Women’s health rights are left behind

In the vote on health care reform offered by the House Democratic leadership, women were given the status of potted plants. It didn't seem to matter that women generally vote Democratic at substantially higher rates than men, their reproductive health care was sacrificed on the altar (and it was an altar) of getting the thing passed.

Rep. Bart Stupak, a Democrat from Michigan and a purported member of the secretive fundamentalist Christian group known as The Family, threatened House Speaker Nancy Pelosi like a spoiled child possessing the playground's only basketball. He promised to let health reform fail, with about 40 members in tow, unless the bill included his amendment that barred abortion coverage from any public option or private health insurance plan purchased with federal subsidies.

Pelosi didn't have a choice. Even with Stupak's amendment, health care reform squeaked by on a vote of 220 to 215.

The stubborn position of Stupak and his lobbying partner, the United States Conference of Catholic Bishops, is made even more extreme by the fact that a compromise had been reached to protect the status quo's strict limits on federal funding of abortion. The House bill contained a provision directing health insurers in the new exchanges to segregate federal subsidies from private premiums and use only the private funds to pay for abortion coverage. No public money would be used for abortions except in cases of rape, incest or to save the life of the mother.

But Stupak and his fellow conservative Democrats wanted more. They wanted to use health reform as an antiabortion tool. Stupak's amendment means insurers in the exchanges are unlikely to offer plans including abortion coverage since most customers will be federally subsidized.

It makes you wonder whom Stupak's team is playing for?

Passing health reform is the Democrats' top domestic policy priority. In addition to helping save nearly 45,000 people who die every year from a lack of health insurance, Democratic hopes in midterm elections may ride on its successful passage.

But Stupak and his crew were prepared to trade their own party's electoral prospects and all those lives for a rule that tells low- and middle-income women that they are on their own to pay for a needed abortion. Even in cases where the fetus is deformed and won't survive outside the womb.

The Catholic bishops also made that calculation. To them, standing in the way of health coverage for an additional 36 million people — which they did aggressively — was worth it. Because now, maybe, some working woman who can't possibly afford another child since she can't even pay for an abortion, will be forced to have an unwanted baby. That was their compassionate, charitable reckoning.

Some Stupak supporters are saying that the amendment will have a limited impact. They point to a 2003 Guttmacher Institute study finding that only 13 percent of abortions were directly billed by abortion providers to private insurance carriers. The suggestion is that even women with health insurance coverage choose to pay for abortions out-of-pocket.

But as the Guttmacher Institute says, the 13 percent figure is misleading. First, it includes all abortions, not just those of insured women. Had the study looked at only privately insured women the billing rate would have been far higher. And second, the 13 percent doesn't reflect the women who were reimbursed from their insurance company for the cost of the procedure. Because so many abortion clinics are not part of private insurance provider networks, there doesn't tend to be direct billing.

Whatever the numbers, the reason Stupak and the bishops were so keen to get their regressive amendment through was to make it harder for women to exercise their right to choose.

So, what will happen next? At this point the Senate plan includes the original compromise on abortion, but murmurs are that Senate Democrats may cave too. President Barack Obama has indicated that he thinks the House went too far. Which offers some hope that Stupak's amendment won't survive the process.

Every lawmaker with a shred of decency knows that health reform is essential for our nation's future. But reform can't take abortion access with it. Women have to count for something.

Women’s health rights are left behind 11/14/09 [Last modified: Saturday, November 14, 2009 3:30am]

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