Steven Waldman

Steven Waldman

Is Health Care Reform Covering Abortion or Not?

It’s very hard to make sense of what’s going on related to abortion and health care. Conservative pro-lifers claim the health care plan recently passed by the House Energy and Commerce Committee would increase the government’s support for abortion. “They wont pay for my surgery but we’re forced to pay for abortions,” says a frightened senior in a new Family Research Council Ad. Pro-choice people look at the exact same legislation and say, no, it just preserves the status quo.
Here’s my best whack at figuring this out.
The current legal reality is this: the government is now not allowed to pay directly for abortions, except in the cases of rape and incest, thanks to the Hyde Amendment (and its cousins).
It does, however, provide support for organizations that might do abortions. For instance, the government gives Planned Parenthood money to help promote family planning. By law, none of that money is allowed to go to abortion. But in an indirect way, it might help Planned Parenthood do abortions, since the family planning funds help sustain the organization.
In addition, though federal dollars aren’t allowed to go to abortions, state governments are free to subsidize abortions. The Medicaid program, which provides health care for the poor, is financed by both the federal and state governments. So the federal government doesn’t pay directly for Medicaid abortions but a “Medicaid recipient” might be able to get state-goverment-funded abortion if they happen to live in one of the states that provides the subsidy. Direct subsidies, no; indirect support, yes.
In theory, both pro choice and pro life groups have said they want health care reform to preserve the status quo.
The problem is that the new health care legislation introduces two new funding schemes. They can’t preserve the status quo because some of these features don’t currently exist.
One key component is the “public option.” Under the House bill, people without insurance will have the option of buying a government plan. The government plan could cover abortion. (“Nothing in this Act shall be construed as preventing the public health insurance option from providing for or prohibiting coverage”). Pro-choicers say that this neither-this-nor-that language is self-evidently neutral. Pro-life activists have argued that since it “could” be covered, it will be covered, a not unreasonable assumption given that, as written, it would be up to the Obama administration to make the determination.
The second key new feature is a health insurance subsidy. Congress would require everyone to have health insurance but provide assistance, in the form of tax credits, to people who don’t have enough income. The House bill doesn’t really subsidize plans, it subsidizes people. But the effect is that some people will get financial help from the government for health care, and then go and buy a plan that covers abortion.
In short…
On the health insurance subsidy, the pro-lifers have a weak case. Providing someone with a tax credit that they then use to buy a health insurance plan that covers abortion is not a direct subsidy of abortion, any more than it would be under Republican plans to subsidize health care through tax credits.
On the public plan, pro-lifers have a slightly stronger case. The house bill does not mandate taxpayer funded abortions, as the Family Research Council claims, but as written it does seem to leave the door open to that possibility down the road. Whether that becomes a direct subsidy or a paltry indirect subsidy would depend on how the program is structured. If consumers paid premiums that basically bore the whole cost of the insurance, it would be at most an indirect subsidy for abortion; if the government ends up charging unrealistically low premium levels, then they would, in effect, be providing a bigger subsidy for abortion (and every other type of health procedure).
I’m not arguing whether abortion should or shouldn’t be in health care reform. But if one believes that health care reform ought to be “neutral” — i.e. pretty much apply the terms of the current legislative stalemate — then there’s another way of doing it that makes things much less ambiguous.
Congress could decree that the basic public insurance option doesn’t include abortion but then offer consumers the ability to buy, with their own money, a rider to the policy that would cover abortions. Then the full direct cost of abortion coverage would carried by the consumer who chooses it.

Comments read comments(7)
post a comment

posted August 7, 2009 at 2:09 am

Congress could decree that the basic public insurance option doesn’t include abortion but then offer consumers the ability to buy, with their own money, a rider to the policy that would cover abortions. Then the full direct cost of abortion coverage would carried by the consumer who chooses it.
This is probably the only option that will make pro-lifers happy. This concept does not completely remove the question of proportionate cooperation with abortion. But I suspect many in the strictly pro-life community suspect that they will eventually pay for abortions anyway, even with a rider system, given that not all women will be able to afford the rider or similar plan. Pro-lifers would rather contend with the system we have now rather than have even the slightest risk of grand-scale public funding of abortion. But the irony is that some private insurers do cover abortion, so in all integrity pro-lifers who hold such private insurance should cancel it and/or also challenge private insurers who will pay for abortion. There’s another knot in the system.

