Archive for the ‘Healthcare Reform’ Category

Pro-Life Hero Bart Stupak to Forego a 10th Term

April 9, 2010

Democrat, and pro-life warrior, Bart Stupak has finally had enough.  Because his pro-life views led him to push for dramatic new restrictions on abortion funding (and dramatically more support for pregnant women), along with getting 31 million vulnerable people health insurance, he was facing both a primary challenge from the ‘liberal’ side and tea party fire from the ‘conservative’ side.  All of this has caused him to do something he had been contemplating for awhile: retire.

The full effect the pro-life assault he led from the heart of the democratic party–connecting the issues of respect for the dignity of the vulnerable human fetus with respect for those vulnerable persons without health care–will take generations to measure.   It goes far beyond the substantial legislative victories he helped win; he almost single-handedly put a magenta consistent-ethic-of-life argument out there in the mainstream media for all to see.  He forced millions to confront the intellectual incoherency of a position which picks and chooses which vulnerable populations deserve government protection.  The movement he created will force millions more to do the same.

God bless you Bart.  You’ve earned your rest.

Health Care Reform: A Pro-Choice Victory?

April 1, 2010

There has been a lot of talk from conservatives, claiming to be pro-life, that health care reform is a pro-choice victory.  I’ve already outlined at length on this blog how this is false and that such persons were almost always against the bill regardless of what abortion language was used.  (What a shame that they used pro-life considerations as a pawn in a battle over something else.  But what else is new, right?)

But now that health care reform has passed, the disaffected pro-abortion rights crowd is making their displeasure that much more public. The whole article from ‘The Nation’ is worth reading, but here are some excerpts:

The months of debate and politicking around the healthcare overhaul provided a glimpse of the political strength of the prochoice movement that hasn’t been possible for years. The picture that emerged wasn’t pretty, as supporters of choice found that they don’t have the influence many assumed they did. Almost as soon as the reform process began, abortion rights became a bargaining chip. And after the frenzied horse-trading that finally produced a law, women across the country were left with less access to the procedure and a seriously weakened power base from which to protect and advocate for abortion rights.  “It’s an enormous setback,” says Laurie Rubiner, vice president for public policy for the Planned Parenthood Federation of America.

In order to win the support of antichoice Democrats and save the bill, the Obama administration embraced the principle of Hyde, signing into law a bill that, in the words of Planned Parenthood president Cecile Richards, “goes far beyond current law by placing unreasonable burdens on those who want to either offer or purchase private health insurance coverage for abortion.” Desperate to keep healthcare reform alive, even prochoice groups found themselves defending the public-funding ban they so despised. “The most damaging thing about healthcare reform is that even our prochoice leadership has been, through no fault of their own, reinforcing Hyde,” says Laura MacCleery, director of government relations and communications for the Center for Reproductive Rights.

The compromise on abortion coverage that became law was only slightly less odious than the Stupak Amendment, which, to the horror of prochoicers, passed the House in a 240-194 vote on November 7, and would have prevented any health plan that receives federal money from paying for abortions. Politically, the Stupak vote laid bare the fact that there simply aren’t enough people willing to go to bat for abortion in Congress. The resounding vote count, coming late on a Saturday evening after hours of back-room scheming, was no surprise to Washington insiders on both sides of the issue. They already knew what would soon become plain to everyone else: a Democratic majority is not the same as a prochoice majority.

What a remarkable statement!   And for those of you who think the language of the Senate bill is ‘pro-abortion’ (full disclosure: I plead guilty to having a misinformed opinion about it at first), please take a look at this reaction:

As the final vote neared, prochoice Senators Barbara Boxer and Patty Murray worked hard to keep Stupak-like language completely banning abortion coverage out of the bill, but they couldn’t even make a show of being able to stop Nelson. Around this time, Scott Brown had won the special election in Massachusetts, dispensing with the Democrats’ supermajority and putting the fate of healthcare reform in serious jeopardy. Though the major advocacy groups raised strong objections to the Nelson language–Planned Parenthood called it “offensive,” NARAL Pro-Choice America called it “outrageous” and “unacceptable”–neither advised voting against the bill.

Now, of course, the Nelson Amendment is law. And unless it is mitigated or eliminated through the regulatory process (a possibility that policy experts and lawyers are delving into), it will definitely create hassles for both women and insurers and will probably result in some health plans dropping abortion coverage altogether. Politically, it will likely create a new platform for antiabortion groups, which are expected to push state legislators to ban abortion coverage offered in their state-level exchanges (existing policies outside the exchanges would not be affected).

