Mother Jones: The Man Who Almost Killed Health Reform

Rep. Bart Stupak, while sincerely committed to the pro-life position, was sincerely determined to see health reform pass. In the case of Richard Doerflinger, a senior analyst with the U.S. Conference of Catholic Bishops and a key architect of their anti-abortion campaign, the commitment to health reform is much less clear, as Mother Jones magazine reports. An excerpt:


Like many other Catholic groups, the bishops have long advocated for universal health care. But as abortion moved to the forefront of the health care debate, a schism occurred. As the health care bill neared a vote in the House last November, Stupak claimed that by providing tax credits to help people buy insurance, the legislation would result in government money being used to pay for abortions. With Doerflinger’s help, he drafted an amendment that required women to purchase a separate "rider" policy with their own money if they wanted abortion coverage. When the action shifted to the Senate, Sen. Ben Nelson (D-Neb.) inserted slightly different anti-abortion language requiring women who receive tax credits to cut a separate check to pay for the part of their insurance policy that would cover abortion. Many Catholic groups who favored health care reform decided that the Senate anti-abortion provisions were acceptable. By late March, Catholic nuns, the Catholic Health Association, and many individual pro-life faith leaders had admitted publicly that the Senate bill would not fund abortion, and expressed support for the Democrats' plan.

But the bishops wouldn't budge. Doerflinger insisted that the Senate bill would still lead to federal financing of abortion, and that only the House version would do. Soon, the ostensibly pro-reform bishops had joined forces with a coalition of conservative groups who had no desire to see a health care bill pass. These included Focus on the Family and the National Right to Life Committee (NRLC), which attacked the Democrats' plan as "death care" and warned that it would lead to the "rationing" of medical treatment.

Before long, liberal Catholics were questioning the motives of Doerflinger and the bishops in aligning themselves with these right-wing groups. In mid-March, the National Catholic Reporter slammed the bishops for embracing a "red herring" argument served up by the NRLC that the Senate bill would allow community health centers to fund abortions. In fact, community health care centers have never performed abortions and there was no plan for them to do so in future. "The bishops have to be clear that some of their talking points might lead honest observers to question their competence—or worse," the National Catholic Reporter concluded. (Doerflinger declined to respond to follow-up questions regarding the community health centers issue.)

...

Stupak pushed Doerflinger's position almost until the very end. On March 17, he told Fox News that he didn’t listen to nuns when drafting pro-life language, and instead relied on "leading bishops, Focus on the Family, and The National Right to Life Committee." But four days later, on the day of the final vote, he abruptly changed course. Over the bishops' objections, he accepted the White House’s compromise: an executive order reiterating that no government money would be used to pay for abortions.

In the days since Stupak voted for the bill, relations between his bloc and the bishops have soured. "The church does have some work to do in dealing with frayed nerves and divisions on policy questions," Doerflinger told Catholic News Service. Last week, Stupak attacked the bishops and other anti-abortion groups for "great hypocrisy" in opposing Obama's executive order after having supported former President George W. Bush's executive order banning stem cell research in 2007. He told the Daily Caller he believed the bishops and the groups they were allied with were "just using the life issue to try to bring down health-care reform." In other words, he suspected he was wrong to trust that his former allies were acting in good faith.

Health Reform Watch Post Mortem: Rep. Bart Stupak comments on why he wrote the Stupak-Pitts Amednent

Mr. Stupak, author of the infamous Stupak-Pitts amendment that would essentially have prohibited all insurance plans on the insurance exchanges from offering abortion services (although buyers might be able to shop for completely separate riders covering abortions), talks in a Washington Post op-ed about the flak he has taken from pro-lifers. Mr. Stupak and many of his original colleagues in the House dropped their earlier demands in exchange for an executive order.

His commitment to health reform as well as his pro-life principles seems clear to me. He even described the entire package, after his agreement with the President, as a pro-life bill, which was significant. In contrast, he says that many conservative pro-life organizations which rallied around him were doing so in hopes that the split on abortion would result in the bill's failure:

When I saw that Kathleen Parker's March 24 op-ed, "Stupak's original sin," defined me as a "backstabber," it reminded me of a Bible verse. Matthew 7:3 asks, "Why do you look at the speck of sawdust in your brother's eye and pay no attention to the plank in your own eye?"

