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On abortion in health-care reform, pro-lifers make two big mistakes

My colleague Michael Gerson thinks I’ve got it wrong on the differences between the House and Senate when it comes to attempting to make certain that federal funding does not go to subsidize abortions. For the record, I don’t think that this issue is “a trivial mix-up.” I think the differences between the two measures are trivial, both on paper and in practice.

As I’ve written previously, while I am firmly pro-choice, I am "respectful of the convictions of those who disagree. And, consequently, sympathetic to the notion that taxpayers should not have to pay for a procedure they believe is tantamount to murder." I think both the House and Senate language go too far in attempting to protect these convictions, but that would not prevent me from voting for them. Gerson has no basis for saying that I hope the principle that federal funds should not be used to subsidize abortion “will be casually abandoned in the confusion of health reform.” I simply believe that those who hold this principle are, first, making a mistake in balancing the equities of health reform (the undeniable benefits it would bring to the uninsured versus the risk of having federal funds end up subsidizing abortions) and, second, misreading the legislative language.

Gerson says, correctly, that federal law currently prohibits the use of federal funds to pay directly for abortions in most circumstances (the Hyde amendment) and that the federal health benefits plan (of which I happen to be a member) does not include abortion coverage. But the federal government subsidizes every federal employee (and family members) who obtain insurance through the federal employee health benefits plan. The insurance exchanges to be set up under the health-care bill would pose a more complicated situation because some people purchasing insurance on the exchanges would be spending entirely their own money. Most, however, would receive some degree of government subsidy. The House bill deals with this situation by requiring people who participate in the exchanges and want abortion coverage to purchase a separate policy. The Senate bill deals with it by requiring people who want abortion coverage to write a separate check and by requiring the insurance companies that offer such coverage to maintain strict separation of the funds between the two accounts.

Gerson considers this an enormous difference. He asserts that there will be “massive public subsidies to health-insurance plans that cover abortion” but does not mention any requirement for separate accounting. Quoting an analysis by the Catholic bishops, he says their “main objection to the Senate bill” is that:

Under the Senate bill, all but one plan in each exchange may cover abortion. Therefore many families will be forced to choose between a plan that best meets their health needs, and one that respects their conscience on abortion. The government, far from helping to protect them from this terrible dilemma, will make it worse by (a) providing federal subsidies for the plans that impose this on people, and (b) requiring any plan that covers these abortions to collect a regular extra payment, solely and specifically for elective abortions, from every enrollee in the plan regardless of their conscientious objection.

I don’t think that families should be forced into “this terrible dilemma.” I also seriously doubt that they will be. The more likely result of the cumbersome Senate restrictions will be that no plans in the exchanges will include abortion coverage. Insurers who for some reason want to offer plans that include abortion coverage could easily offer identical plans that don’t. Indeed, they would have every incentive to. They won’t make money by giving people who oppose abortions reason to choose a competing plan.

As for the likely effect of health reform on the number of abortions, my former Post colleague T.R. Reid made this argument far better than I could.

By Ruth Marcus  | March 18, 2010; 7:23 PM ET
Categories:  Marcus  | Tags:  Ruth Marcus  
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I do not get it. One of the best ways to reach pregnant women and ensure a healthy birth is through pre-natal care. Women with means will have access to abortion. Poor women still will not but at least they will have health care so that if they choose to continue with their birth, which they may more likely do so in a successful manner if they have health care, we will have more healthy live births than before. This is pro-life. Stopping health reform is not.

Posted by: Jerry26 | March 18, 2010 9:26 PM | Report abuse

Let me see if I get this straight.

A women in a middle income family that is paying approximately. TO make ends meet, both parents work. They make approximately $60,000 a year combined. They already have two children. Taxes take over $11000 from their income making their take home pay less than $50,000 a year.
NOw the woman gets pregnant when their birth control fails.
Lets examine there budget
1. They pay $1500 a month on mortgage/rent
2. Utilites are another $500 on utilities
3. Transportation and fuel $200
4. Food and sustenance $300
5. Clothing and sundries $100
6. Insurance (HOME HEALTH AUTO) $1500
7. Retirement and savings $300

While both work, only one employers provide health insurance.
Their employer decides that the company can no longer afford FAMILY COVERAGE and can only provide for the employee, leaving the family out.
The female will need to take time off for the birth and afterwards.

Now they are faced with having to purchase health insurance for the mother and the children. This will cost them in addition to the insurance they already carry an additional $800/month and because she is already pregnant - the pregnancy will not be covered.

Where are they to come up $ for PRENATL doctors visits, ultrasounds, bloodwork, and a delivery. Where are they to get the money to cover the new childs expenses (AND GOD FORBID THE CHILD OR THE MOTHER HAVE COMPLICATIONS)
What if that child has a congenital birth issue such as a heart disorder. Or has an early childhood illness like juvenile diabetes and is uninsurable.

