Anthony Stevens-Arroyo, writing for the Washington Post's On Faith column, asks if the abortion regulations in the House reform bill could have been done differently. As it is, the amendment offered by Bart Stupak would prohibit abortion services from being offered in any plan on the proposed exchanges. Previously, the intent was to have providers segregate public subsidies from individual payments, so that the government was not subsidizing abortions. Insurance companies could instead offer separate riders covering abortion services. As I recall, this is done in a handful of states. Overall, this separate rider stuff isn't likely to work very well. Unplanned pregnancies are, by definition, not planned. Stevens-Arroyo is Catholic himself.
Passage of the Affordable Health Care Act of 2009 was aided by the Stupak Amendment at the last hour. The U.S. Bishops were quick to hail not only passage of the House version of long-awaited reform but also for inclusion of that amendment. However, the double-dip victory may auger double trouble.
Cardinal George cast the Stupak Amendment as clarification of President Obama's pledge that "no federal funds will pay for abortions." But some say the bill goes further: now for the subsidized exchanges, no one receiving federal funds can have an abortion. According to the Hyde Amendment, the abortion issue was outside of government funding in most cases (rape and incest are exceptions). If a woman wanted an abortion - which is (unfortunately) a constitutional right according to the Supreme Court - she had to pay for it from her private funds. Now the acceptance of federal funds for any health care purposes by an individual or even by their insurance company excludes abortion (Sec. 265, 2(b) 1-2).
On the face of it, Catholic America has succeeded once again in the strategy promoted by Obama adviser and pro-life lawyer, Douglas Kmiec: Death to abortion by a thousand cuts and nicks in law. However, a look at the voting in the House suggests that there is a lot of politicking going on. Most of the representatives voting for the amendment, DID NOT vote for Affordable Health Care that the bishops advocate. On the other hand, most of those voting AGAINST THE AMENDMENT, voted for the bill. In other words, it would be naïve to think that a Catholic position on abortion has rallied both parties to a single cause. Rather, abortion remains a divisive issue.
I expect an amendment to the amendment at some point, probably along the lines of what was offered by Rep. Brad Ellsworth (D-Ind.). Given the partisan voting cited above, the Church runs the risk of being "used" for very mundane purposes. If the focus on abortion only serves a Republican Party strategy of protecting the status quo in favor of insurance companies to prevent reform, then the Stupak Amendment could become the equivalent of "throwing out the baby with the bathwater."
But can you get both restriction of abortion funding AND health care reform? The compromise proposed is supposed to do this. It involves separate accounting of private funds paid to cover abortions for those who so choose. While such persons might be eligible for subsidies from the government to pay for some health care costs, the money to purchase coverage for abortions would have to come out of their own pocket.
The process might be compared to using food stamps at the check-out counter in a supermarket. Food stamps do not cover chewing gum. On more than one occasion, I have seen an expectant mother using the government's nutrition assistance set two piles on the belt. The first stack includes formula and basic foods like cereal and milk. She uses the food stamps to pay for these. The second pile has a bag of chewing gum and the mother pays for this with cash from her pocket. I watched one woman give a stick of chewing gum to her child at her side during the drudgery of shopping. All this seemed like common-sense living to me. The food stamps do not buy chewing gum, the mother bought it from her own cash. After all, chewing gum is not illegal.
In the analogy, abortion insurance is like the private purchase of chewing gum. Its cost is separated from the subsidy, but taking government aid does not place the recipient into a separate category of citizen with different rights. Granted that the moral issue is much more serious, but the legal principle is the same.
This sort of "two piles" purchasing has been part of the implementation of the Hyde Amendment in the past, so it seems to be an extension in accordance with Catholic teaching. A reach too far would place the Church in the crossfire of partisan politics that the bishops say they want to avoid. If rational compromise is in order, I'd prefer a "two piles" solution to a "double trouble" problem.