Should health insurance reform allow direct government subsidies for abortion? Yes, it should. Should we drop the Hyde Amendment, the law that has, since 1976, barred spending of government money for abortions under Medicaid except in cases of incest and rape, and when the woman's life is at risk? Yes, we should.
But, contrary to what Rep. Bart Stupak and his congressional disciples in the House have been saying, the health insurance reform bill - the Senate bill - does not subsidize abortion. To repeat, it does not.
Stupak told the Associated Press yesterday that he is more optimistic than he was a week ago about getting this disagreement settled.
"The president says he doesn't want to expand or restrict current law (on abortion). Neither do I," Stupak said. "That's never been our position. So is there some language that we can agree on that hits both points — we don't restrict, we don't expand abortion rights? I think we can get there."
Ensuring that all women - including women without the requisite financial resources - have equal access to abortion would not, of course, be an expansion of "abortion rights." What we've actually seen over the past 37 years - and early on in the case of low-income women - is a narrowing of reproductive rights as laid out in Roe v. Wade as law after law, including the execrable Hyde Amendment, has been passed to curtail freedom of choice. The Stupak Amendment would be another step down that same path. Whatever else it does or does not do, the Senate health reform bill sticks with current law on abortion.
As Timothy Noah pointed out last week in Slate:
Let's go to Page 2069 through Page 2078 of the Senate-passed bill. It says, "If a qualified plan provides [abortion] coverage ... the issuer of the plan shall not use any amount attributable to [health reform's government-funding mechanisms] for purposes of paying for such services." (This is on Page 2072.) That seems pretty straightforward. No government funding for abortions. (Except in the case of rape, incest, or a threat to the mother's life—the same exceptions granted under current law.) If a health insurer selling through the exchanges wishes to offer abortion coverage—the federal government may not require it to do so, and the state where the exchange is located may (the bill states) pass a law forbidding it to do so—then the insurer must collect from each enrollee (regardless of sex or age) a separate payment to cover abortion. The insurer must keep this pool of money separate to ensure it won't be commingled with so much as a nickel of government subsidy. (This is on Pages 2072-2074.)
Stupak is right that anyone who enrolls through the exchange in a health plan that covers abortions must pay a nominal sum (defined on Page 125 of the bill as not less than "$1 per enrollee, per month") into the specially segregated abortion fund. But Stupak is wrong to say this applies to "every enrollee." If an enrollee objects morally to spending one un-government-subsidized dollar to cover abortion, then he or she can simply choose a different health plan offered through the exchange, one that doesn't cover abortions. (Under the Senate bill, every insurance exchange must offer at least one abortion-free health plan.)
Stupak and his backers in the House, who, if they stick together, could be enough to keep a health care bill from reaching the President's desk, seem determined to do so if they don't get their way on something they are wrong about. To repeat one more time, the Senate health bill does not include subsidies for abortions. Does not.