Tuesday, December 8, 2009

Trying to Sort Out What is Going On With Abortion and Health Care

By Paula Ruddy

The U.S. Senate is on the verge of a vote, maybe today, Tuesday, December 8, on the use of federal funds to pay for abortion procedures under the proposed insurance provisions of the health reform package on the table

Federal funds have not been permitted to be used for abortion procedures since 1976. What is the question now? Archbishop John C. Nienstedt is quoted by MPR news reporters Tom Crann and Madeleine Baran on December 3 as saying that, “The question is, What kind of health care do we want as a nation? And any health care program that would include the killing of the unborn is unacceptable.”

Does Archbishop Nienstedt mean that there should be no health care reform at all so long as abortion is legal within the health care system?

To make abortion illegal, Roe v.Wade would have to be overturned and states would have to enact criminal laws prohibiting it. Is that what the Archbishop is advocating?

He should be more explicit; general talk about “killing the unborn” is not helpful.

Some may not know, or have forgotten, the legal history. After Roe v. Wade (1973) held it unconstitutional for a state to criminalize abortion or to restrict it unless some conditions are met, the question arose whether federal funds could be used for programs that provided abortion. In 1976, Senator Henry Hyde, a Republican from Illinois, sponsored a bill that prohibited the use of federal funds, Congress passed it, and it has been in effect with various amendments ever since. Private insurance companies can cover abortion and states can use their own funds to cover Medicaid recipients’ abortion, but federal funds cannot be used. In 1980, the Supreme Court held restriction of funds to be constitutional in Harris v. McRae. Women are free to have abortions but they are not constitutionally entitled to funding for them. The current law makes exceptions for abortions following rape and incest, as well as in life-endangering circumstances.

Now come the health care reform bills. The House version was passed on November 7 by a vote of 240 to 194 with an amendment by Bart Stupak, Democrat from Michigan, and Joe Pitts, Republican from Pennsylvania, essentially including the Hyde amendment restrictions on the use of federal funds for abortion in the provisions for insurance coverage. Federal funds may not be used except for procedures following rape, incest, and life endangerment to the mother. People with insurance from their employers are not affected. One area that is in question is whether “affordability credits,” federal subsidies offered under the bill to help income qualified people buy coverag,, could be used to cover abortions. The Stupak-Pitts language prohibits that. If people want abortion coverage, they will have to purchase with their own money a “rider” to the insurance offered in the insurance exchange. The Senate version of the bill is being debated now. Senator Ben Nelson, Democrat from Nebraska, has introduced an amendment with Stupak/Pitts language, and that is the vote we are waiting for now.

The U.S. Conference of Catholic Bishops has said the Stupak-Pitts amendment in the House version of the bill “is a modest and reasonable measure.” In their fact sheet accompanying their letter to the Senate asking for comparable language in the Senate bill, the bishops ask: “Is the Stupak amendment broader than the Hyde Amendment that has prevented federal funding of abortion for decades?” They answer No. The upshot is that if the US Catholic Bishops are telling the truth, the situation with regard to abortion services provided in the health care system will be exactly as it is now.

Opponents of the Stupak-Pitts amendment argue that it will have more restrictive effects on abortion than the current version of the Hyde Amendment. They argue that insurance riders will be expensive for the very people who need the “affordability credits” and that insurance companies will find it cost ineffective to offer riders.

Although the amendment will make it harder for a woman with low income to obtain an abortion, the legislation is certainly not going to prevent a person who can pay for abortion or afford insurance for it from obtaining either. I don’t know how the U.S. bishops rationalize their intense campaign to make it harder for women of low income to get an abortion. How they could more effectively spend their time and money on reaching the hearts and minds of women who need help is a question for another day.

If anyone has a better handle on this situation, please chime in with additions and corrections.


  1. The costs of medical services and medical insurance have been going through the roof these past ten years. The number of those who cannot afford medical insurance is escalating rapidly.

