Opponents of abortion rights won a significant political victory last night, making it more likely that millions of American women will no longer be able to purchase insurance that covers abortion services.
At issue is what happens inside the new insurance exchanges, through which small businesses and people purchasing coverage on their own would shop for insurance. People purchasing coverage through the exchanges would be eligible for subsidies if their household incomes were below four times the poverty level. Abortion rights opponents don't want those subsidies going towards policies that cover abortion services, since that would mean taxpayers opposed to abortion were, in effect, paying for the procedure.
While such "mixing" of funds happens all the time, as Time's Amy Sullivan has observed, the Democratic leadership have tried to accommodate the opposition by proposing to create nominally distinct funds for abortion services or contracting out the financing to a private entity.
But the abortion rights opponents, led by Michigan Democrat Bart Stupak, wouldn't budge. They wanted the chance to introduce an amendment that would prohibit any plan that covers abortion services from accepting subsidies--a move that would effectively make policies covering abortion unavailable not only for people who need subsidies but, quite possibly, even those who don't.* After a furious day (and days) of negotiation, last night the Democratic leadership--desperate for every vote it could get--finally and very reluctantly gave in.
The amendment could very well pass, since those 40-odd Democrats will likely have the support of most Republicans. If it does, abortion rights advocates are hoping that they can prevail in the Senate.
It's not an unrealistic hope: As one lobbyist tells me, "The vote is better in the Senate"--not withstanding its generally more conservative tilt. But to prevail, abortion rights advocates will have to overcome the power of the U.S. Conference of Catholic Bishops, who have been lobbying furiously on this issue. Despite their avowed and long-standing support for measures that will help the poor--which health care reform surely will do--the Conference have urged members to vote against the House bill if the exchange provision doesn't change.
One interesting question: Is the White House weighing in on this? I asked spokesperson Linda Douglass if they were taking a position on Stupak's amendment--or, more generally, whether they had a position on whether policies inside the exchanges should cover abortion services. "We are not going to be commenting on provisions of the bill as they evolve today," she told me.
*Correction and clarification: I originally wrote that the Stupak amendment would prohibit any insurance plan inside the exchanges from covering abortion services. That's incorrect. The amendment would allow a plan to cover abortion services as long as it didn't enroll people who were using federal subsidies to help pay for premiums.
In theory, an insurer could offer two sets of plans, identical except for the fact that one covered abortion services and one didn't. The insurer would simply have to make sure the plans with abortion coverage were available only to people buying coverage without subsidies.
But would insurers actually go to that trouble? Abortion rights advocates are highly skeptical--and with good reason. Among other things, these advocates note, official projections suggest that just 15 percent of people in the exchanges--3 million of 20 million total--would be buying coverage without subsidies. That's probably not enough to make it profitable for insurers to offer such policies. As Laurie Rubiner, vice president for public policy and advocacy at Planned Parenthood, says, "While it doesn't appear to ban coverage of abortion in the exchange altogether, that is the effect."
Update: Amy Sullivan gives the backstory on this amendment. Her conclusion? The Democratic leadership could have avoided this episode by reaching out to abortion rights opponents earlier in the process.
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COMMENTS (15)
The U.S. Conference of Catholic Bishops have shown an "avowed and long-standing support for measures that will help the poor". That's funny, because, fundamentally, the only thing this amendment would do is disadvantage poor women who choose abortion, as wealthier women can afford private insurance plans that pay for the procedure, or pay for the procedure outright. No mention of anything in the bill that will subsidize mental health services for women who are forced to go through with pregnancy.
Is the irony of their platitudes ever not lost on the U.S. Conference of Catholic Bishops?
The U.S. Conference of Catholic Bishops have shown an "avowed and long-standing support for measures that will help the poor". That's funny, because, fundamentally, the only thing this amendment would do is disadvantage poor women who choose abortion, as wealthier women can afford private insurance plans that pay for the procedure, or pay for the procedure outright. No mention of anything in the bill that will subsidize mental health services for women who are forced to go through with pregnancy.