report abuse


posted August 7, 2009 at 11:09 am

It’s true that Medicaid doesn’t pay for abortions, nor does TriCare (the military health system.) I’m not sure about Medicare–since most of the people it covers are past the age where abortion is an issue, it’s easy to lose sight of the fact that some Medicare recipients are people under 65 with disabilities. Not sure how the Hyde Amendment impacts them.
But I suspect that none of the people working on formulating health plans now want to deal with that issue. It’s as much of a poison pill to the health care reform process as Jerusalem is to the Middle East peace process, and gets treated pretty much the same way.

report abuse


posted August 7, 2009 at 3:54 pm

Thank you for this article. You did a wonderful job explaining the fine lines of funding.

report abuse


posted August 7, 2009 at 5:47 pm

The Blue Cross/Blue Shield health insurance plan for federal employees states:
“Not covered:
• Procedures, services, drugs, and supplies related to abortions except when the life of the mother would be endangered if the fetus were carried to term or when the pregnancy is the result of an act of rape or
I do not understand why the exception for rape or incest is acceptable for pro-life individuals. A life is a life.

report abuse


posted August 8, 2009 at 10:52 am

You are right a life is a life. Abortion should not be covered unless it is done to save the life of the mother and this happens less than 1% of all pregnancies. Today both lives can be saved.

report abuse


posted August 9, 2009 at 10:23 am

False witness is still a sin, at least in my version of the Bible.
Pity, the christianists around here have cherry-picked this commandment out of their versions. Maybe they needed room to add the word ‘homosexual’.
Regardless of whether we get single-payer, public-option or purely private insurance, there has to be a means for women who need an abortion to have one safely.
Instead of pretending they are pro-life, the hateful, spiteful conservative Christians should better name themselves: Anti-woman’s-choice.
I plead for the direct inclusion of provisions to provide free contraception and free education in human sexuality, including contraception into all insurance plans. Educated people who have access to birth control methods don’t need to get abortions except for rape and medical emergencies.

report abuse

Your Name

posted August 15, 2009 at 11:44 pm

Not only will it cover abortion, it will cover sex change operations for all (including children), and invitro-firtilization for un-wed teens, such is the case in the UK system which is the model letfists worship.

report abuse

Post a Comment

By submitting these comments, I agree to the terms of service, rules of conduct and privacy policy (the "agreements"). I understand and agree that any content I post is licensed to and may be used by in accordance with the agreements.

Previous Posts

More Blogs To Enjoy!
Thank you for visiting this page. This blog is no longer being updated. Please enjoy the archives. Here are some other blogs you may also enjoy: Top Religious News Most Recent Inspiration Post Happy Reading! ...

posted 6:00:22pm Apr. 20, 2012 | read full post »

Good Bye
Today is my last day at Beliefnet (which I co-founded in 1999). The swirling emotions: sadness, relief, love, humility, pride, anxiety. But mostly deep, deep gratitude. How many people get to come up with an idea and have rich people invest ...

posted 8:37:24am Nov. 20, 2009 | read full post »

"Steven Waldman Named To Lead Commission Effort on Future of Media In a Changing Technological Landscape" (FCC Press Release)
STEVEN WALDMAN NAMED TO LEAD COMMISSION EFFORT ON FUTURE OF MEDIA IN A CHANGING TECHNOLOGICAL LANDSCAPE FCC chairman Julius Genachowski announced today the appointment of Steven Waldman, a highly respected internet entrepreneur and journalist, ...

posted 11:46:42am Oct. 29, 2009 | read full post »

My Big News
Dear Readers, This is the most difficult (and surreal) post I've had to write. I'm leaving Beliefnet, the company I co-founded in 1999. In mid November, I'll be stepping down as President and Editor in Chief to lead a project on the future of ...

posted 1:10:11pm Oct. 28, 2009 | read full post »

"Beliefnet Co-Founder and Editor-in-Chief Steps Down to Lead FCC Future of the Media Initiative" (Beliefnet Press Release)
October 28, 2009 BELIEFNET CO-FOUNDER AND EDITOR-IN-CHIEF STEPS DOWN TO LEAD FCC FUTURE OF THE MEDIA INITIATIVE New York, NY - October 28, 2009 - Beliefnet, the leading online community for inspiration and faith, announced today that Steven ...

posted 1:05:43pm Oct. 28, 2009 | read full post »


Report as Inappropriate

You are reporting this content because it violates the Terms of Service.

All reported content is logged for investigation.