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
By PETER STEINFELS
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?