Is the irony of their platitudes ever not lost on the U.S. Conference of Catholic Bishops?
dylan, sorry but I don't care. If you want to ensure that poor women are able to get abortions, donate to Planned Parenthood. I just don't want to see the whole reform deal go down, which will very strongly adversely affect the poor, men, women, and children out of some kind of "subsidized abortions for everyone" purity.
And if you believe abortion is the taking of a human life, what is the logic of saying since the rich can do something morally objectionable, lets make sure poor can as well? The Catholic Church, in fact, does subsidize mental health services for women who go through pregnancy.
(not sure where you get the forced line from) if you want to see that poor women can get abort ... view full comment
dylan, sorry but I don't care. If you want to ensure that poor women are able to get abortions, donate to Planned Parenthood. I just don't want to see the whole reform deal go down, which will very strongly adversely affect the poor, men, women, and children out of some kind of "subsidized abortions for everyone" purity.
And if you believe abortion is the taking of a human life, what is the logic of saying since the rich can do something morally objectionable, lets make sure poor can as well? The Catholic Church, in fact, does subsidize mental health services for women who go through pregnancy.
(not sure where you get the forced line from) if you want to see that poor women can get abortions paid for, then pay for them yourselves, just don't expect others to do so as well. Something tells me that if you pay for some woman to get multiple abortions yourself, at some point you are going to want to smack her and tell her to get her ass on birth control. And yes, there are women who use abortions as a form of birth control. I am supposed to subsidize that choice?
These are the days of the after morning pill, it isn't expensive. At some point women should take responsibility for their actions that if they have a lapse in judgment then take that cheap pill. Don't give me bs they aren't educated enough to do that either, the solution is to educate them. At some point pro-choicers have to put their money where their mouth is. See to it that all young women have access to safe, reliable birth control. Win that war.
Yes, I know the church will bitch about that, but that is all they can do.
dylan, I am not angry at you, (I realize I sound pissed) I just want this goddamned bill to pass. once it passes it can be modified over time. For now, I would rather keep abortion out of this equation. Lets get basic healthcare for everyone, lets not hand Republicans a way to stop this.
dylan, I am not angry at you, (I realize I sound pissed) I just want this goddamned bill to pass. once it passes it can be modified over time. For now, I would rather keep abortion out of this equation. Lets get basic healthcare for everyone, lets not hand Republicans a way to stop this.
You may not be angry blackie, but I am. It is outrageous to characterize this issue as being about "abortion rights".
This issue is about using the power of the Federal Government to compel people who believe deeply that abortion is murder to subsidize it with their tax dollars. However you feel about when life begins, becomes "human", and etc., there is simply no excuse for this kind of high-handed tyranny.
Under current law, women have a right to get an abortion. They don't have the right to make me pay for it.
You may not be angry blackie, but I am. It is outrageous to characterize this issue as being about "abortion rights".
This issue is about using the power of the Federal Government to compel people who believe deeply that abortion is murder to subsidize it with their tax dollars. However you feel about when life begins, becomes "human", and etc., there is simply no excuse for this kind of high-handed tyranny.
Under current law, women have a right to get an abortion. They don't have the right to make me pay for it.
"Is the irony of their platitudes ever not lost on the U.S. Conference of Catholic Bishops?" This is the same church that condoned or shielded pedophile priests for decades. You really had to ask this?
"Is the irony of their platitudes ever not lost on the U.S. Conference of Catholic Bishops?" This is the same church that condoned or shielded pedophile priests for decades. You really had to ask this?
"This issue is about using the power of the Federal Government to compel people who believe deeply that abortion is murder to subsidize it with their tax dollars. However you feel about when life begins, becomes "human", and etc., there is simply no excuse for this kind of high-handed tyranny."
Come again? My wife is a committed, lifelong pacifist. She is nonetheless required to pay taxes that support the US military, including the production and maintenance of weapons of mass destruction - weapons the communal possession of which she finds every bit as deeply morally repugnant as any Catholic does abortion. That is not high-handed tyranny - it's democracy. Now, if there are the votes in ... view full comment
"This issue is about using the power of the Federal Government to compel people who believe deeply that abortion is murder to subsidize it with their tax dollars. However you feel about when life begins, becomes "human", and etc., there is simply no excuse for this kind of high-handed tyranny."
