The Tortured Logic of Health Care's Abortion Foes

The importance of this debate may be that it galvanizes more women to stand up to elected officials like Stupak who want to interfere with their health care and dictate what services they can and cannot get because of the moral sensitivities of certain vocal constituents.

Anti-abortion forces suffered a setback recently in their drive to exclude abortion coverage from health care reform. The Senate voted to reject abortion limits in its version of the health care bill, defeating a proposal that would have banned abortion coverage by insurers who participate in a program that uses federal tax dollars to subsidize coverage for low and moderate income Americans.

"This is the first thing we've won in years," Senator Dianne Feinstein, Democrat of California, said of the amendment's defeat. But an amendment almost identical to the one the Senate rejected is still attached to the House version of health care reform, thanks to Representative Bart Stupak, Democrat of Michigan.

Representative Jan Schakowsky, Democrat of Illinois, called the Stupak amendment "the most crushing blow we have seen to reproductive rights since Roe v. Wade."

Bart Stupak begs to differ. In an op-ed in Tuesday's New York Times, headlined "What My Amendment Won't Do," he defended his abortion ban saying it "maintains current law, which says that there should be no federal financing for abortion."

Stupak's defense of his amendment shows the tortured logic of excluding abortion coverage from health care. Under the Hyde amendment, he says, "the Federal Employees Health Benefits Program provides health insurance through a variety of companies to more than eight million Americans--but it does not allow abortion coverage in any of its policies. Yet the same companies that offer these abortion-free plans to federal employees also offer separate plans with abortion coverage to non-federal employees."

You see? It's simple! Just quit your federal job and get a new employer who doesn't offer "abortion-free" insurance if you think you might have an unplanned pregnancy.

Jan Schakowsky pointed out on the floor of the House how ridiculous the anti-abortion amendment really is:

"This Stupak-Pitts Amendment goes way beyond current law. It says a woman cannot purchase coverage that includes abortion services using her own dollars . . . in every single public or private insurance plan in the new Health Care Exchange. Her only option is to buy a separate insurance policy that covers an abortion--a ridiculous and unworkable approach since no woman plans an unplanned pregnancy. . . . Our bill is about lowering health care costs for millions of women and their families, not for further marginalizing women by forcing them to pay more for their care."

Despite the criticism, Stupak says, "the intent behind our amendment is simple and clear: to continue current law, which says that there should be no federal financing of abortions."

But what is simple and clear when the government has a very limited role in health care for its citizens becomes a lot more far-reaching and complicated when that role expands.

It was always galling that federal employees, and women serving in the military in particular, were singled out for discrimination under the Hyde Amendment. If the federal government wants to ban abortion for all women, that is at least a logically consistent position. But to target groups of women--those who work for the government, and those poor enough to qualify for government-subsidized health care--is simply unfair.

The unfairness becomes more apparent to all as more women are affected.

In the context of the health care debate this is a largely symbolic issue. Declining access to abortion, reproductive health care, and health care in general across the country affects far more women than will be affected by the ridiculous, jerry-rigged, partial-non-coverage envisioned in the Stupak Amendment.

The importance of this debate may be that it galvanizes more women to stand up to elected officials like Stupak who want to interfere with their health care and dictate what services they can and cannot get because of the moral sensitivities of certain vocal constituents.

If the Republicans and Blue Dog Democrats are worried about keeping the government out of people's health care decisions a good place to start is by dropping unfair and convoluted rules preventing some insurers from covering abortion services.