices,” he said. “Because one of the pledges I made in that same speech was to say that if you’re happy and satisfied with the insurance that you have, that it’s not going to change.”

    “I’m confident that we can actually arrive at this place where neither side feels that it’s being betrayed,” the president said. The House amendment, which was sponsored by Reps. Bart Stupak (D-Mich) and Joe Pitts (R-Pa.), would allow people buying insurance in the exchange to purchase separate “riders” that would cover abortions. Abortion-rights advocates say few would do so, because few women anticipate an unplanned pregnancy and few insurers are likely to offer such a separate service.

    Dr. Willie Parker, a board member at Physicians for Reproductive Choice and Health, said the amendment could have the greatest impact on women whose underlying health conditions require hospitalization in order for a safe abortion to be performed.

    Parker cited an example of a woman with a pregnancy that involves abnormal attachment of the placenta. While a standard abortion may cost just $350, the cost in that situation would range between $3,000 and $4,000.

    “Many women don’t have that kind of disposable income. If we allow the Stupak amendment to stand, we have just set women back 30 years in guaranteed access to safe abortion services,” Parker said, referring to the House measure.

    Charmaine Yoest, president of Americans United for Life, which opposes abortion rights, said she was confident that the Senate ultimately would take a similar route as the House. “There is a division on abortion in the country,” Yoest said. “There’s not a division on federal funding.”

    The United States Conference of Catholic Bishops, which played an instrumental role in the House legislation, has already asked its 19,000 member parishes to contact the Senate in a bid to see the House language adopted.

    But Cecile Richards, president of Planned Parenthood, said prior bids to tighten the abortion language in the Senate had failed, and that the Senate would not follow the House’s lead.

    “The most important part of health care reform to us has been the guarantee that the president made that no one would lose their benefits as a result, and the Stupak amendment undercuts that promise,” Richards said. “I think cooler heads will prevail in the Senate.”

    The President has a peculiar idea of balance on this issue. His choice of words shows how he opened the door to this betrayal. Sneaking in funding for abortion? His attitude must be the basis for that brazen denial by Charmaine Yoest of a division on federal funds for abortion. The Hyde Amendment has been a sore spot for feminists since it was passed, and that Obama would go out of his way to reassure abortion opponents that it would remain in force is a complete betrayal of his promise to pass the Freedom of Choice Act. This is the man Ms. Magazine put on their cover wearing that This is What a Feminist Looks Like shirt. No, it is not. This is what a Democratic politician looks like, making promises to women he had no intention of keeping. During the campaign, Obama said passing the Freedom of Choice Act was a top priority, but he rescinded that commitment soon after taking office, and now the Hyde Amendment will be expanded. I see no reason for the optimism of Planned Parenthood. At least the House has a pro-choice woman as its leader. Harry Reid is neither. The priorities of the Democratic Party and President Obama are clear. Health insurance reform must be passed, and if the rights of poor women to obtain abortion must be sacrificed, so be it.

  3. Aletha Says:

    According to Senator John Kerry, the Senate bill just unveiled will not carry such onerous restrictions on abortion.

    Sen. John Kerry, D-Mass., said all consumers who purchase insurance from private companies in the exchange would have access to abortion coverage.

    He said plans without abortion coverage also would have to be sold, giving consumers a choice. That is less restrictive than a provision in the House-passed bill that has angered liberals and abortion rights supporters.

    The President has also reiterated his desire to maintain the status quo on abortion funding, so it is possible the final bill will not be more restrictive than the Hyde Amendment, but that would just be one more example of how women must fight on the defensive, to keep men from rolling back hard-won rights, even with a Democratic President and large majorities in both houses of Congress. It is hard to imagine things getting better for women, if this is what happens when Democrats hold virtually all the cards.

  4. Aletha Says:

    President Obama unveiled his new plan for health insurance reform, hoping to jumpstart the legislation after its momentum was rudely interrupted by the upset victory of Scott Brown, capturing the seat held by Senator Kennedy in Massachusetts. Details are sketchy at this point, but according to Think Progress, the new plan contains no “public option,” but goes along with the Senate language on abortion funding, which is not quite as onerous as the House language. Thanks for nothing, President Obama.

    But it’s unclear if progressive House members will embrace the new compromise. While the bill addresses House members’ affordability concerns, increases the excise tax thresholds and completely closes the donut hole in Medicare Part D, the legislation does not include a public option, retains the Senate bill’s state-based exchanges and keeps the start date for most reforms at 2014. (Obama’s plan also retains the Senate’s abortion compromise and most other core provisions).

  5. Aletha Says:

    President Obama must not think the opinions of women on his health care proposal are important. Out of 22 lawmakers he invited to his summit, there was one woman, Nancy Pelosi. Since these were supposed to be the most important members of Congress, he could hardly leave her out. The four top leaders of Congress were also asked to name four more legislators, for a grand total of 38. Three more women were selected, so women made up just over ten percent of the total. One of them was Rep. Marsha Blackburn, Republican from Tennessee. The other two were Democrats, Rep. Louise Slaughter from New York and Sen. Patty Murray from Washington. Perhaps the President did not want women there who might make a fuss over abortion. Regardless of his motives, this stinks. The complete list can be found at the Washington Post. Among the angry responses in the feminist blogosphere are White House health summit: Women left out in the cold at Women and Politics, which links to Shades of Stokely Carmichael: Where Is the Female Leadership in the Health Reform Summit? at RH Reality Check.

    This snub of women is obvious and ominous. It appears the last thing the President wants is to put health insurance reform at risk by alienating Democrats who oppose abortion rights. He would rather risk alienating pro-choice women, who need to wake up and smell the coffee. President Obama and his party do not view the rights of women as a high priority. The votes of women, now that is of some importance, but since women supposedly have nowhere else to go, Democrats must think those votes can be taken for granted.

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