The debate over health care reform has hit a predictable bump in the road: abortion. Opponents of abortion rights want to ban abortion coverage from any health insurance plan where customers receive federal subsidies — going against the trend in the private market and effectively preventing millions of American women from choosing to have access to a legal medical procedure. Congressional leaders need to steer clear. The best solution is to embrace an option that gives women access to abortion coverage but does not spend federal dollars to do it.
The so-called Capps amendment in the House plan would allow recipients of federal health care subsidies to purchase insurance with abortion coverage — but the abortion coverage would be paid for with private dollars. Contrary to the claims of Rep. Bart Stupak, D-Mich., who has been leading the antiabortion effort, the Capps amendment would not expand federal funding for abortion. Instead it would establish some basic principles to reflect the current health insurance landscape in which nearly 90 percent of private plans offer abortion coverage.
Under the amendment, the government could not mandate abortion coverage in private health plans but at least one plan in any new health exchange would have to include abortion coverage, and one plan would have to exclude it. Here abortion foes would be benefiting by having guaranteed choices they don't have today, since most health insurance policies include abortion coverage.
The amendment bars federal subsidies from being used to pay for elective abortion services, except in extreme cases as current law allows. Any insurance plan that offered abortion coverage would have to maintain at least two segregated accounts, one that receives that part of the premium paid for with public subsidies and the other that receives wholly private premium dollars. It is from this latter account that abortions would be funded. There would be no commingling of money, eliminating the concern that public funds may be going to pay for abortion.
When it comes to abortion and politics there tends to be little room for compromise. But this approach is probably as good as it gets. It responds to the concerns of all but the most hardened antiabortion lawmakers while ensuring that health care reform does not become an opportunity for new limits to be forced on women's reproductive choices.