Debate over Obama’s healthcare plan has, so far, tended to center on just how public the so-called “public option” will be. And while that is a huge, difficult and supremely important topic, it seems to be precluding discussion of what a government health plan should — and shouldn’t — cover. Until now. Can you tell what’s coming next? That’s right: Politicians have commenced bickering over whether subsidized healthcare plans should cover abortion.
In the depressingly titled piece “Could Abortion Coverage Sink Health-Care Reform?” Time’s Karen Tumulty reminds us that, since 1976, The Hyde Amendment has prohibited Medicaid from using federal funding for abortion. But now that massive healthcare reform is on the agenda once again, lawmakers will have a chance to tackle the issue anew. Although current versions of the plan include no mention of abortion, some politicians are attempting to preempt any attempt to include such coverage. Republican stalwarts Orin Hatch, Michael Enzi and Tom Coburn have just proposed a suite of anti-choice (and just plain anti-woman) amendments to the Senate Health, Education, Labor and Pensions (HELP) committee.
And, unfortunately, it’s not only Republicans who oppose using public funds for abortion. As Time reports, in late June no fewer than 19 House Democrats wrote to Nancy Pelosi saying that they “cannot support any health-care-reform proposal unless it explicitly excludes abortion from the scope of any government-defined or subsidized health-insurance plan.” Tumulty points out that two of the signatories include Michigan’s Bart Stupak and Louisiana’s Charlie Melancon, members of the House Energy and Commerce Committee, a group that will have major influence over the healthcare plan. (This seems like a good time to remind Stupak and Melancon’s constituents to write your representative.)
What’s truly chilling about Tumulty’s piece is its warning about the widespread effects of banning federal funding for abortion under Obama’s healthcare plan. While The Hyde Amendment was only concerned with Medicaid, the new legislation may also affect women who use government subsidies to buy private health plans. “[I]f the antiabortion legislators get their way, those subsidies would have a big string attached; they could not be used to purchase a policy that has abortion coverage,” Tumulty writes. “For many women, that would mean giving up a benefit they now have under their private insurance policies. And it would raise all sorts of other questions if insurers were allowed to discriminate among their customers based on whether or not they are using federal dollars to pay for their policies.”
Although the legislation is likely to affect most American women in some way, a decision to prohibit federally funded plans from covering abortion will undoubtedly be most detrimental to poor and working-class women. And that kind of discrimination is nothing new. As Supreme Court Justice Ruth Bader Ginsburg — who, by my reckoning, should know better than just about anyone — told The New York Times Magazine, in an interview that will appear in print this Sunday, “There will never be a woman of means without choice anymore. That just seems to me so obvious. The states that had changed their abortion laws before Roe [to make abortion legal] are not going to change back. So we have a policy that affects only poor women, and it can never be otherwise, and I don’t know why this hasn’t been said more often.”