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Michael Sean WintersNovember 19, 2009

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.  

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15 years ago
According to American Health Rankings, the top ten un-healthiest states are all Red States except for Sen Reid's Nevada which was barely blue in 2008.. .. The top ten healthiest states are all Blue States except for Utah....[Mormons take care of their people]...talk about tossing the un-insured under the bus, the Red States tea baggers are doing a 'real push them under the wheels' job..
Charles Camosy
15 years ago
Micheal, this is your usual great work.  I have two questions that I hope you can answer:
1.  First, do you think this is just Harry Reid asking for the whole store to start out so that after negotiations with Casey and others the compromise ends up being less restricitve than Stupak?  (With a bone thrown to the pro-abortion-rights folks as well?)
2.  American Life League's website says that Stupak said he will vote for the bill even if it comes back from conference with his language erased or changed.  Is that correct?  What is your read of how the 64 dems are going to react should the language be significantly changed?  The worrier in me says in the House negotitations they said to the leadership that they just needed the first vote for Stupak to give them pro-life cover for midterm elections...but that they'd vote for the bill the second time through.
Christian Westergaard
15 years ago
I'm interested in your throw away comment at the beginning of the article stating that higher taxes are always a good thing. Higher tax rates have always reduced the amount of taxes collected, which would in theory, reduce the services that government can offer. Any real world questions to this theory should direct their attention to my State of California, whose revenue collections are plummeting under one of the highest tax burdens in the country. 
Charity should remain the province of the individual, not the State. It is foolish to try to redistribute wealth in every new government initiative, the citizens with wealth, yet without a conscience, will avoid paying. Legislating compassion is inappropriate. True giving comes with free will from the grantor. Not to mention, this will backfire, costing the government even more than planned (how did we ever get to a point where $1 trillion is thrown around like a rational number?), driving the country to bankruptcy and ending this grand health care experiment.
James Lindsay
15 years ago
First, we are still in the sausage making phase of the legislative process. There will likely be a compromise.

Second, abortion is already subsidized for those who get private insurance (as I have said and Ruth reminded us). The public option (if it even survives) would not be materially different from that - which means that any arrangement that is similar should not be a deal breaker.

As has been said before, this talk of abortion is more about symbolism than actually prevening any abortions. Indeed, making the working poor better off is likley to prevent more abortions than any coverage given for abortion. If you trust Guttmacher on the number of lives saved because of Hyde, you must also trust Guttmacher on the fact that 73% of abortions happen because families don't feel they can support the child.

While I fully expect some compromise on this issue, the lack of it won't change my voting. What is more important is whether Obama deals with late term abortion, as he promised in the third debate. Of course, dealing with this issue would likely deprive the National Right to Life Committee of their dead baby pictures and their fundraising oomph (which is another reason to support such a change).
James Lindsay
15 years ago
Christian, I don't think the Bishops agree with you on the tax issue (nor does the Pope). Nor do I.
Martin Gallagher
15 years ago
Jim McCrea,
 
Do you think Marie Rehbein would still say "I do not believe it is up to me or my government to force people to behave in God-pleasing ways" if we were discussing murdering adults rather than abortion?
Ed,
I don't know if Utah is healthy necessarily because "Mormons take care of their people" because Mormons typically take care of themselves with healthier habbits.
 
 
 
Marie Rehbein
15 years ago
Well, Martin, since I am reading, I will tell you that I what I wrote about our government or myself preventing people from behaving in God displeasing ways applies also to murder of adults. 
 
The reason is that we do not actually prevent anyone from committing murder by having laws against it.  What we do with the law is punish murderers so that those whose loved ones have been murdered do not take matters into their own hands and escalate the violence in society.  
 
I doubt very much that the reason that you did not murder someone today is because it is illegal or because someone personally intervened to stop you.
Marie Rehbein
15 years ago
It's not as simple as saying "NO" to the Senate bill.  It's time to call your Senator and let him or her know that you wish to have your religious freedom protected so that you are not forced to participate in what you know to be the gravest of sins.  This is necessary in order to counteract the calls coming in that demand that the rights of women be protected.
 
No one has a right to have government pay for his or her elective medical procedures, but pro-abortion groups are claiming this right under the guise of protecting women's rights.  However, women are not losing any rights simply because taxpayers do not pay for something that pertains only to women's bodies.
 
If abortion payments are included in health reform, then face lifts should also be included.  If abortion payments are excluded, then probably ED meds should also be excluded.  The whole idea here is to make getting and staying healthy accessible, effective, and affordable.  In my opinion, a simple, single-payer system that does not cover elective procedures and medications is the answer.
Marie Rehbein
15 years ago
RE: the taxation issue
Increasing the Medicare tax on people earning over $250,000 is not necessarily fair.  This is because the Medicare tax is placed on gross income, not adjusted taxable income.  Someone with a large family to support and/or living in a place with a high cost of living, is burdened more by this increase than someone with fewer dependents or someone living in a less costly area. 
 
Whatever increases might be necessary to fund health care reform as it is currently proposed should be based on adjusted taxable income.  However, by far, the least expensive way to reform health care would be for everyone to contribute one more percent of their gross income into a single-payer system-cutting out the insurance purchase costs all together.  This system would not cover any elective procedures or medications, thereby eliminating the abortion question and keeping costs down.
Martin Gallagher
15 years ago
Jim.
 
OK - I see that it is tongue-in-cheek.
 
 
Martin Gallagher
15 years ago
Jim.
 
OK - I see that it is tongue-in-cheek.
 
 
GIOVANNI SAFFIRIO
14 years 12 months ago
Christian Westergaard's comment is quite right. I had assumed that the crack about raising taxes on the "rich" being "always a good thing" is intended to be ironic.
Confiscating productive resources and diverting them to serve the whims of political hacks and bureaucrats is nearly always a VERY BAD thing that manifestly harms society in the long run. As Christian notes, California is Exhibit A.

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