The US Catholic Bishops, major providers of health care in the United Sates, (and supporters of the ‘liberal’ bill proposals in Congress) have sent a letter to the Senate showing the hypocrisy of voting against amendments like Stupak/Nelson (sorry this is a bit long, but worth it):
The central argument against the Nelson amendment, voiced during floor debate by many
Senators, was that this amendment goes too far by barring federal subsidies to entire
health plans that include abortion coverage. The three-decades-long precedent of the
Hyde amendment and similar provisions governing all other federal health programs, it
was claimed, is this: Federal funds may not be used “directly” for an elective abortion,
but non-Federal funds such as private premium dollars may be used in the same health
plan for such abortions.1 The underlying health care reform bill was said to respect this
tradition by “segregating” funds with plans to allow “private” funding of abortion. It was
chiefly on the basis of this argument that the Nelson amendment was tabled
However, yesterday’s overwhelming vote to approve the Consolidated Appropriations
Act creates a new situation. In that vote, almost all Democrats, including almost
every Senator who claimed the Nelson amendment’s policy goes too far, voted in
favor of that exact policy. For these Senators voted to retain the actual current
language of the Hyde amendment, and of the parallel provision governing abortion in the
Federal Employees Health Benefits Program – and that language clearly requires a policy
in all other federal health programs that is identical to that of the Nelson amendment.
Here is the language of the Nelson amendment that Senators claimed was new and
1 No abortion provision at issue forbids funding abortions (or plans including abortion) when the mother’s life is endangered or in cases of rape or incest; these exceptions are not at issue and will not be included in quotes from the provisions. Abortions not covered by these exceptions are here called “elective” abortions.
2 No funds authorized or appropriated by this Act (or an amendment made by this Act) may be used to pay for any abortion or to cover any part of the costs of any health plan that includes coverage of abortion.
Here is the Hyde amendment, governing all current programs funded by the Labor/HHS
appropriations bill, which the Senate just voted to reaffirm:
None of the funds appropriated in this Act, and none of the funds in any trust
fund to which funds are appropriated in this Act, shall be expended for any
abortion…. None of the funds appropriated in this Act, and none of the funds in
any trust fund to which funds are appropriated in this Act, shall be expended for
health benefits coverage that includes coverage of abortion…. The term “health
benefits coverage” means the package of services covered by a managed care
provider or organization pursuant to a contract or other arrangement.
(H.R. 3288 as approved by the Senate on December 13, Division D, sec. 508;
The Hyde amendment states further that it does not prevent use of state, local or private
funds for abortions, as long as these are separate from the state matching funds that
combine with federal funds to purchase a benefits package. In other words, not only
federal funds, but other funds used to purchase the same package, may not pay for
Here is the parallel provision governing the Federal Employees Health Benefits Program,
which the Senate also approved yesterday:
No funds appropriated by this Act shall be available to pay for an abortion, or
the administrative expenses in connection with any health plan under the
Federal employees health benefits program which provides any benefits or
coverage for abortions.
(H.R. 3288 as approved by the Senate on December 13, Division C, sec. 613;
Neither of these longstanding provisions says anything about “segregating” private and
federal funds within a health plan or benefits package. Attempts to achieve such
segregation are irrelevant to current policy, which bars federal funds from being used for
any part of a package that covers elective abortions.
Literally the only substantive difference between these noncontroversial and widely
supported provisions and the Nelson amendment is that the latter explains at length that
(a) it does not prevent purchasers who do not receive federal subsidies from buying a
health plan including elective abortions, even on the Exchange created by the health care
reform bill, and (b) it does not prevent purchasers receiving federal subsidies from buying
separate supplemental abortion coverage with their own funds.
What this means substantively is that the democratic opposition to Stupak/Nelson-like amendments is a disingenuous political ploy. They really don’t have principled opposition, but rather this is the kind of public face they have to put forward to keep NARAL and Planned Parenthood happy. While frustrating, the fact that they really ultimately don’t care about the principle might make a ‘manager’s amendment’ which brought back this kind of language that much more likely to get through. Again, whether or not this happens–especially if Senators Nelson and Casey steel their spines and insist on it–will be a major turning point in the self-definition of the democratic party.
And it might be the basis of the only remaining problematic opposition to the bill as both the public option and medicare buy-in appear to be dead. More drama to come.