Abortion funding fallacy

Since the Supreme Court’s ruling in Roe vs. Wade, every federal health insurance program has become enmeshed in the debate over federal funding for abortion. This year’s efforts to reform the healthcare system have triggered a new tussle, with opponents of abortion claiming that the proposals would change the long-standing policy against using federal tax dollars to terminate pregnancies. But the provision that antiabortion groups find so objectionable would actually have the opposite effect, forcing private insurers to go further to fund and account for abortion coverage separately from federally subsidized services.

U.S. law bars federal Medicaid dollars from being used to pay for abortions except when the pregnancies result from rape or incest or threaten the mother’s life. It also prohibits insurance plans for military personnel, federal employees and lower-income children from covering abortion. This page has opposed these rules because they deter poor women from obtaining the constitutionally protected medical care available to women with means. Legislators in California and about a dozen other states agree, and they provide funding for elective abortions with their own states’ Medicaid contributions.

Rep. Lois Capps (D-Santa Barbara) has proposed a variation of that approach for the healthcare reform bill, restricting how federal dollars are used but not private ones. The House version of the reform bill would require everyone to carry insurance while providing subsidies for low-income workers who don’t have access to coverage on the job. It also would establish an insurance “exchange” in which uninsured individuals and small businesses could buy policies. Capps’ amendment, which the House Energy and Commerce Committee approved by a narrow margin, would prohibit the basic plans offered through the exchange from covering elective abortions. It also would bar federal subsidies from being used to pay for elective abortions in optional plans, but it would allow those who receive subsidies to buy such coverage with their own money.

Abortion opponents argue that Capps’ proposal is an artfully worded ruse to enable the proposed “public option” -- one of the plans available through the new exchange -- to cover abortion. But any abortion coverage offered by the public plan would have to be purchased with private funds. Her amendment also would require insurers to segregate the premiums for abortion coverage from other services, and would require the new exchanges to offer at least one plan that does not cover elective abortions at all -- a degree of choice that abortion opponents may not have today. The Capps amendment isn’t a nefarious plan to promote abortions. It’s a reasonable compromise.