It appears that the GOP and the TEABAGGERS would be saying to this family _ SCREW YOU - your young child can die and so can you because even though you and your husband work hard to provide for your family -- you do not DESERVE to have a life.

Can you see where in this type of situation, more and more women would be looking to have abortions SOLELY BECAUSE SOCIETY HAS TOLD THEM THAT THEY AND THEIR CHILDREN ARE UNWORTHY OF AFFORDABLE HEALTHCARE.

Such is the PRO-LIFE ATTITUDE. The middle class can DIE as far as the PRO_LIFE and GOPers are concerned.

God would love their attitude of greed and selfishness. Sentencing the most vulnerable of use (the sick) to death solely for monetary reasons.

Can you see children dying of the flu or chickenpox, measles or simply treated diabetes solely because of AMERICAN GREED AND SELFHISHNESS.

And you all rant about human rights abuses in other countries.

Posted by: racerdoc | March 18, 2010 10:17 PM | Report abuse

I do not get it. One of the best ways to reach pregnant women and ensure a healthy birth is through pre-natal care. Women with means will have access to abortion. Poor women still will not but at least they will have health care so that if they choose to continue with their birth, which they may more likely do so in a successful manner if they have health care, we will have more healthy live births than before. This is pro-life. Stopping health reform is not.

Posted by: Jerry26 |


Well stated Jerry26!

Posted by: JilliB | March 18, 2010 11:27 PM | Report abuse

I simply cannot understand why it is ok to protect a child before he or she is born, but believe it is ok that children already born do not deserve health care.

I also cannot understand why policies that actually have been proven to reduce the actual rates of abortions (teen sex education, contraceptive access, prenatal health care, etc.) are opposed by the same groups who claim to be against access to abortion.

I really have never seen these inherent contradictions explained. Anyone want to give it a shot?

Posted by: reussere | March 19, 2010 12:37 AM | Report abuse


There are millions of taxpayers who feel that capital punishment is murder.

Seems like only pro-lifers get attention on these issues.

"And, consequently, sympathetic to the notion that taxpayers should not have to pay for a procedure they believe is tantamount to murder."

Posted by: ABarsamian | March 19, 2010 1:24 AM | Report abuse

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Posted by: aragoran | March 19, 2010 4:21 AM | Report abuse

Most people hate the fact that politicans make so much money. These elected people were supposed to be "public servants" that wanted to run for an office to make a differance and help all Americans. The new "public servants" are making a carrer out of this office and it was not intended to be like that. Some of the incumbants have a great deal of power over others and use this power to get their way in certain ways, this is not fair. The money was never an issue for these people when these jobs first started, they did it because they believed in something and wanted a change. Our Politicians now have to much power and seem to forget that they are in office to help all Americans have a better life and protect our freedoms. What a change in politics in the last 100 years.

Posted by: randykree | March 19, 2010 5:58 AM | Report abuse

I think the invasion of Iraq was wrong and war is tantamount to murder unless one is defending oneself. Why should I pay taxes to finance that?

Posted by: NancyESL | March 19, 2010 6:26 AM | Report abuse

Did you here the one about the guy’s wife that killed all of his children because she wanted to make more room for the home invaders?

Oh what.

It wasn't his wife. It was his country.

Back in the 60’s the Federal Government came into the public schools and brainwashed us as little children with the message that the children we were about to have were unwanted because the population was rising so fast. They launched a program called, “Zero Population Growth”. They pushed Family Planning and birth control pills. Now they call the same programs, "Safe Sex" but the results are the same. I think you and I both know that you only have to trick people for their few child bearing years and there is no going back.

Many of us never had a say in the future of our unborn.

I am the result of two living cells. One from each of my parents. They are the result of two living cells, one from each of their parents. I wasn't just born. I am a continuation of life. I am a living thing that reaches back into time perhaps 400 million years and the result of billions of joining of pairs of cells. It is possible that if you were to follow my cells back to my parent’s cells and beyond that my family tree touches every living thing here on earth. That is if we limit ourselves to believing life was created here on earth. If it rained down from the immensity of the universe it could reach back into that immensity of time and space, and who knows what relationships and who knows what species.

My family line succeeded, at least until I came up against the Federal Government.

I have seen the Federal Government do little else to control the population.

The open borders, United States laws only apply to some, is a serious slap in the face. No. Not a slap in the face. It reaches well beyond that. Maybe back to the beginning of time and stretch to the bounds of the universe.

Posted by: Stokeybob | March 19, 2010 8:48 AM | Report abuse

Life is cheap to Michael Gerson. In 2005 he thought starting another war with Syria was just a terrific idea. Why anyone would pay attention to anything this immoral chickhawk has to say is beyond me.

