In the end, it will come down to abortion. A year of heated debate on a health care bill -- and decades of earlier efforts -- will all hinge on the votes of a handful of House Democrats who believe they must take a strong stand to discourage or prevent as many abortions as possible.
This may well be a noble goal -- I’ll try to leave that debate for others -- but the hard truth is that voting against the health care bill over the abortion issue makes no sense. It won’t prevent a single abortion from taking place. In fact, it may well have the opposite of the intended effect, causing the country to miss out on a move that really will lead to fewer abortions.
The anti-abortion Democrats who are threatening the health bill, about a dozen strong, are led by Rep. Bart Stupak of Michigan. They succeeded in winning language in the House-passed health bill that prevents any woman from using her own money to buy health insurance that covers an abortion if the plan accepts any other enrollees who are using taxpayer-subsidized funds. She would have to buy a separate rider, which no insurer is likely to offer.
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The Senate refused to go quite that far, though it went plenty far. The Senate bill that Stupak and others refuse to vote for because it’s “too lenient” bans the use of federal subsidies to pay for abortion services. It also allows any state to ban insurers from providing abortions on the newly created exchanges. If a plan does offer abortion coverage, any woman who wants it (not just those getting tax subsidies) would have to provide a separate check each month to her insurer to cover the abortion services. This would be an extremely cumbersome procedure, not only for the woman, but also for the insurer. So cumbersome, in fact, that no insurer would offer the coverage. That is exactly what has happened in states that allow separate abortion riders under similar conditions. No one even asks for a separate rider because no woman ever plans in advance to have an abortion.
Stupak has repeatedly mischaracterized the Senate bill, saying it would allow federal funding of abortions. That is not the case, and several fact checkers have pointed that out. In fact, the Senate language has been endorsed by pro-life Democrats in that chamber (Ben Nelson of Nebraska and Bob Casey of Pennsylvania), by some pro-life groups and by groups representing Catholic Bishops. But it’s not good enough for the handful of House Democrats who seem intent on a game of one-upmanship that is as much politics as policy. Stupak, in fact,
But I digress. The point is that both the Senate and the House language would have the same practical effect – they would mean no coverage of abortion procedures for women getting insurance through the new exchanges. (Most employer-provided coverage includes abortion services, but they’re beyond the reach -- so far -- of Stupak and others.)
Amidst this splitting of hairs comes an interesting contribution to the debate from T.R. Reid, who has spent the better part of a decade comparing and evaluating health care options in the U.S. and abroad. In an op-ed article in The Washington Post, Reid argues that if abortion is the main concern, there’s a strong case for passing the bill because increasing access to health care is the most powerful tool for reducing the number of abortions. Reid cites United Nations data showing that the U.S. has one of the highest abortion rates of any industrialized country -- not because the U.S. is any less pro-life, but because so many Americans lack access to affordable health care. Cardinal Basil Hume, the former Catholic prelate of England and Wales, told Reid that he attributes Britain’s lower abortion rate to the U.K.’s universal health care system. “If that frightened, unemployed 19-year-old knows that she and her child will have access to medical care whenever it’s needed,” Hume told Reid, “she’s more likely to carry the baby to term. Isn’t it obvious?”
Yes, in a word, it is. There may be many reasons to oppose the health care legislation that President Obama is pushing, but arguing that it’s not tough enough on abortion shouldn’t be one of them. Those who really want to lower the abortion rate need to give Hume’s argument some serious thought.
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