By the time you see this, the fate of the Democrats' health-care legislation will probably have been decided. The House of Representatives plans to vote on the Senate bill a few days after we go to press. Whatever the outcome, one thing is already certain: the debate over the bill has left a deep rift—and not only between the two major parties.
Prominent representatives of the prolife community, including the Secretariat of Pro-Life Activities for the United States Conference of Catholic Bishops and the National Right to Life Committee, have rejected the Senate bill, claiming that it allows direct federal funding of elective abortion. Meanwhile, Catholic supporters of the bill, including the Catholic Health Association, have said that it does not. One needs a good reason to oppose a bill that would cover 30 million uninsured Americans and greatly improve insurance for those who already have it. If the Senate bill did clearly authorize the federal government to pay for elective abortions, prolife Americans might have such a reason. To conclude the bill does this, however, requires one to believe that every ambiguity—every possible complication the bill doesn’t explicitly address—is a ploy by prochoice politicians to sneak abortion funding into the system. President Barack Obama and his party’s leadership have promised the bill won’t be used in this way. Their critics instruct us to presume that they’re lying.
These critics point out that the bill departs from the Hyde Amendment’s ban on federal support for any health plan that covers elective abortion. They insist this is the only conceivable way for the government to subsidize insurance without paying for abortion. This is false, as the Senate bill itself clearly demonstrates. Under the bill, anyone who buys a plan that covers elective abortion would have to pay a separate, unsubsidized premium for that coverage. Such premiums would be segregated from premiums for all other services in a special account, which would have to cover the full cost of elective abortions and couldn’t receive a penny from the government. In other words, the bill would preserve the Hyde Amendment’s principle without applying its method.
Critics also claim that the money the bill appropriates for community health centers is not subject to the Hyde Amendment. No doubt the bill would be strengthened with the addition of language that clearly imposes the Hyde rule on any federal money given to health centers. But since such money will in any case be channeled through the Department of Health and Human Services (HHS), where the Hyde Amendment obtains, there is no good reason to suppose that it will be exempt from the amendment’s constraints. Besides, if HHS really could spend any part of the new funding on elective abortions, it wouldn’t matter that the Hyde Amendment keeps it from using the rest of its money for this purpose: as the bill’s critics never tire of telling us, money is fungible—the Hyde Amendment works only if it covers everything HHS spends. It’s also worth mentioning that none of the existing health centers, which provide care to one in eight children born in the United States, has ever offered abortion services.
Many of the bill’s most prominent critics are lobbyists, and for the purposes of lobbying, a plausible falsehood is often as useful as the truth. But crying wolf is always a dangerous game. If prolife groups raise false alarms to bully politicians and scare up donations, they risk being ignored when a real threat arises. Some of the same groups that are now loudly predicting disaster if health-care reform passes warned that the Freedom of Choice Act (FOCA) was sure to be passed and signed into law if Barack Obama was elected president. People remember these predictions, and eventually they stop paying attention. If the Senate bill does not pass, conservative lobbying groups, most of which are opposed to reform for other reasons, and the bishops conference, which supports reform in theory, will bear some responsibility for it.
If one wants to claim that no politician who’s really opposed to abortion can support the Senate bill, it’s not enough to show that the bill’s provisions are inferior to the House’s Stupak Amendment; one must also argue that the Senate bill is inferior to the status quo. The government is already subsidizing group plans that cover elective abortion by means of tax breaks for businesses that offer them. Millions of Americans must now choose between accepting such a plan and going without good health insurance; the only other option, a decent individual plan, is now just too expensive for them. The Senate bill would give such people the wherewithal to buy insurance that doesn’t cover elective abortion, which means that, in addition to its many other benefits, it would save millions of Americans from having to choose between their conscience and their health.