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So long as Democrats and health care reform proponents allow themselves to be pushed into exhorting about the false choice between health care reform and access to this legal medical procedure aka abortion, real reform is in peril.
The single most important thing you need to know and repeat to everyone you know as the reform debate moves to the U.S. Senate after narrow passage of the Affordable Health Care for America Act (HR 3962) last Saturday, November 8, 2009 is that opportunism seen by abortion opponents has allowed this false choice to be framed and embraced and we must reject it.
This editorial in the New York Times, published last Monday, describes the beginning:
The bill [HR 3962] brought to the floor [prior to the Stupak Amendment] already included a careful compromise that should have satisfied reasonable legislators on both sides of the abortion issue. The vast majority of people expected to buy policies on the new exchanges would pay part of the premium and receive government tax credits to pay for the rest. The compromise would have prohibited the use of the tax subsidies to pay for almost all abortions, but it would have allowed the segregation and use of premium contributions and co-payments to pay for such coverage. A similar approach allows 17 state Medicaid programs to cover abortions using only state funds, not federal matching funds.
Yet neither the Roman Catholic bishops nor anti-abortion Democrats were willing to accept this compromise. They insisted on language that would ban the use of federal subsidies to pay for “any part” of a policy that includes abortion coverage.
The Stupak amendment enshrined that exclusionary language and garnered votes from 64 Democrats - yes, 64 (62 men and two women - Marcy Kaptur of my own Ohio and Kathy Dahlkemper of Pennsylvania). Thus, they helped the Republican representatives pass it.
The editorial also explains succinctly how Stupak changes everything:
If insurers want to attract subsidized customers, who will be the great majority on the exchange, they will have to offer them plans that don’t cover abortions. It is theoretically possible that insurers could offer plans aimed only at nonsubsidized customers, but it is highly uncertain that they will find it worthwhile to do so.
In that case, some women who have coverage for abortion services through policies bought by small employers could actually lose that coverage if their employer decides to transfer its workers to the exchange. Ultimately, if larger employers are permitted to make use of the exchange, ever larger numbers of women might lose abortion coverage that they now have.
The restrictive language allows people to buy “riders” that would cover abortions. But nobody plans to have an unplanned pregnancy, so this concession is meaningless. It is not clear that insurers would even offer the riders since few people would buy them.
And that is how health care reform could fail millions of Americans and become, as some commentators have said, a "vagina-added tax" and a "penis subsidy."
Strident answers to the bottom-line question (and false choice) of what must be sacrificed in the name of achieving health care reform have been colliding ever since. Until the last few days, the answers were of two types:
One type is typified by a post at Betty Dodson with Carlin Ross. It notes that U.S. Senator from California, Barbara Boxer, believes that she has enough votes to block Stupak in the Senate:
"If someone wants to offer this very radical amendment, which would really tear apart [a decades-long] compromise, then I think at that point they would need to have 60 votes to do it," Boxer said. "And I believe in our Senate we can hold it."
"It is a much more pro-choice Senate than it has been in a long time," she added. "And it is much more pro-choice than the House."
And on the House side, U.S. Rep. Diane DeGette led a group of 41 female Members of Congress to sign a letter to Speaker Pelosi indicating their refusal to go along with a health care reform bill that includes Stupak restrictions. In her own words:
Our message is clear: we will not support any final bill that restricts women's access to reproductive health services beyond current law. Before any bill reaches the President's desk, language that takes us back to the last century by undermining women's rights must be eliminated.
Along the same vein, U.S. Senate Democratic primary candidate and current Massachusetts Attorney General, Martha Coakley, values the pre-Stupak standard of
