After a week of high-stakes negotiation and an unprecedented push by U.S. Catholic bishops to involve U.S. Catholic parishioners in a last-minute campaign to keep federal funding for abortion out of the bill, the U.S. House of Representatives narrowly passed a health care reform package on Nov. 7 by a vote of 220 to 215. The Affordable Health Care for America Act (H.R. 3962) includes the Stupak-Pitts Amendment, which was supported by the U.S. Conference of Catholic Bishops. That measure prohibits the government “public option” plan or any private plan subsidized with federal money that participates in the reform package’s insurance exchanges from offering coverage for abortion procedures, except in the case of rape or incest or when the mother’s life is in danger.
A Senate vote could come any time the Senate majority leader, Harry Reid, Democrat of Nevada, thinks he has 60 votes. Lawmakers appear to be angling to put a reform package on the floor by Christmas.
The Nov. 7 vote was a victory for the Catholic pro-life and national right-to-life community, though less of an achievement than pro-choice advocates are suggesting, since the amendment does not add new restrictions on abortion but continues Hyde Amendment prohibitions on the use of federal money for elective abortion. President Obama appeared to endorse that position in an interview with ABC News on Nov. 9. “I laid out a very simple principle,” he said, “which is this is a health care bill, not an abortion bill. And we’re not looking to change what is the principle that has been in place for a very long time, which is federal dollars are not used to subsidize abortions.” While Democratic senators were scrambling to replicate the Stupak Amendment, the president indicated that changes in the amendment’s language were likely. “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.”
The intensity of the pro-choice backlash to the Stupak Amendment was a surprise to some observers, since the provision merely codified what has been for decades established policy. The health insurance offered to employees of the federal government, upon which a public option may be modeled, for example, does not include coverage for abortion. Neither do federally funded military or Medicaid plans.
Nonetheless, the pro-choice camp’s response to the amendment has been energetic. The president of NARAL Pro-Choice America, Nancy Keenan, said in a statement: “We will hold those lawmakers who sided with the extreme Stupak-Pitts Amendment accountable for abandoning women and capitulating to the most extreme fringe of the anti-choice movement.”
Lynn Woolsey, Democrat of California and co-chair of the Congressional Progressive Caucus essentially called on the Internal Revenue Service to investigate the U.S.C.C.B. “The role the bishops played in pushing the Stupak Amendment...was more than mere advocacy.... The I.R.S. is less restrictive about church involvement in efforts to influence legislation than it is about involvement in campaigns and elections. Given the political behavior of U.S.C.C.B. in this case, maybe it shouldn’t be.”
U.S. bishops and Catholic pro-life advocates have been accused of jeopardizing health care reform because of their insistence on including prohibitions on federal money for abortion in whatever plan emerged from Congress. But it could just as easily be argued that it was the church’s alleged brinkmanship that helped propel a floor vote on health care reform in the first place. That vote would not have happened without Stupak-Pitts clearing the way for moderate and conservative Democrats to support the reform package, and the amendment was the tipping point for Anh Cao, of Louisiana, who became the only Republican member to vote in support of the House health care reform bill.
As the debate moves to the Senate, now it is pro-choice advocates who threaten to stall health care reform if abortion-funding constraints are not weakened in the final proposals to come out of the congressional conference committee.