The true motives of many blogs and organizations claiming to be pro-life have become clear in recent days: to politicize life issues as a means to defeat health care reform. One group even sent an e-mail to supporters saying they are "working feverishly to stop this legislation from going forward."

The pro-life groups rallied behind me -- many without my knowledge or consent -- not necessarily because they shared my goals of ensuring protections for life and passing health-care reform but because they viewed me as their best chance to kill health-care legislation.

He admits that an executive order does not quite have the force of law. However, while an executive order can indeed be overruled by legislation or by the judiciary, the order that the President signed will likely not be overturned.

Therefore, I and other pro-life Democrats struck an agreement with President Obama to issue an executive order that would ensure all Hyde Amendment protections would apply to the health-care reform bill. No, an executive order is not as strong as the statutory language we fought for at the start. We received, however, an "ironclad" commitment from the president that no taxpayer dollars will be used to pay for abortions.

Throughout history, executive orders have carried the full force and effect of law and have served as an important means of implementing public policy. Perhaps the most famous executive order was the Emancipation Proclamation signed by President Abraham Lincoln in 1863. More recently, in 2007, President George W. Bush signed Executive Order 13435, restricting embryonic stem-cell research. This executive order protected the sanctity of life and was "applauded" and "welcomed" by pro-life advocates. That these same people would now claim that President Obama's executive order maintaining the sanctity of life is not worth the paper it is written on is disingenuous at best.

Some, including Parker, have criticized Obama's executive order as unenforceable in the courts and therefore just a "fig leaf." Yet the language that critics point to is standard language with any executive order, including Bush's ban on embryonic stem-cell research. Again, many of these pro-life groups did not express concern over the Bush language but claim it is unacceptable under Obama.

To further protect against federal funding for abortion, during floor debate on the health-care reform bill I engaged in a colloquy with Rep. Henry Waxman to make clear congressional intent that the provisions in the bill, combined with the executive order, will ensure that outcome. Such colloquies are often referred to in court cases when an attempt is being made to determine Congress's intent. This, too, was no minor concession by those opposed to our efforts, and it is a tremendous victory for those protecting the sanctity of life.

I absolutely disagree with Mr. Stupak that an accounting segregation of funds was insufficient, as well as on the basic issue of abortion. While abortion is never good, because it ends a human life, it does not end the life of a human person. It is a terrible choice that should be left to parents, if they feel they need to make that choice. However, it should be emphasized that Mr. Stupak was committed to passing health reform. Speaker Nancy Pelosi said so herself in an interview with Rachel Maddow. Pro-choicers should cut him a break - we can live with the resulting legislation, and again, abortion deeply divides the American people and this uneasy cease-fire is something we have to live with. Furthermore, Mr. Stupak is to be commended for his willingness to abide by his principles and to be flexible in doing so. If the pro-lifers who thought that insuring all Americans was not pro-life want to take shots at him, let them do so on their own.

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.

Catholics in Alliance for the Common Good and Catholic Health Association both urge passage of health

Both the Catholics in Alliance for the Common Good (joined by other Catholic and Evangelical leaders) and the Catholic Health Association, which represents Catholic health systems, have both urged Congress to pass the reform bill. They feel the restrictions in the Senate bill do not constitute federal funding for abortion and are no more lenient than current law.

Abortion restrictions defeated in Senate health bill

For now, the Senate has rejected an abortion amendment similar to the one in the House bill which has passed. However, further challenges could emerge.

The NY Times Economix blog cited several experts who agreed that the Stupak amendment in the House was a significant change from the status quo. Private insurers would be unable to offer abortion services in plans on the insurance exchange - furthermore, the insurance exchange is expected to grow over time, as more small and medium companies opt into the exchange. There is the possibility that insurers might sell separate abortion riders, which would be legal. However, five states presently restrict the availability of abortions in plans regulated by their insurance commissioners and all indications are that markets for riders have not developed.

Experts at George Washington University, led by Professor Sara Rosenbaum, have a detailed analysis.