And, yes, the key now is where we all go from here.  Some in the pro-abortion rights crowd hope that, “The real policy setbacks of healthcare reform could also serve as the wake-up call for women that prochoicers need.”  But the pro-lifer who still thinks that the health care reform bill was a pro-choice victory, and that its passage is somehow evidence that they don’t need ‘fake’ or ‘insincere’ Democrat pro-lifers like Bart Stupak, needs a wake up call of their own.  This country has gotten more liberal even as it has gotten more pro-life.  The big tent approach to the pro-life movement is working.  Let’s continue to press forward together.

A Pro-Life Victory

March 22, 2010

The passage of health care reform (something which, incidentally, I don’t think I’ve fully processed yet) is, on multiple levels, a pro-life victory.   The dozens of millions of vulnerable persons who have little to no hope in their illness will be brought into the community of persons provided for by our health care system.  It doesn’t get more pro-life than that.

And mostly due to the heroic efforts of pro-life democrats like Bart Stupak this bill is a pro-life victory on the abortion front as well.  As I’ve mentioned several times before on this blog, even the original House bill (which the US Bishops supported) funded abortions, so what was left was jockeying for political and legislative points to make it as baby-friendly as possible.   What the pro-lifers got out of this battle was simply extraordinary: not only the Senate bill’s abortion language (which was actually not bad at all), but a public executive order–full of pro-life language stigmatizing abortion as something other than ‘normal’ health care–that has not only powerful symbolic force but also the bite of actual public policy:

The fact is, this is a very big deal.  Although the Hyde Amendment is repeatedly renewed, it is not a law on the books per se.  It must be renewed each year as part of the budget.  This means that every year we have the opportunity to get rid of it (although we have as yet been unsuccessful).  An executive order, in contrast, would put these provisions on the books until it is rescinded.  It is much harder to rescind an executive order than to change language that must be inserted in the budget yearly.  Really, what president would stick his neck out for the 1/3 of women who will need abortions?  If we are to be guided by history, nobody.

What the whole health care reform process symbolized and demonstrated is a larger movement away from our old categories and toward a consistent ethic of life.  Those on the extremes–who either (1) want to see abortion treated similarly to any other kind of medical procedure, or (2) make anti-abortion arguments while rejecting broader concern for the vulnerable (characterized perfectly by the republican who called Bart Stupak a ‘baby killer’ on the House floor yesterday)–are being pushed to the margins.

The complex, magenta reality is finally starting to push through.  And it’s about time.

Pelosi’s Moment of Truth

March 20, 2010

I’ve been highlighting the choice that democrats, largely in the person of Nancy Pelosi, have to make in the health care debate: will she sell out to abortion-rights extremists who want to see abortion like any other kind of health care and risk killing health care reform?

Well, it looks as if the President and Pelosi had worked out a deal to give Stupak a manager’s amendment to get his preferred language…and it was likely to pass given republican support.  However, this is what appears to have happened:

The publication of the amendment triggered a flurry of activity within the pro-choice community, who began hammering their own leadership, who in turn put pressure on members of the pro-choice caucus as well as Pelosi herself. Although NARAL’s Nancy Keenan had not planned to oppose the measure, outrage from within her own ranks caused her to speak out.

According to the source (and with no small amount of irony), “Nancy Pelosi finally grew balls.”

Pelosi had wanted the pro-choice caucus to accept a deal whereby after the House voted to pass the health care bill with the Senate’s Nelson language, Stupak would get a stand-alone vote that could pass with the help of anti-choice Republicans.

Members of the pro-choice caucus felt that Nancy had “sold us out,” according to one member. “She is just going along with whatever the boys in the White House tell her to do.”

This sell out to pro-abortion rights extremists might be the death knell of health care reform:

As Dave Dayen notes in his whip count, even if Pelosi gets every other uncommitted vote, she still needs to crack the Stupak block to get to 216.

Abortion and Health Care Reform: Wading Through the Complexity

March 6, 2010

Like most conflicts that have very smart people on multiple sides of the argument, the debate over abortion and health care reform is complicated.  But here is one thing we now know: the final act of the health care debate will come down to how this argument plays out.  Indeed, Politico reported yesterday that Nancy Pelosi has invited several woman’s groups to a strategy meeting to figure out how to approach the very real final problem they face: overcoming the twelve+ pro-life democrats who, though they voted for the House bill, are not expected to vote for the Senate bill.

But those who wish to see the strongest language possible prohibiting our money from going to subsidize abortions need to be honest about something.  Many of the premiums we pay into our own private health care insurance company go to pay for others’ abortions.  Many of the taxes we pay go to state medicaid programs which cover abortions.  Indeed the Roman Catholic Church, which considers abortion even in the case of rape to be an intrinsic evil, strongly supports the House health care reform bill–a bill which uses taxpayer money to subsidize abortion in the case of rape.  What we need to be honest about, then, is that this is not some ultra-principled, never-say-die, fight.  This is an important political calculation.  The U.S. Bishops, along with many of those who are rightly object to our tax dollars going to fund abortion and yet support the House bill, are apparently willing to make the calculation that the good of health care reform outweighs the evil of having some abortions federally subsidized.

