Saturday, March 13, 2010

What's Missing In The Abortion Red Herring

 Last November, Chris Mathews, an astute observer of Washington politics, expressed his fear the abortion issue may kill health care reform legislation. The House had just passed its version 220-215 but only after an amendment spearheaded by Rep. Bart Stupak (D-Michigan) that banned any federal funding for abortions.

The host of MSNBC's "Hardball with Chris Mathews" said as a Catholic he opposed abortion on moral grounds except in cases of rape, incest and the mother's life in danger. But in terms of real politics, he said the hot button issue clouds the minds of passionate people to make rational decisions. Besides, he said, there is the Hyde Amendment since 1976 that bans federal funding for abortions.

So why the fuss?

As late as two weeks ago, Stupak said he and a group of 11 other Congressmen who voted for the House bill would vote against the Senate version because he insisted the language on abortion was too weak. Compounding it was distrust of House members believing the Senate would accept the House amendments on abortion during the reconciliation process.

It appeared Mathews' prediction was coming true. Not yet, but the outcome still is in doubt as the political winds began a blowback against Stupak's stubborn stand.

Bear with me as I set the record straight and put this argument in perspective with data not discussed in this debate.

First, the Stupak amendment. In the broadest terms, it bans abortions even for women who are covered by a policy that includes reproductive services but is funded in part or whole with federal subsidies. From's First Read:

The Michigan congressman later said this to ABC's George Stephanopoulos: "The bill that they're using as the vehicle is the Senate bill, and if you go to page 2,069 through page 2,078, you will find in there the federal government would directly subsidize abortions, plus every enrollee in the Office of Personnel Management enrolled plan, every enrollee has to pay a minimum of $1 per month towards reproductive rights, which includes abortion."

In the Senate, the abortion amendment offered by Ben Nelson, D-Nebraska, says this, again according to First Read:

From pages 2,071-2,072: "If a qualified health plan provides coverage of services described in paragraph (1)(B)(i)" -- i.e., abortion -- "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. 

The Nelson amendment goes further:

States can choose NOT to offer abortion coverage in the health exchange. Page 2,069: "A State may elect to prohibit abortion coverage in qualified health plans offered through an Exchange in such State if such State enacts a law to provide for such prohibition." And those states that do not prohibit abortion coverage must provide a choice of health plans on the exchange that include abortion coverage and don't include abortion.  

Translation and consensus: Stupak is wrong.

My purpose here is to provide perspective from the data on abortions to offer insight on just how big a deal it really is. At first blush, it is more widespread than I imagined.

The estimated 2009 U.S. population is 308 million with about half women.

Abortion data lags about five years behind current time. The National Right To Life Web site estimates 45 million abortions between 1973 when the Supreme Court issued its ruling on Roe vs. Wade, to 2005. It reports an average of 1.2 million abortions annually in recent years, down from the high of 1.6 million in 1990.

The Henry J. Kaiser Foundation reports the following for the 41 million low-income women earning $12,000 annually -- employer insured 27%, uninsured 29%, Medicare 24%, MediCaid 15% and Medi/Medi 5%.

The fact is 17 states have bypassed the Hyde Amendment by enacting laws offering abortions beyond the Hyde exceptions of rape or incest, as well as when a pregnant woman's life is endangered by a physical disorder, illness, or injury.

The American Civil Liberties Web site says four of those states use state money to fund abortions. They are Hawaii, Maryland, New York and Washington.

In 13 states, state constitutions allow nondiscriminatory public funding of abortion. They are Alaska, Arizona, California, Connecticut, Illinois, Massachusetts, Minnesota, Montana, New Jersey, New Mexico, Oregon, Vermont and West Virginia. One state, South Dakota, violates the Hyde Amendment by providing coverage only for lifesaving abortions, the ACLU claims.

Still, there are other legal obstacles for poor women. Reports the ACLU:

The Balanced Budget Act of 1997, for example, permits health maintenance organizations (HMOs) serving Medicaid recipients to refuse to cover counseling or referral for services, such as abortion, to which the HMO objects on moral or religious grounds.  As a result, even in states with nondiscriminatory funding, women seeking abortions may face obstacles in even finding a provider.  

Additional amendments to Hyde in the 1980s affected 20 million women to include Native Americans, federal employees and their dependents on MediCaid, Peace Corps volunteers, low-income residents of Washington D.C., federal prisoners, military personnel and their dependents and disabled women who rely on Medicare.

The abortion ban is unfair and discriminatory. If a poor woman chooses to abort her fetus, she's denied coverage. If she opts to go full term, the government pays a portion if not all prenatal, delivery and postnatal care.

I agree with the ACLU argument which says:

It should not use its dollars to intrude on a poor woman's decision whether to carry to term or to terminate her pregnancy and selectively withhold benefits because she seeks to exercise her right of reproductive choice in a manner the government disfavors.

I'm not so sure about the ACLU argument that funding abortions would not cost taxpayers money.

Because the costs associated with childbirth, neonatal and pediatric care greatly exceed the costs of abortion, public funding for abortion neither costs the taxpayer money nor drains resources from other services.



Although the incidence of abortions is higher than I expected, it is still peanuts when the entire health reform legislation is at risk because of it. It is a deep-seated moral issue imposed by the passion of right-to-lifers on the entire nation. I don't especially endorse the Senate bill, but at least it can be amended immediately and refined in coming years as is the case in all landmark legislation.

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