Anthony Stevens-Arroyo (Washington Post): Double Trouble on Abortion?

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.

Huffington Post: Pro-Life Pretense

Christina Page, writing on Huffington Post, says that the hardline part of the pro-life movement touts its Crisis Pregnancy Centers on one hand, but criticizes funding for social services on the other hand ... and yet, the Centers refer women to those social services.


President Obama's still-to-be released common ground agenda in the abortion conflict is already having a profound and largely overlooked effect: it has exposed deep fault lines in the pro-life movement. Obama's focus on reducing the need for abortion has been embraced by some practical-minded pro-lifers who are tired of decades of intransigence, and who also appear jaded by the counterproductive "culture of life" sloganeering of President Bush. Pro-choice Bill Clinton presided over the most dramatic decline in abortion rates in the history of our country after all. Pro-lifers Reagan, Bush I and Bush II did not. For an emerging movement of reasoned, results-oriented, non-ideological pro-lifers results count. If a pro-choice president produces pro-life outcomes, they ask, are they any less worthy?

For the traditional pro-life establishment, however, they are. In fact, to them, Obama's common ground call is perceived as a threat. Since Obama takes them, their beliefs and their proposals seriously they have been forced to justify some fundamental hypocrisies, the kind that have in the past led to rhetorical victories and little progress (unless you count fundraising). Consider, for example, the clash between pro-life rhetoric and reality when it comes to crisis pregnancy centers, a much-cherished initiative of the old guard pro-lifer. A recent report, "A Passion to Serve, a Vision for Life," released by the Family Research Council is a valentine to the nation's 3,000 crisis pregnancy centers (CPCs). It commends them for communicating "to women and their families that their lives are valuable and that their needs - emotional, psychological, medical, spiritual and practical - can and will be met ."

The report details the intense efforts CPCs undertake to persuade women to not choose abortion. The main message broadcast to those coming to a center is: "support is available, you do not need to discontinue this pregnancy for financial reasons." But beside the ultrasound image women are provided and medically inaccurate pitch against abortion, the most persuasive arguments available to CPCs, as any staff or volunteer will readily admit, is that women facing crisis pregnancies can make it work by depending on a network of publicly-funded social services. For the vast majority of women convinced to become mothers, CPCs are a gateway to the welfare system.

Theoretically, a pro-life, common ground approach then would be to take seriously the benefits of CPCs as, essentially, referral agencies to services which can support women who really do want to keep a pregnancy. And also to say, "Let's make sure the right social services are in place - those that women really need - and that they are well-funded."

And here's where that old-guard rhetoric runs into the brick wall of common ground (and fact-based) reality. The Family Research Council valentine to crisis pregnancy centers may sound pretty, and even compelling, but on closer examination is it sincere? In effect, groups like the Family Research Council as well as most pro-life politicians have been two-timing their devoted crisis pregnancy center partners. While professing their love for their work, they batter the social programs on which the crisis pregnancy center movement places its trust.

The Family Research Council carefully details in its report the many federal and state-sponsored programs to which CPCs direct women including: Head Start, Medicaid, Local Health Departments, Legal Aid, State Children's Health Insurance Program (S-Chip), State Health Departments, Women Infants & Children (WIC), and the Department of Job and Family Services.

Yet when it's suggested that support for these very agencies should merit pro-life support, the Family Research Council lines up in opposition. Michael New, a senior fellow at the Family Research Council, recently launched an attack on the progressive, pro-common ground, pro-life group, Catholics in Alliance for the Common Good (CACG) for suggesting just that. CACG conducted a study linking states that provide more generous services to the poor with lower abortion rates. CACG suggested that to reduce abortion rates pro-lifers should consider the policies traditionally championed by Democrats--extending publicly-funded social services to poor pregnant women--rather than exclusively focus on restricting abortion. But suddenly, the programs that are so effective when used as resources by crisis pregnancy centers, are suspect. New writes,
"[The study's] questionable methodology and inconsistent results should give pro-lifers serious pause before they enthusiastically embrace higher welfare benefits as a strategy to reduce abortion. Furthermore, there is little peer-reviewed research which indicates that more generous welfare benefits have a significant impact. [Other studies] find that welfare benefits only have a marginal impact on abortion rates. However, as I will discuss later in the response, there exists plenty of evidence from studies in reputable peer reviewed journals that various types of pro-life laws reduce abortion rates."

