Q&A: Abortion & the health care plan

by Michael Foust

On the same day that a leading pro-family group released a TV ad claiming the health care plan would lead to government-funded abortion, President Obama spoke to a group of mostly liberal religious groups and called such charges “fabrications.”

So, who’s right?

Following is a list of frequently asked questions, along with answers, about the controversy over abortion coverage in the health care plan:

What is President Obama’s position on the issue?

As president, Obama has not come down firmly on whether he believes the health care plan should cover elective abortions. He came closest to doing so during a July interview with CBS’ Katie Couric, saying, “I’m pro-choice, but I think we also have the tradition in this town, historically, of not financing abortions as part of government-funded health care.” He did not, though, say whether he agreed with that tradition. During the same interview he said he was “not trying to micro-manage what benefits are covered.” Pro-lifers are concerned not only because Obama, as a believer in abortion rights, is pushing health care reform, but also because as a candidate, he explicitly backed government-funded elective abortions. He told Planned Parenthood during a 2007 speech that “reproductive care is essential care. It is basic care. And so it is at the center, the heart of the [health care] plan that I propose.” He also said during the same speech, “We also will subsidize those who prefer to stay in the private insurance market, except the insurers are going to have to abide by the same rules in terms of providing comprehensive care, including reproductive care.”

What are the concerns of pro-lifers?

Pro-lifers have three primary concerns: 1) that a public option (that is, a taxpayer-funded, government-run insurance plan) will cover elective abortions; 2) that federal subsidies to lower-income people will be allowed to be used to purchase insurance plans that cover abortions; and 3) that a health care plan will force private insurers to cover a list of “essential benefits” that includes abortions. Under all three scenarios, pro-lifers say, the number of abortions will increase.

So, under the public option in the current health care reform bill, are elective abortions covered?

There are multiple bills in the House and Senate, but under the leading House bill, H.R. 3200, elective abortions would be covered under a public plan, as both sides acknowledge. But the two sides disagree strongly over whether the public plan would use federal money to fund abortions. Before the August recess began, a House committee passed an amendment by Rep. Lois Capps, D.-Calif., who is pro-choice, that would pay for elective abortions only through the premium monies collected from enrollees. Capps and her supporters said the amendment would prevent the government from financing abortions. (The committee defeated amendments that would have explicitly prohibited elective abortion coverage.) Critics of the Capps amendment — including several conservative Democrats — called the amendment a bookkeeping sham and said common sense dictates that under a public plan, all the money is federal money. “You have a federal agency collecting these monies, getting bills from the abortionists and sending checks to the abortionists drawn on a federal account,” National Right to Life’s Douglas Johnson told Baptist Press. “… The federal government is running the whole scheme from start to finish.” Speaking to the Weekly Standard, Rep. Chris Smith (R-N.J.) called the amendment “one of the most deceptive amendments I have ever seen.” Rep. Bart Stupak (D.-Mich.) called it a “phony compromise.” Pro-life citizens who want to enroll in a public plan would have no choice but to pay the same premiums that would finance the abortions. Regarding the debate the non-partisan FactCheck.org, run by the Annenberg Public Policy Center, concluded, “As for the House bill as it stands now, it’s a matter of fact that it would allow both a ‘public plan’ and newly subsidized private plans to cover all abortions.”

If, under a health care plan, lower-income families receive federal subsidies to purchase their own health care plan, then why shouldn’t they be allowed to buy a plan (public or private) covering elective abortions?

Pro-lifers argue that under the current federal employees health program — the same health insurance plans that members of Congress have – abortion coverage is prohibited. The same principle should apply to federal subsidies, they say, adding that if federal subsidies are used for health insurance plans that cover abortion, then the number of abortions would only increase and taxpayers would be footing the bill. The Capps amendment has a say in the matter by allowing federal subsidies to be used for plans that cover abortions but preventing the subsidies themselves to be used for the abortions. In other words, private insurance companies would have to segregate their internal accounts. Pro-lifers call it another bookkeeping scam. Melody Barnes, Obama’s domestic policy adviser, seemed to defend the pro-choice argument Aug. 19 during a conference call with liberal religious groups, when she answered a question about abortion and said the health care proposals are “not intended to reduce insurance coverage that Americans already have.” In other words, she seemed to be saying, if a citizen currently is paying for a private plan that covers abortion, then they should be able to do so also in a public plan or a private plan under health care reform. (Barnes formerly served on the board of two abortion rights groups, Emily’s List and Planned Parenthood.)

Is the word “abortion” even in the bills?

It’s not in most of them, but, as pro-family leader Tony Perkins said, neither are the words “tonsillectomy” or “bypass,” and such procedures would of course be covered. Ever since the U.S. Supreme Court issued its 1973 decision legalizing abortion nationwide, there has been an understanding in Congress — thanks mostly to federal court rulings — that unless a federally funded health care program explicitly excludes abortion coverage, then the controversial procedure must be covered.

How has the White House reacted to such charges?

With the exception of a couple of recent comments by Obama, the White House has said very little. The White House’s own health care fact-checking webpage, called “Reality Check,” includes videos on 13 topics, but none deal with abortion. Obama told a group of mostly liberal religious groups Aug. 19, “We’ve heard that this is all going to mean government funding of abortion. Not true. These are all fabrications.” The next day, he told a health care forum, “There are no plans under health reform to revoke the existing prohibition on using federal taxpayer dollars for abortions. Nobody is talking about changing that existing provision, the Hyde Amendment.” But the non-partisan FactCheck.org posted an article Aug. 21 saying that Obama “goes too far when he calls the statements that government would be funding abortions ‘fabrications.'”

What’s the Hyde Amendment?

Passed first in 1976 and tweaked during the Clinton administration, the Hyde Amendment is an addition to the annual Health and Human Services Department appropriations bill that prevents Medicaid (the insurance program for low-income people) from covering abortions except in the cases of rape, incest and to save the life of the mother. The amendment, though, has to be re-approved annually — meaning that a pro-choice Congress could reverse policy — and it also would not apply to the health care plans being considered. Funding for the health care plans would not flow through the Health and Human Services Department. The Associated Press reported Aug. 5 that “the health overhaul would create a stream of federal funding not covered by the [Hyde Amendment and other] restrictions.”

What about co-ops? Are there pro-life concerns about them?

Although none of the bills currently promotes co-ops, some legislators in Washington have floated the idea of co-ops as an acceptable alternative to a public option. In theory, a health care co-op would be owned and managed by its enrollees, and possibly even pay its own doctors and have its own health care facilities — all without federal control. If this is the case, National Right to Life’s Johnson said, “then it would be the same principle as other private insurance, which is they can do what they want, but if they want to qualify for a federal subsidy, then that plan shouldn’t cover abortions.” But if a co-op receives federal dollars and has federal control, then pro-lifers would have the same concerns that they have about the public option.

Where is public opinion on the issue?

A 2008 Zogby poll found that 69 percent of Americans support the Hyde Amendment and oppose “taxpayer funding of abortions.” On another issue, an Aug. 18 MSNBC poll showed that 50 percent believe the health care plan “likely will use taxpayer dollars to pay for women to have abortions.” Thirty-seven percent said it is unlikely.

Source: Baptist Press, August 21, 2009

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