There is much about the Senate’s health care reform bill to commend it for passage. It keeps costs lower than those anticipated in the House bill. It raises taxes on rich people, which is always a good thing, raising the Medicare tax on those making more than $250,000. It reduces the federal deficit over the long haul. It has robust conscience clause protections. And, while we are still trying to figure out the fine print (and I am not a lawyer) it appears to cover legal immigrants. All this is good and makes me think the bill should pass.
Except for abortion. The Senate bill erects what it calls a "firewall" between federal funds and non-federal funds pertaining to policies that cover abortions services in both the public option and in those policies offered in the exchanges that will be subject to subsidies. But, this is nonsense. The fungibility of money argument has not been addressed and while the bill would extend coverage for pregnancy care to millions of women who currently lack it, a very good thing seeing as a pregnancy, even without complications, can cost $10,000, it will also increase abortion coverage significantly and it will do so with federal money. A source close to the Senate negotiations described the Senate provisions as "Ellsworth Capps on steroids." Steroids or not, the premise of the Capps Amendment, and the finessing of the Capps Amendment with the Ellsworth proposals, was flawed from the beginning.
These provisions are worse than nonsense. They go beyond the criticism that pro-choice critics have been leveling since the Stupak Amendment passed. That criticism has focused on a consequence of the Stupak Amendment, that the insurance companies would not offer plans covering abortion to women, even if they are paying with their own money. That was a legitimate complaint for those of us, like myself, who felt that the health care reform effort should be neutral regarding abortion. But, this new language goes further, bringing back federal funding for abortion into the public option and the subsidies plans. Pro-life Democrats like Sen. Ben Nelson and Sen. Bib Casey should dig in and insist that the Senate bill only address the issue of access to plans paid for entirely with private money. They should insist that the ban on abortion in coverage in the public option and the subsidized plans be reinserted into the Senate bill.
I have dealt previously with the argument that the Catholic Church "segregates" funds it receives from the government for social services from the privately raised funds it uses for specifically religious purposes. This analogy was re-introduced in yesterday’s Post by Ruth Marcus. It is offensive to compare religious services to a procedure that many Americans believe is the taking of an innocent human life. It also overlooks the fact that government monies are awarded not to parishes but to organizations like Catholic Charities, which have their own boards, their own by-laws, and which do not proselytize.
Of course, the Stupak Amendment has already passed the House, and it did so with overwhelming numbers. So, even if the current language on abortion passes the Senate, it will need to be merged with the Stupak language passed by the House. But, it will be easier to do that, and the likelihood of an acceptable bill will be heightened, if the Senate passes a bill that forbids abortion coverage from the public option and from federally subsidized plans.
In a television interview, President Obama said that he opposed federal subsidies for abortion coverage. He needs to involve himself in the Senate negotiations to see that the bill recognizes that opposition, which the current language does not. The President, of course, needs to pass a bill no matter what it says about abortion, but he has to do so with an eye towards both the re-election of moderate and conservative Democrats in next year’s midterm elections, who will be vulnerable if the pro-abortion arguments prevail, as well as to his own re-election three years hence. As I said back in July, all of his hopes for common ground on this issue will go out the window if the public option contains abortion coverage.
The Stupak Amendment represents the profound ambivalence that many Americans feel about abortion. Some American Catholics (and others) are unflinchingly pro-life and they probably did not vote for Obama last year anyway. Some Catholics are unflinchingly pro-choice, but they voted for John Kerry too. The center of the electorate, the Catholic swing voters who decide elections, are those who may not want to see abortion made illegal but really, really do not like abortion and do not want to encourage it. One of the keys to the President’s success with those Catholics who voted for Bush in 2004 and for Obama in 2008 was the way he gave voice to this ambivalence they feel about abortion. It is a threshold issue for many centrist Catholic voters: If someone is hostile to pro-life concerns, these swing Catholic voters will not listen to anything else a candidate has to say. Last year, during the election, Obama showed no such hostility to our pro-life concerns, indeed he took steps to highlight his understanding of those concerns. He crossed the threshold, and that allowed these swing voters to listen to him on other issues.
The Stupak Amendment does not bar federal funds for elective abortions to save money, it does so because millions of Americans do not want to encourage abortion with their tax dollars. There is a principle at stake here. I hope the administration recognizes that not only a principle is at stake, but their entire effort to reach out to centrist Catholic voters. The solution is there: Keep the Stupak Amendment but add provisions to ensure the availability of plans that cover abortion for women who are paying with their own money for whatever coverage they want. The so-called "compromise" in the Senate bill released yesterday is not a compromise. It is a sham.
Ms. Marcus finished her article by stating her opposition to the Stupak Amendment but also arguing that pro-choice groups should not let it stand in the way of the health care bill: "The Stupak amendment is not worth killing health reform over." She is right, but as much as I want to see health care reform pass, the absence of the Stupak Amendment's real, rather than illusory, ban on federal funding of abortion is worth killing health reform over. Let's hope cool heads prevail in the Senate and the Conference Committee.