Come again? My wife is a committed, lifelong pacifist. She is nonetheless required to pay taxes that support the US military, including the production and maintenance of weapons of mass destruction - weapons the communal possession of which she finds every bit as deeply morally repugnant as any Catholic does abortion. That is not high-handed tyranny - it's democracy. Now, if there are the votes in this democracy to remove abortion from subsidized insurance, so be it. Abortion opponents have every right to lobby their representatives to make that happen. But if the votes aren't there, then tough. One of the price citizens of a democracy must pay is supporting the execution of policies that they, as a minority view holders, may find personally objectionable.
sdemuth, are you willing to put abortion rights up to a state by state vote and let the states decide? If you are, then I have no major objection to what you are saying about abortion, except that the majority does not always equal justice (witness Maine and gay marriage). Are you willing to go up to gays in Maine and say"tough, live with it." I hope not.
"Now, if there are the votes in this democracy to remove abortion from subsidized insurance, so be it." Yes, I get your point, but how many Liberals will say the same? Do we really need this flame war? Do we really want a never ending battle over this issue over all others? Beyond this, I think you are being cavalier as to the attitudes and ... view full comment
sdemuth, are you willing to put abortion rights up to a state by state vote and let the states decide? If you are, then I have no major objection to what you are saying about abortion, except that the majority does not always equal justice (witness Maine and gay marriage). Are you willing to go up to gays in Maine and say"tough, live with it." I hope not.
"Now, if there are the votes in this democracy to remove abortion from subsidized insurance, so be it." Yes, I get your point, but how many Liberals will say the same? Do we really need this flame war? Do we really want a never ending battle over this issue over all others? Beyond this, I think you are being cavalier as to the attitudes and beliefs of others. I am against the Death penalty (except in extremely rare cases) so I choose not to live in Texas. I have that option. Do you really think I should be forced to pay for Texas and their death penalty regime?
What you write sounds a little bit like rubbing the noses of people in it. When a reasonable accommodation can be made, no federal subsidizing of abortions (with states having every right to do so) then how can you say "tough?" This rhetoric that both sides use of "eat my shit" is tiresome. The best thing about this whole debate up to now is how much more reasonable and just the Democrats have been. Republicans have been given every opportunity to contribute (and some have) but as a whole they have been dishonest, obstructionistic, and generally assholish. All I want is for the millions who are uninsured that chance to be insured, and for insurance companies to stop screwing over Americans. Lets do this first.
Hey blackton, it's okay to get angry, just don't get all george on me.
I agree with you that the important thing is to get the bill passed. I'm just dismayed about the USCCB.
Hey blackton, it's okay to get angry, just don't get all george on me.
I agree with you that the important thing is to get the bill passed. I'm just dismayed about the USCCB.
I meant the only red flag would be if you went george on me, not that you did there.
I meant the only red flag would be if you went george on me, not that you did there.
Blackton: I in fact agree that it is more important to pass a reasonable health care bill, than that it is have subsidies for insurance that covers abortion. I'm not particularly upset that the subsidies were removed, because I agree that getting coverage for the uninsured, and starting to rationalize our absurd system, are more important than any one medical procedure about which the nation manifestly cannot agree.
I was making a very different point: there is nothing "tyrannical" - Robert Powell's claim - about expecting citizens of a democracy to pay taxes for polices they don't agree with. It is a necessity, and it happens all the time, with issues both trivial and of deep moral resona ... view full comment
Blackton: I in fact agree that it is more important to pass a reasonable health care bill, than that it is have subsidies for insurance that covers abortion. I'm not particularly upset that the subsidies were removed, because I agree that getting coverage for the uninsured, and starting to rationalize our absurd system, are more important than any one medical procedure about which the nation manifestly cannot agree.
