In his “chairman’s mark” on health care reform, Senate Finance Committee Chairman Max Baucus had rejected the pure pro-choice position — he limited direct government funding for abortion — but still included provisions that pro-lifers viewed as supporting abortion.
Republicans have offered several amendments to move the health care bill in a more pro-life direction.
Republican Senator Michael Enzi and Orren Hatch have proposed that:
1) Government tax subsidies could not help people buy insurance that covers abortion. (Enzi and Hatch)
2) Insurers could (as they can now) offer consumers the ability to purchase, with their own money, insurance supplementals that do cover abortion. (Hatch)
3) State insurance exchanges could not be required to offer plans covering abortion. (Enzi)
I’m going to analyze this not from the perspective of whether this is morally good or bad but whether it basically accepts the status quo approach to abortion, which prohibits direct federal funding for abortion but allows some indirect support.
On the first point, they are being consistent to the pro-life position and to the status quo. The Finance committee bill would provide subsidies directly from the Treasury to health plan, so preventing that from covering abortion would be consistent with current practice
On the second, let’s remember that even pro-choice Democrats accept the idea that, at least in terms of this health care bill, pro-life citizens shouldn’t see their taxdollars going to subsidize abortion. Democrats attempted to do that through a system in which money would be segregated into different accounts so taxpayer dollars wouldn’t fund abortion. Hatch took a different approach: while the basic insurance plan wouldn’t cover abortion, insurance companies could offer consumers the option of buying, with their own money, a supplemental insurance plan covering abortion.
Though pro-lifers attacked the Democratic approach as a scandalous assault on human life, and Democrats will no doubt attack the Republican approach as a scandalous assault on freedom, they actually are trying to achieve the same goal.
In my opinion, the Republican approach is simpler and cleaner (I actually advocated for something like this a few weeks back.) But it does have flaws. For instance, it may be unrealistic to expect that women will be thinking about the prospect of abortion when they’re buying health insurance. Also, oftentimes, the policyholder is not the beneficiary. A woman might buy the supplemental but will a father who has a teenage daughter decide to buy the supplemental? (And I thought the Democrats approach basically passed the status-quo test too)
On the third item, Enzi did something that definitely moves government policy away from the status quo in a markedly pro-life direction. The Senate bill (as well as the key house bill) had a provision that local insurance exchanges be required to offer at least one plan that covers abortion and one that doesn’t. Democrats viewed this as an innovation in fair-mindedness. No one would be forced to buy a plan that violates their ethical code.
Enzi deleted the part saying that exchanges would have to offer abortion-covering plans — but left in the clause saying they’d be forced to offer no-abortion-coverage plans! This is a definite departure from current practice and a push of state laws in the pro-life direction.
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posted September 22, 2009 at 12:52 pm
Steven,
These Republican efforts amount to nothing more than yellow lights and speed bumps along the road to federally funded abortions under the single-payer system that is being pushed. Under the single-payer system ( If that comes to pass) how could abortions NOT be covered?
So for now we will assuage ourselves that it won’t happen in the immediate future, while allowing the dismantling of the current system. Once the new system is in place, abortions will continue to proceed apace, being given priority funding as health care is rationed. That isn’t a matter of ‘if’ but only of ‘when’.
posted September 22, 2009 at 2:41 pm
It violates my ethical code to prohibit coverage of any sort of medical procedure on the basis of any non-health related criteria. Any absolutist position regarding coverage of abortion does this.
I trust women to be able to evaluate the implications of a decision to terminate a pregnancy. I trust physicians to provide medical care. I do not trust politicians to determine whether or not abortion is necessary, and I do not trust those that would take the decision away completely. Not all fetuses are viable. Not all women are able to bear children, despite their ability to become pregnant.
When you say that the Republican position is more “fair” – fair to whom? To taxpayers that believe they have the right to dictate the availability of coverage for abortion? To all of you that erase women as capable, autonomous and reasoning beings, fully capable of considering the implications of pregnancy and termination of pregnancy- and given that understanding, sometimes making a decision that you consider an evil?
posted September 22, 2009 at 3:38 pm
Akd, the only abortions that would qualify as healthcare are the ones pertaining to pregnancies that supposedly threaten the life or health of the mother. Cosmetic surgery isn’t health care. Botox injections aren’t healthcare. Sex change operations aren’t healthcare. The vast majority of abortions can scarcely be construed as healthcare.
posted September 22, 2009 at 3:49 pm
Is there a single member of the Senate whose vote is being swayed by the abortion provisions? If Baucus appeases the pro-lifers, whose vote does he change?
posted September 22, 2009 at 7:48 pm
Tom – regardless of your feelings about what constitutes healthcare, you are not qualified to make blanket statements about whether an abortion might be required to preserve a woman’s life or health. Equating abortion with botox or other cosmetic procedures is just one more aspect of the myth that women go around getting recreational abortions because their vanity demands it. Your assumptions about what it means to preserve life or health are not relevant to the question of whether there should be a ban on health insurance being offered in an exchange, or whether the public plan offers abortion as part of comprehensive reproductive services. Women are competent to make decisions about their health – and this includes pregnancy – whether it is the prevention of pregnance, termination of pregnancy or carrying a pregnancy to term. Physicians are competent to provide or recommend that care. Carving out reproductive health as an area where other people are more competent to make the decision than the patient – the woman – is an unacceptable restriction.
posted September 23, 2009 at 10:47 am
I made no such “blanket statements”. My only reason for making the comparison was to demonstrate that abortion by and large is elective and does nothing to improve the health of the mother; therefore, it isn’t healthcare per say, nor should it be included in any piece of healthcare legislation.
posted September 23, 2009 at 1:11 pm
Tom – you just repeated the blanket statement – by claiming that “abortion by and large is elective and does nothing to improve the health of the mother” with absolutely no evidence to back it up, you are making a blanket statement about abortion. By and large, many medical procedures are “optional” – but that doesn’t mean they aren’t healthcare. Banning a medical procedure, or excluding it from coverage because you believe that it is usually not necessary for health or life is interfering with the medical care of another. Would you ban all plastic surgery because most plastic surgery is elective? Banning coverage of a specific medical procedure because of generalized beliefs about the need for it should be no part of any healthcare legislation. A pregnant woman and her doctor are the only people that should be making decisions about what is medically necessary. Not you. Not Congress.
posted September 23, 2009 at 6:00 pm
The esteemed Mr. Waldman himself posted a poll from the Alan Guttmacher institute a few months ago asking why women seek late-term abortions, with a very minut percentage citing health/jeopardy of life issues. Please try to stay on topic here, as we’re not discussing the complete eradication of abortion. Only what should or shouldn’t apply to healthcare. So-called “theraputic” abortion is already covered regarding health & mortality issues, as well as rape & incest. We’re not currently discussing what medical procedure should be allowed between a woman, her unborn child, and her doctor. The article is about direct and indirect subsidizing of taxpayer funded (elective) abortions and their inclusion in proposed legislation. If a procedure doesn’t improve or preserve the physical health of a patient (or even puts them in jeopardy) then how can it possibly be construed as healthcare?
posted September 29, 2009 at 5:19 am
May I offer a practical option?
If it’s a health issue (and the mother’s health, mental AND physical, is just as important as the child’s), then let health care subsidize it.
If it’s just a matter of personal issue (and the mother and child are both healthy, and there’s therefore no medical reason to abort), then let the mother foot the bill.
What I’m saying is, you just can’t generalize or pigeon-hole these kinds of situations. We tend to (want to) do that to make OUR own choices easier. Doesn’t mean we make it easier for others.