On Monday, I made the argument that the differences between the House/Stupak bill and the final/Senate bill were so small, as they relate to abortion, that those differences should not be the ground for opposing the final/Senate bill. I directed my criticism at the USCCB, and specifically at their point man on life issues, Mr. Richard Doerflinger. In a comment to my post, Mr. John Carr, who also works at the USCCB, writes that I overstate Mr. Doerflinger’s influence and that if I have objections to the USCCB stance, I should direct it to the bishops. I stand corrected on the issue of Mr. Doerflinger’s influence, but I stand by the basic argument of my post, that the differences are so thin (and in some ways I think the Senate bill is preferable from a pro-life perspective), that this should not be the grounds for bringing down health care.
This argument, of course, works both ways. What if, tomorrow night, it becomes clear that Speaker Nancy Pelosi does not have the 216 votes needed for passage. Will she do what she did in November and permit a vote on the Stupak Amendment? Why not? Then, in November, the choice was between Stupak and the Capps amendment, and that was a real choice with real consequences. I am afraid that by now Stupak has taken on symbolic importance for both sides – and touched the strings of political loyalties and hatreds – and while people of good will can always negotiate policy, they will die for a symbol.
Why did the pro-choice groups oppose the Stupak amendment with such vigor? They argued that it went beyond Hyde. The Stupak amendment did not ban insurance policies that cover abortion from the exchanges, but it insisted that any company that offered a policy that covered abortion must offer an identical policy that did not cover abortion. The chief actuary for the insurance companies said that realistically this effectively meant that no company would offer policies that cover abortion, because the pool would be too small. I said at the time that this was the problem with Stupak but no one focused on how to fix that precise difficulty. Now, the Senate bill I think will have the exact same result although it may take a few months for people to tire of writing and companies to tire of processing and accounting for the separate checks for abortion coverage. And, yes, this all could have been avoided if the Senate had adopted Sen. Bob Casey's suggestion of an individual opt-out provision. But, we are here now. And, the question for the Democratic Party may be: Which is more important, your commitment to health care reform or your commitment to abortion rights groups?
I am not sure where the Democrats would come down on that question. In November, Speaker Pelosi threw the pro-choice groups under the bus, but then she could assure them that their concerns would be addressed subsequently. There is no "subsequently" after this week. It was telling, last November, that President Obama – who has been wrongly vilified by pro-life groups as "the most pro-abortion President ever" – did nothing to rescue the Capps amendment.
There is a further complication. If the Democrats need the Stupak coalition to pass the bill, the amendment will have to be included in the reconciliation bill. But, because the issue has no impact on the federal budget, it could be excluded from the reconciliation bill under the Byrd rule. All forty-one Republican senators have vowed not to permit any exceptions to the Byrd rule. In an op-ed in the Washington Post’s "On Faith" the bishops who have been at the heart of the negotiations note this fact: "On the other hand, Republicans pledge to do all they can to defeat the legislation by threatening to object to any improvements in the Senate bill, further complicating the process." If the House accepts Stupak, it is hoped the bishops will push as hard for the bill’s passage as they are currently pushing to defeat it. It is also worth noting that if the Senate bill really did fund abortions with federal dollars, it would have an impact on the budget and would meet the standard of the Byrd rule. By calling attention to the need to get around the Byrd rule, the bishops unintentionally gut their principal argument against the bill.
The bishops’ op-ed also takes note of the bill’s provisions regarding immigrants. These provisions are truly shameful. Still, a society that accepts its obligation to provide health care to all its citizens is a society more likely to extend that health care to immigrants. And, the prospect of comprehensive immigration reform will allow legislators to revisit these harsh provisions. The immigration language should not be a deal breaker.
In all these complicated negotiations, it is important to recognize that most, if not all, of the principal actors are acting in good faith. I commend the bishops for declining to write fellow Catholics off, or question their Catholicity, because they have reached different conclusions about the bill from those arrived at by the conference. Their concerns have been well known and well stated from the beginning, including their commitment to universal health care, which is why they are still party to the negotiations. If health care fails, there will be plenty of blame to go around, and the blame should not be foisted upon the bishops themselves nor their staff at the USCCB. As the President never tires of saying, if this were easy it would have been done along time ago. Passing universal health care is not easy, but it is urgent, and that sense of urgency applies equally to the USCCB and to the pro-choice groups that may, come this weekend, have to bite the bullet and accept the Stupak Amendment again.
Michael Sean Winters