New himself didn't miss the chance to praise the work of crisis pregnancy centers; he weighed in when the Family Research Council report came out, writing, "PRCs have offered real alternatives to literally millions of women facing crisis pregnancies. Countless women regret their abortions. However, the testimonials in FRC's latest report are evidence of the positive impact of the life-affirming options offered by many pregnancy-resource centers." Of course, the "life-affirming" options are now no more than a euphemism for the "welfare" which, according to New, has a "marginal impact on abortion rates.

New's attack on the Catholics in Alliance for the Common Good's policy proposal is a reflection of an all-consuming hypocrisy plaguing an ideologically entrenched pro-life establishment. Crisis Pregnancy Centers rely on a welfare system to support the women they persuade to become mothers while pro-life groups and politicians actively undermine the very programs and agencies that are the only resources available to support many women who want to have a child, as CPCs know.

In 2007, The Children's Defense Fund published its Congressional Scorecard on the best and worst legislators for children. The organization scored congressmembers votes on many of the policies that help pregnant women decide whether to parent or abort. The votes were on Head Start, increasing the minimum wage, reauthorizing and increasing funding for S-CHIP, increasing funding for children with disabilities, job training, Medicaid funding, helping youth pay for college, and tax-relief for low-income families with children. Based on their votes on these issues, the Children's Defense Fund ranked 143 congressmembers as 'the worst" for children. Of the 143 worst legislators, 100% are pro-life.

The long-established, and long-dominant pro-life complex speaks out of both sides of its mouth, praising crisis pregnancy centers and yet disparaging the social services upon which they rely. In the upcoming months, the Obama administration will be revealing its common ground agenda and one part of it promises to be supports for pregnant women. It is just the sort of agenda designed to appeal to a nascent pragmatic and moderate pro-life movement. Let's hope this rising voice of reason can lead the crisis pregnancy center movement to support an administration plan to help struggling families and indigent pregnant women. Praise for CPCs can't come packaged with attacks on the very supports they rely upon. It not only defeats common ground; it defeats reason.

Joseph Schiedler, president of the Pro-life Action League, wrote an op-ed in USA Today claiming pro-lifers who embark on the search for common ground betray the pro-life cause and, in making his case, reveals the classic characteristics of pro-life schizophrenia. He writes,

"There is no evidence that increasing social programs -- such as low-cost health care and day care, college grants and maternity homes -- will impact a woman's abortion decision. It is rare in our experience to find a woman who says the reason she is choosing abortion is that she doesn't have day care, or that she'd rather go to college...More than 3,000 pregnancy centers in the U.S. are ready to help a woman with material needs, emotional support, counseling and medical care. Anyone who wants to stop abortion should promote these centers."

Once we begin to till the soil of common ground, these contradictions and inconsistencies will become clearer. It is then that pragmatic pro-lifers may realize there will be unlikely partners along the path to genuine pro-life victories.
This post originally appeared on RHRealityCheck.org's OnCommonGround forum which publishes perspectives and breaking news on common ground in the abortion conflict. Join the conversation at OnCommonGround or follow us on www.twitter.com/commongrnd


Read more at: http://www.huffingtonpost.com/cristina-page/pro-life-pretense_b_331070.html

NYT: Kansas Abortion Clinic Operated by Doctor Who Was Killed Closes Permanently

From the New York Times, the closure of Dr. Tiller's clinic after his murder has led to significant limitations in abortion access in his service area. I imagine Dr. Tiller also provided other reproductive health services and education.


The Kansas abortion clinic run by the doctor who was shot to death in church last month has closed permanently, his family said on Tuesday.

The clinic of Dr. George R. Tiller, in Wichita, had been one of a few in the country to provide abortions to women late in their pregnancies, and for decades, women had traveled there from all over the nation and overseas. The office, Women’s Health Care Services Inc., was also the state’s only remaining clinic, even for abortions performed early in pregnancy, outside the Kansas City area.

