Health Reform Watch: Abortion Update

As readers probably know, the House passed both the Senate health reform bill and a reconciliation package containing some fixes. The underlying bill now goes to the President for his signature. The reconciliation package goes to the Senate where it must pass by a mere 50 votes out of 100, as opposed to the regular 60.

Bart Stupak, a Democrat from Michigan who inserted the Stupak-Pitts amendment that would have essentially barred all plans on the exchanges from offering abortion services, struck a deal with the President to drop his earlier requirements. In exchange, the President will issue an executive order stating that the Hyde Amendment applies to the exchanges. That amendment was the first pro-life victory after Roe v Wade. It mandates that no federal dollars can be used to subsidize abortion services, except where the mother's life is endangered. Executive orders come close to having the force of a law passed by Congress, although a future President can undo them.

Substantively, this is no change from the proposed policy from the view of the pro-choice side. The bill is already relatively restrictive of access to abortion. I think we can live with this.

However, I believe one of the major concerns on the pro-life side is that the Hyde Amendment is an annual amendment. Although it's practically permanent law, if the Congress didn't pass it one year, then abortion services would be available on the exchanges and the plans would not have to take steps to segregate the dollars, accounting-wise.

Also, it appears that Mr. Stupak may have seen that his previous "money is fungible" argument was incorrect. Either way, the pro-life Democrats have agreed that this is an acceptable compromise.

These contortions are symptomatic of Americans' conflicted attitudes toward abortion. The uneasy detente between pro-choice and pro-life was nearly shattered during health reform, and it could have taken the bill down. It's good that it didn't.

Going forward, the pro-life side is likely to seek a permanent passage of the Hyde Amendment. The Catholic Bishops still don't agree with the compromise and they are likely to press for changes.

A number of pro-choicers are not happy with this compromise. The pro-choice side wanted to work with the President to loosen the Hyde Amendment. If that is not possible, my guess is that pro-choicers will work to secure funding to make sure that abortion services are affordable.

For those interested in reading further, Kaiser Health News has two op-eds, one from the Chuck Donovan with the conservative Heritage Foundation and another with Jessica Arons of the liberal Center for American Progress.