    Hospitals and clinics are subsidizing medical care for emergency room patients who can't afford treatment.

    Medical insurance plans now routinely have premiums in the thousands of dollars annually. Many have deductibles also in the thousands of dollars.

    And the average price of an abortion is maybe $350-400, cash up front, I have read.

    Why this incredible amount of pressure for the adoption of abortion coverage in the proposed health care system reform bills now pending?

    I would say they are subsidy programs for the for-profit abortion factories like Planned Parenthood.

    I would imagine the morning after pills, also condemned by the Catholic Church, are drastically reducing their income.

    So the pro-abortion lobby probably would rather see no law passed at all, sacrificing the health of millions of American with serious illnesses, because some of their customers (or their boyfriends) can't come up with 350 bucks?

    Maybe Planned Parenthood should do like the hospitals do and give free abortions to those who can't afford them. Just jack up the rates for those with higher incomes and personal insurance, like the hospitals and clinics do for normal medical care.

  2. Hi, Ray. Thanks for responding. Can we sort this out together? There is tremendous effort on the part of both sides--one to restrict funding for abortion and one to provide federal funding for abortion. Can we agree to presuming that both sides have the common good in mind? Presuming that makes it easier to get at the rationale for each side.

    Without imputing other motives, can we say people who want to restrict funds for abortion think that it will reduce the number of abortions, the number of deaths of unborn children? And can we say that people who want federal funding for abortion services are thinking that the lives of low income women who have the highest number of abortions are being made more difficult by the restrictions. Is this a fair way to state the disagreement?

    The common good is served by reducing the number of abortions and the common good is served by alleviating the burden of unwanted pregnancies on low income women. Isn’t the question how can we best achieve both of those goals? Do you think the federal funding provisions of health care programs is the arena for answering the question? I wonder what is the arena?.

  3. Paula:

    Since the purpose of abortion, no matter what the extenuating circumstances in the mind of the mother, is to take a human life I can't see that it is possible to compromise on this issue.

    Proponents of abortion always bring up worst case scenario issues to tug at the heart strings of opponents to get them to approve of exceptions.

    But the vast majority of abortions are performed to get rid of unwanted babies for reasons such as "can't afford", "can't lose work", "my husband doesn't want more children", "wrong sex", "I'm too old/young", and many more. I am not at all an expert in this area at all.

    My comment to your original post is on how energetically Planned Parenthood and other abortion companies are working to get themselves included in the proposed health care plan for funding purposes.

    Especially when an abortion performed, God forbid, in the early months, is relatively inexpensive.

    If their customers can't afford it and Planned Parenthood feels it is so important that it be subsidized, let the rest of their customers and their insurance companies provide the subsidy.

    Then we can have a health care bill that most all will agree upon.

  4. I think I agree with you, Ray, about the health care bill. Is it clear to you (not just an ideological position) that the Stupak-Pitts language is no broader than the Hyde provisions? I talked with a friend today who is adamantly holding to the ideological position that the language is much more restrictive. From what I read I see that it could be pushed to be more restrictive but that it also could be held to the status quo. Of course, if insurance companies can't make money on abortion riders they won't be available. We just don't know whether they will be able to make money on them or not.

    But there is something in your first two paragraphs that I am wondering about--just to practice our moral reasoning. I don't think it is about compromise and I don't think it is about heartstrings. Faced with the grave matter of extingishing the life of a (potential) human, is it impossible that a woman can in some conceivable circumstances be justified? I think many of us are put off by the righteousness of people who say that it is impossible to justify. That's where the extreme circumstances in examples come from.

    But even if abortion is impossible to justify, the fact is, as you say, people do acts without considering whether they are right or wrong at all. They are thinking instead of convenience or preference. And then, isn't it true, that people also deliberately do what they know to be wrong because acting justly is not as important to them as some other good they are choosing? So is the law supposed to punish all people who behave immorally?