Posted by: RoyFan | March 19, 2010 9:14 AM | Report abuse

Passing the health care bill is a Pro-Life stand. I'm not using the term "Pro-Life" as the purely rhetorical logo of the Right Wing. I'm using it in its literal sense. If more women, of all economic status, receive access to health care, more healthy babies will be born, and in fact, abortions are decreased in number.

Furthermore, many fewer people die simply because they couldn't afford to go to the doctor. Those lives, sadly, belong to people that the GOP does not care about (the GOP cares about rich, white, and mostly male people). The far right wing who claim to be "pro-life" are actually anything but "pro-life" when it comes to war, death penalty, and poverty. They suddenly become "hawks", "tough on crime", vengeful, and "let them eat cake".

The anti-abortion faction, like Gerson, are primarily male. It's about controlling women. It gives the pro-death (re: war, death penalty, etc) one single way to show "compassion", but don't be fooled. They are anti-women.

Posted by: cturtle1 | March 19, 2010 10:16 AM | Report abuse

There will be billions given to all these local health centers so that they can continue to dole out abortions like a blue light special so dont worry Ruthie. The Democrats have made sure that although they talked AGAINST the funds they are indeed in there for these clinics so you can send all your koolaid murdering friends to get an abortion 24/7. Obama- the Abortion President - add it to his many titles. Evil overtakes our White House and bewitches the public once again. Soon you will be forced to wake up. Its coming..

Posted by: JUNGLEJIM123 | March 19, 2010 10:40 AM | Report abuse

I am really getting sick of all of this. Women are summarily discrimiated in this country and primarily when it comes to their health issues, Men, who get government subsidized b***r pills, are always telling women what they can and cannot have. Birth control pills, btw, are rarely covered by insurance. They weren't when I was young and I had good insurance. Stupak is willing to kill an entire bill because he is against legalized abortions. The nuns opinions don't matter to him -- just the male bishop's. I am unclear exactly what the abortion language is in this bill, but it does not make it easy for a woman to get an abortion no matter what the reason. Pro-lifers -- abortions are legal in this country. Don't want one, don't get one. Men -- don't want your girlfriend or wife to have an abortion for any reason? Don't get them pregnant. In Stupak's case and many others, it is a religious conviction that colors his opinion about abortion. Why are they allowed to force it on the rest of us? I am well past childbearing years and too young for medicare, and I sure do need help with health care. Why are pro-lifers going to punish me and millions of others over one issue that is, I repeat, LEGAL in this country? I am sick and tired of the discrimination against women.

Posted by: creatia52 | March 19, 2010 11:45 AM | Report abuse

reussere posted on March 19, 2010 12:37 AM
“I simply cannot understand why it is ok to protect a child before he or she is born, but believe it is ok that children already born do not deserve health care.”

Since most insurance companies are moving towards only covering a woman’s first pregnancy, declaring subsequent pregnancies a pre-existing condition they are in effect attempting to reduce family size by applying economic pressure on their customers to not have more than one child.

I’m surprised Christians haven’t jumped all over insurance companies for their decision to classify pregnancy as a preexisting condition.

Posted by: knjincvc | March 19, 2010 12:04 PM | Report abuse

I didn't realize until yesterday that Rep Stupak was a "C" street resident.

Members of congress who vote against reforming health care will pay the price in the next election.

Posted by: knjincvc | March 19, 2010 12:14 PM | Report abuse

I am shocked to read this article. Apparently even WOMEN have been bamboozled into believing this crazy notion that outlawing abortion will create some lovely, birds-singing-in-the-garden variety of a perfect world. Women get pregnant and seek abortions because of men, sorry guys. A woman who is poor, whether or not she is covered by health insurance, is especially vulnerable. And who, of this outspoken group of anti-abortionists, is going to pop up at her door to help her raise another child? The catholics? The Mormons? The Republicans in Congress? I recommed making it illegal for any man, anywhere, to have sex without wearing a condom. A woman doesn't necessarily have the freedom to say "no". This whole notion of punishing women for becoming pregnant reminds me of the mind control that Hitler used to convince Germans that they it was okay to exterminate Jews,Gypsies, disabled people, babies who appeared to not be healthy and so many other groups. What kind of country bans womanhood, as well as an ever-growing assortment of others? We better think this over very carefully, as we are not immune to another fascist movement that will eventually include everyone but a few. And those few will not necessarily be the people who put forth such laws.

Posted by: GalenB | March 20, 2010 5:53 AM | Report abuse

I am "respectful of the convictions of those who disagree. And, consequently, sympathetic to the notion that taxpayers should not have to pay for a procedure they believe is tantamount to murder.

so.... what about war.

what about shipping garbage to third world countries. what about specifically manufacturing goods in countries which have no regard for their worker's safety because it's cheaper. what about selling weapons to questionable regimes and bombing poor people in the middle east.

i think these are murder and i want no part in it.

Posted by: SiebenStern | March 21, 2010 7:23 PM | Report abuse

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