Update: Abortion & Health Care

The health care bill that passed the Senate in the wee hours of the morning is much, much better on the issue of abortion funding than the original bill it amended. The most important new provision is that which requires a woman who has purchased a plan that includes abortion coverage in the federally-managed exchanges to write two premium checks, one for the basic plan and the other for the part of the plan that covers abortion services. This is very similar to the “abortion riders” that the Stupak Amendment foresaw in the House-passed bill.

Does a rider by any other name smell as sweet? Yes. The purpose of the “riders” was to demonstrate two things, both of which are important. First, a rider paid for entirely out-of-pocket would show that the federal subsidies are not paying for the abortion coverage. Here the funds are not arbitrarily segregated for accounting purposes, as the original bill decreed properly raising the charge that it was an accounting gimmick. Here the funds are not segregated because they are never combined in the first place.

The second achievement here is, to my mind, just as important. One of the most persuasive arguments that we in the pro-life community have advanced in the past few months is that abortion is not like other medical procedures, that it deserves to be treated differently because it is different. Stupak had the great advantage of clarity, but the Senate approach may be even more didactic: Every month, when writing that separate check, the individual will be reminded that abortion is not like the rest of their health plan, that this extra check is needed because of that difference, and that this extra check is, in its way, a testimony to the nation’s refusal to use tax dollars to pay for abortions.

Conservatives have begun to argue that all people who buy insurance through the exchanges will need to pay for the abortion coverage, that this is, in effect, an abortion tax. That is simply false. You only write the additional check if you pick a plan that covers abortion services in the first place. Look for similar objections from the far right in the days ahead. They are getting desperate. They see that the President and the Congress are about to achieve health care reform. They will do and say almost anything to keep that from happening. Even those of us who have championed the Stupak Amendment these past few months have to acknowledge that in some ways, the Senate version is even better. In other ways, I would prefer Stupak. But, any proposal that gets condemned with equal vehemence by the National Right to Life Committee and Planned Parenthood probably is the kind of genuine compromise that will pass both houses.