“Notice is being given today to all concerned that the Tiller family is ceasing operation of the clinic and any involvement by family members in any other similar clinic,” a statement issued by Dr. Tiller’s lawyers read. The lawyers said the Tiller family would offer no additional comments.

After Dr. Tiller was killed as he served as an usher at his church on May 31, national abortion rights advocates had hoped, they said, that others might step in and keep his clinic open to provide late-term abortions. Many of these advocates expressed empathy on Tuesday for the decision of the Tiller family, which had been the target of criticism, protest and attacks for more than 30 years, but they also said the loss of the clinic might prove devastating to families of those few women who learned late in pregnancy of catastrophic health issues.

“It is unacceptable that anti-abortion intimidation and violence has led to the closing of Dr. Tiller’s clinic,” said Nancy Northup, president of the Center for Reproductive Rights. “Not only have we lost a fearless defender of women’s fundamental health and rights in Dr. Tiller’s murder, but the closing of his clinic leaves an immediate and immense void in the availability of abortion.”

Warren M. Hern, a doctor from Boulder, Colo., who also performs late-term abortions and was a friend of Dr. Tiller, described the outcome as “horrifying.”

“Where does it end?” Dr. Hern said. “The anti-abortion fanatics got exactly what they wanted.”

Dr. LeRoy Carhart, a Nebraska physician who had worked with Dr. Tiller in his clinic at times, issued a statement saying he was “currently exploring every option to be able to continue to make second- and early, medically indicated third-trimester abortions available.” Nebraska law bars such abortions, and Dr. Carhart provided no details about what options he was considering to make them available without Dr. Tiller’s Kansas clinic.

Abortion opponents, who had devoted years to fighting Dr. Tiller’s clinic with criminal investigations, protests and, earlier, blockades of the building, described this outcome as “bittersweet.”

“We are thankful that Tiller’s clinic will not reopen and thankful that Wichita is now abortion free,” Troy Newman, the president of Operation Rescue, which moved to Wichita because of Dr. Tiller’s clinic, said in a written statement. “It is our sincere prayer that threats to open another third-trimester abortion clinic in Kansas will not come to fruition so that the healing process for this state and community can begin.”

Still, Mr. Newman said, “we have worked very hard for this day, but we wish it would have come through the peaceful, legal channels that we were pursuing.”

Mr. Newman and many others in Wichita have said since Dr. Tiller’s death that they firmly believed an investigation by Kansas regulators into possible license violations would have resulted in Dr. Tiller’s losing his clinic in a matter of months. (That investigation, a Kansas spokeswoman said Tuesday, was closed after Dr. Tiller’s death.)

The president of the Kansas Coalition for Life, Mark S. Gietzen, who since 2004 had arranged for daily volunteers to stand outside the clinic and call out to the women going in, said his group might turn its efforts to abortion centers in the Kansas City region now, or perhaps to North Dakota.

“It looks like our prayer was answered,” Mr. Gietzen said of the clinic’s closing.

“We would have liked to have done this a different way though,” he said. “Now we have thousands of people bad-mouthing us, refusing to donate, telling us our Web site incited this.”

Scott P. Roeder, an abortion opponent from Kansas City, Mo., is in a Wichita jail, charged with murder in Dr. Tiller’s death. In Wichita, the anti-abortion groups have said Mr. Roeder was not a member or donor, though some leaders said they had seen him before or received phone calls from him.

In a jailhouse interview on Tuesday, Mr. Roeder told a reporter from CNN that he had received letters of encouragement, and described the closing of the clinic as “a victory for all of the unborn children,” according to CNN.

In the first days after Dr. Tiller’s death, his family said the clinic would close for the moment, but no permanent decision was made public until Tuesday.

In the statement released by lawyers, Dr. Tiller’s family said it wished to assure his previous patients that it would work to keep their medical histories and patient records “as fiercely protected now and in the future as they were during Dr. Tiller’s lifetime.”

The family also said Dr. Tiller’s work would be honored through private charitable work. Abortion rights advocates said they thought the abortion providers nearest to Wichita might now be about three hours away, in Overland Park, Kan.; Kansas City, Kan.; and Tulsa, Okla.