Semi-Private WombSelling out abortion rights for health care reform.
Posted Monday, Nov. 9, 2009, at 8:21 AM ET
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StumbleUponAbortion rights have been sold out for health care reform.
House Speaker Nancy Pelosi couldn't round up enough votes for her party's health care bill without pro-life Democrats. So on Friday night, she agreed to let the House vote on an amendment to restrict abortion coverage under subsidized insurance plans. Everybody knew the amendment would pass. To get the bill through, Pelosi traded away abortion.
Naral Pro-Choice America is furious. It points out that more than 85 percent of private health insurance plans cover abortion. By forbidding such plans from competing in the new, lucrative federally supervised insurance exchanges, the bill would force them to drop abortion coverage. This would eliminate such coverage even for policyholders who pay their own way—"a radical departure from the status quo," the group complains.
The Planned Parenthood Federation of America seems even angrier. On Saturday, it announced its opposition to the House bill. According to PPFA President Cecile Richards, the bill strips women of abortion coverage even "in the private health insurance market" and leaves them "worse off after health care reform than they are today, violating President Obama's promise to the American people that no one would be forced to lose her or his present coverage under health reform."
Welcome to socialism.
I don't mean to exaggerate the House and Senate bills. They don't nationalize medicine or set up a single-payer system. As socialism goes, they're modest. But they do mandate, standardize, and subsidize health insurance. They mix public with private. And when you do that, you invite public-sector problems into matters that used to be nobody's business.
One of these problems is that people don't like their tax money being used for procedures that offend them. You may think that's stupid. You may point out that your tax money is used for wars you don't like. But you don't have two or three dozen swing votes in the House. Pro-life Democrats do. They don't have the clout to ban abortion, but they have the clout to keep tax money from paying for it.
Until health care reform came along, this wasn't your problem. It was a problem for women who depended on public programs like Medicaid. But you wanted a better world. You wanted health insurance for everyone, and you wanted the government to help pay for it. Congratulations. You've brought the tax moralists into your life.
Pro-lifers say the health insurance abortion restriction, known as the Stupak amendment, is just an extension of the Medicaid abortion restriction, known as the Hyde amendment. Pro-choicers say the Stupak amendment is much more invasive. The pro-choicers are right. But pro-lifers didn't create that difference. Democrats did. By mixing public and private health care, they complicated the separation of taxation from abortion. If pro-lifers can't keep their money out of the insurance exchanges, they'll fight to keep the insurance exchanges out of abortion.
Granted, there are less onerous ways to interpret the no-taxes-for-abortion principle. Pelosi tried to sell these alternatives to the pro-life Democrats. They weren't buying.
There's something poignant about the last-minute outrage of the pro-choice groups. The complaints they're leveling—that people had more choices in the private market, that the House bill radically upsets this market, and that it violates Obama's promise not to deprive anyone of their existing coverage—are hardly novel. Republicans have issued such warnings all year. But liberals didn't pay attention until the coverage in jeopardy was abortion.
I'm not saying we shouldn't socialize health insurance. I'm pretty comfortable with the House and Senate bills. But let's give up the two lies we tell ourselves about such legislation. One is that it won't cost us much money. The other is that it won't cost us much choice. When you throw in your lot with other people and agree to play by the same rules, you surrender some of your freedom and risk losing some of your options. Sometimes it's coverage of an MRI or a hip replacement. Sometimes it's coverage of abortion. If that's the price of health care reform, are you willing to pay it?
(Now playing at the Human Nature blog: 1) Genes, murder, and bad driving. 2) A compromise on outdoor smoking. 3) Charging fat people more for ambulance service.)
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Please correct me if I'm wrong. I think the ban is supposed to be similar to what some states (Missouri, Kentucky, etc.) and Medicare have already enacted. Basically, in order to pay for an abortion, you'd have to buy an additional "rider" which counts as an extra premium to cover the abortion. Essentially this amounts to an out-of-pocket expense for the rider, which is dropped after the abortion is performed. As with most things health-insurance related, I'm not sure I fully understand what this means either. Also, in talking with a co-worker, apparently a number of "national" insurance companies don't seem to cover elective abortions anyways (no idea if this is true) :)
It would be nice to have a genuine civil discussion about health-care that did not dissolve into zealous shouting matches. That way us independents would be able to get some real information to make an informed judgment on the whole set of issues.
-- shusaku
(To reply, click here)
"Supplemental coverage" = rider. Yes, you can buy a rider. Abortion is dropped as part of the basic health insurance plan.
Guess how many people are going to buy an abortion rider? If people were that rational about their risk of unintended pregnancy and abortion, they'd be more diligent about birth control.
-- Will Saletan
(To reply, click here)
One difference between wars and abortions, as far as public funding goes, is that wars, like restrictions on pollution, have inherently communal benefits. An individual may believe that a war is of no benefit, just as an individual may believe that a little more pollution would be worth the cost savings looser standards would bring, but it's impossible for that individual to opt out. You can't say "Just make my air dirtier and cut my taxes, but Joe can have cleaner air if he's willing to pay for it." You both breathe the same air, and you both live in the same international community, and there's no way around that.
Abortion funding, by contrast, is an individual benefit to the patient (and possibly the father). It's a zero sum game - if I have to pay for your abortion, you're richer and I'm poorer and I have no benefit whatsoever to compensate for the cost. And it is absolutely possible for individuals to opt out, it's only the government saying they can't. This is a problem that is inherent to entitlements, and it's one reason they're so politically divisive. Adding private morals into the mix just ups the ante. And it doesn't help that, unlike the MRI or triple bypass surgery, it's purely optional nine times out of ten. You face the same problem with Viagra, there just isn't an organized political constituency opposing it.
But aside from that, this was an amazingly honest article. Saletan hit it dead on: if you don't want me telling you what's covered, don't make me pay for your health care. The flip side is, of course, if you don't want to cover my abortion, Viagra, obesity, or smoking, don't insist on pooling our health care costs.
-- TheyCallMeBruce
(To reply, click here)
This is something I have tried to tell my liberal democrat friends for a long time; it's not just conservatives or Republicans that oppose this, there are those of us who are independent of political party and look at any time we look at turning some choice over to the gov't, creating mandates, etc., we are losing our own opportunities. Sometimes that's a trade-off we're willing to take, sometimes not; but living in never-never land, thinking the gov't providing or mandating something is gonna' result in services and opportunities where we expand our options and choices is naive at best.
And the funding of wars compared to funding of abortions analogy, while illustrative, is silly; the conduct of national defense is clearly the responsibility of any national gov't; if we didn't and it wasn't, we'd all be speaking German or Russian now. Funding of abortions still is about personal choices and, thankfully, not all of us are going to ever avail ourselves of that choice. But there is a huge difference between mandating use of taxes for things the gov't does, on behalf of all, and those things that are provided to individuals, even when the rationale for it is making it available to all.
-- machouston
(To reply, click here)