I was making a very different point: there is nothing "tyrannical" - Robert Powell's claim - about expecting citizens of a democracy to pay taxes for polices they don't agree with. It is a necessity, and it happens all the time, with issues both trivial and of deep moral resonance. Your own counterarguments make the point better than I can: if we defer the subsidies to the states, then there will be states where some people feel strongly that abortion is a moral abomination, but whose state taxes subsidize them. You can say, "well then, they should move," but is that really any less callous than my argument that as citizens of a democracy, they have to accept that government for which they pay, and to which they are bound, will not always act in a way consistent with their beliefs? Would you have them choose between their beliefs and staying in their home town to care for aging parents, or between moral purity and a job that feeds their family, and that they may not be able to replace? And, as for the death penalty - I'm in the same boat you are, but short of leaving the country, I can be sure that my tax dollars will pay for executions - Timothy McVeigh was executed in a Federal prison, not a state institution, after all. And yet, I would hardly go so far as to claim that the Federal governments refusal to abolish executions that I help pay for is "tyrannical.". I would just say it puts me on the losing end of a legitimately conducted moral and legal argument in a largely democratic society. Indeed, I can almost hear some of those same folks terrified that having $0.001 on the dollar of their tax money maybe funding insurance for some poor soul who might want or need an abortion, telling me "tough. It's a democracy, and the majority favors capital punishment."
Or maybe not - maybe they'd happily give up their vengeance to honor the moral precepts of a different principled minority.
Right.
"short of leaving the country, I can be sure that my tax dollars will pay for executions"
Actually, as you likely know better than most, even leaving the country wouldn't get me off this hook. I'd have to renounce my citizenship as well.
"short of leaving the country, I can be sure that my tax dollars will pay for executions"
Actually, as you likely know better than most, even leaving the country wouldn't get me off this hook. I'd have to renounce my citizenship as well.
sdemuth, actually I don't live in America, and don't pay taxes there. The first pretty high amount is tax exempt. I have a different attitude than you since I not only left my city, state, country, I also left my continent (initially). I made myself a promise I would not live in the states as long as Bush (shrub) was President and I didn't, and not a penny of my taxes went to him.
I don't think it is callous to say move. I would never have lived in the Jim Crow south. Would not have vacationed there. Yes, I know my own experience doesn't apply to everyone, but I also can't discount it. America is a country of migrants, moving for principle is (to me) more valid than moving for money. You woul ... view full comment
sdemuth, actually I don't live in America, and don't pay taxes there. The first pretty high amount is tax exempt. I have a different attitude than you since I not only left my city, state, country, I also left my continent (initially). I made myself a promise I would not live in the states as long as Bush (shrub) was President and I didn't, and not a penny of my taxes went to him.
I don't think it is callous to say move. I would never have lived in the Jim Crow south. Would not have vacationed there. Yes, I know my own experience doesn't apply to everyone, but I also can't discount it. America is a country of migrants, moving for principle is (to me) more valid than moving for money. You would be amazed at how little it takes to live provided you give up credit cards, and a lot of the crap people buy. What most people lack is imagination. If you can't live your life at least attempting to live according to your principles, what really is the point?
Blackton - I have lived on sub-taxable incomes as an adult with a family, by choice, and I've lived with generous enough income to be solidly upper middle class. Either works, although the latter is a bit easier to my mind. But both can make you crazy about money, if you let them, albeit in different ways.
I don't really believe that you think my argument that sometimes we have to put up with our government doing things with our tax money that we don't approve is somehow more burdensome or tiresome, than telling people who don't like such a fact to move. I'm glad moving worked for you (although you obviously didn't leave the US for China in order to live under a government that abhors capi ... view full comment
Blackton - I have lived on sub-taxable incomes as an adult with a family, by choice, and I've lived with generous enough income to be solidly upper middle class. Either works, although the latter is a bit easier to my mind. But both can make you crazy about money, if you let them, albeit in different ways.
I don't really believe that you think my argument that sometimes we have to put up with our government doing things with our tax money that we don't approve is somehow more burdensome or tiresome, than telling people who don't like such a fact to move. I'm glad moving worked for you (although you obviously didn't leave the US for China in order to live under a government that abhors capital punishment, and I sincerely doubt you approve wholeheartedly of everything the Mexican government does), but realistically, many people are very attached to their place of residence, for very good reasons. I have had ample opportunities to work and live overseas, for example, but have passed them up because my wife's profession (nursing) is extremely difficult to transfer to the places I"ve had the opportunity to go. I won't she give up her profession, and I won't leave her, so I stay here.
Life is full of compromises. Sometimes it really is just "tough," and you live with the compromises.
I don't know if this will ever be read, but I was thinking about sdemuth's response to my post and hope he gets my reply:
First, I'll grant that "tyranny" may be a bit strong, but in matters of this nature (arguably involving millions of deaths and billions of dollars), maybe not by much.
Second, as one with some pretty strong libertarian beliefs, I'm sympathetic to anyone who wants more control over how their tax money is spent. I'd like to see your wife have the option to insist that all of her taxes were spent on healthcare or whatever. I'm sure there will be plenty of us who will opt for military spending, etc. Unfortunately, this seems to have a likelihood approaching zero.
Finally, I'd sa ... view full comment
I don't know if this will ever be read, but I was thinking about sdemuth's response to my post and hope he gets my reply:
First, I'll grant that "tyranny" may be a bit strong, but in matters of this nature (arguably involving millions of deaths and billions of dollars), maybe not by much.
Second, as one with some pretty strong libertarian beliefs, I'm sympathetic to anyone who wants more control over how their tax money is spent. I'd like to see your wife have the option to insist that all of her taxes were spent on healthcare or whatever. I'm sure there will be plenty of us who will opt for military spending, etc. Unfortunately, this seems to have a likelihood approaching zero.
Finally, I'd say that military spending is fundamentally different from abortion funding. Even though both issues involve life-and-death morality, the fact is that no one in this country is going to be forced to either have an abortion or refrain from having one, and no one else is going to be directly involved. Without military spending, however, it is quite likely that all of us, including pacifists, would be living under some form of totalitarian tyranny. The benefits of having defeated Fascism and Communism accrue to your wife as well as to me, so there's a lot less of an argument for excepting her from paying her fair share.
Robert Powell - Time was, when I would have agreed with you about more direct, individual control over how our tax money gets spent. Then came the 25 year long saga of California, self-disintegrating through the use of popular referendums, a powerless executive, and feckless legislature. I've come in my later years to the conclusion that a democracy needs a little more starch in it than one gets from hewing too closely to popular will.
In the bigger picture, I tend to think that the presence and voice in our society of pacifists, or deeply convicted abortion opponents, or most any other ideologically firm minority whose proposed program does not undermine the core principles of democracy an ... view full comment
Robert Powell - Time was, when I would have agreed with you about more direct, individual control over how our tax money gets spent. Then came the 25 year long saga of California, self-disintegrating through the use of popular referendums, a powerless executive, and feckless legislature. I've come in my later years to the conclusion that a democracy needs a little more starch in it than one gets from hewing too closely to popular will.
In the bigger picture, I tend to think that the presence and voice in our society of pacifists, or deeply convicted abortion opponents, or most any other ideologically firm minority whose proposed program does not undermine the core principles of democracy and tolerance, is a good thing. It takes a great many voices to make a thriving debate, and sensible policies. But I do expect that in exchange for being heard and respected, those in such minorities accept that they have an obligation to the common policy of the democratic institutions that give them their voice, even when such policy is painfully out of step with their beliefs. The legitimacy of a democratic republic such as ours comes from the fact that we must all respect the execution of policies agreed on through those institutions, whether or not we respect or agree with the policies themselves. Exceptions to this principle certainly exist, but they must be rare, or they will ultimately be fatal.
As I've said to Blackton, pragmatically, I am not particularly concerned that abortion subsidies have been removed from the House bill. They are peripheral to the main import of the legislation, and their removal was done in a proper, above-board fashion - there were no hidden amendments in must-pass appropriation bills, or the like. Bully for the opponents of publicly funded abortions.