But many believe that such a calculation nevertheless involves making absolutely clear that no abortions done for reasons of mere birth control should be covered in a federally managed and subsidized health care insurance exchange.  That’s their line in sand.  They therefore support the House bill which explicitly mandates this over the Senate bill which does not.   Nevertheless, many like Timothy Noah over at Slate assure them that ‘the Senate bill doesn’t fund abortions’ and:

What really rankles Stupak (and the bishops) isn’t that the Senate bill commits taxpayer dollars to funding abortion. Rather, it’s that the Senate bill commits taxpayer dollars to people who buy private insurance policies that happen to cover abortion at nominal cost to the purchaser (even the poorest of the poor can spare $1 a month) and no cost at all to the insurer. Stupak and the bishops don’t have a beef with government spending. They have a beef with market economics.

But this just is government funding of abortion.  If I buy a health insurance policy with the expressed desire to have abortion as part of my coverage, and the government says, “Sure, go ahead…we’ll even help you with your payments in such a policy…but we’ll require you to send a separate check to fund your abortion coverage,” is this really anything more than an accounting trick?   Indeed, it seems that even pro-choice leaders have described it as such:

In January, Senator Barbara Boxer (D-Ca.), a pro-abortion leader in the Senate, assured McClatchy News Service that the abortion surcharge requirement is only an “accounting procedure,” and DHHS Secretary Kathleen Sebelius also assured pro-abortion listeners that the Nelson language was of no consequence.  Yet today, in an effort to entice pro-life Democrats in the House to vote for the bill, the White House and Democratic leaders are working on “convincing as many as a dozen antiabortion Democrats in the House that abortion language in the Senate bill is more stringent than initially portrayed,” according to a report in the March 5 Washington Post.

The bottom line is that if the Senate bill is passed, for the first time ever we will have (multiple)  federal government managed and subsidized insurance companies offering birth control abortions.  This is what those who want the House bill don’t want to see.  But even even if they are wrong about that (and I think that good people can disagree) the Senate bill funds abortion in multiple other ways that the House bill does not.  Here are just two examples:

The Senate bill would reauthorize all federal Indian health programs, without including language to prohibit funding of elective abortion, even though such an amendment (the Vitter Amendment, similar to the Stupak Amendment) was approved by the Senate when it last considered Indian health legislation on February 26, 2008.   There is a clause in the Senate health bill [Sec. 10221, pp. 2175-2176] that has been misrepresented as an abortion restriction, but it actually contains no policy standard on abortion funding — it merely “punts” the question to the annual appropriations process, an unacceptable approachA vote for the Senate bill is a vote to open the door to future federal funding of abortion on demand through all Indian health programs.

The Senate bill, due to a last-minute amendment, provides $7 billion for the nation’s 1,250 Community Health Centers (CHCs), without any restriction whatever on the use of these federal funds to pay directly for abortion on demand.  (These funds are both authorized and appropriated by the bill, and thus would be untouched by the “Hyde Amendment” that currently covers Medicaid funds that flow through the annual Health and Human Services appropriations bill.)  Two pro-abortion groups, the Reproductive Health Access Project and the Abortion Access Project, are already actively campaigning for Community Health Centers to perform elective abortions.  In short, the Senate bill would allow direct federal funding of abortion on demand through Community Health Centers.

But those who want the House bill  instead of this (and, in my view, rightly so) have a major problem.  The way that health care reform will be passed, if at all, is by the House passing the Senate bill–and then using budget reconciliation to pass amendments that will appease a simple majority of House members.  Unfortunately, though this isn’t totally clear (and the we are learning just how much power the parliamentarian of the House and Senate has in this process in determining this), Stupak’s abortion amendment to the House bill  appears not to fall under the budgetary procedure that would make it open to being inserted into the final bill via reconciliation.  If so, and Pelosi cannot get 12+ new votes for the bill to balance the democrat pro-lifers who want Stupak language (an unlikely prospect to be sure), then the only way to do this would be to have the Senate pass the House bill and then do reconciliation (an even more unlikely prospect).

But I think I’ve actually changed my mind about this.

I’m glad Stupak and company are doing what they are doing, and I think they should continue to try to force the issue to get what is clearly the better abortion language, but if it comes down to passing health care reform or not I think the duty we have to the dozens of millions without health insurance trumps the abortion coverage difference between the two bills.  Remember, we are already simply playing for political points here and not standing by principle: every single supporter of the House bill is willing to support subsidized abortion in some form already.  Would the Senate bill be that much worse?  I think that the ‘separate check’ strategy, though clearly not stopping federal support of abortion, sends a wonderfully symbolic message that we as a country do not put birth control abortions in the same category as the rest of medicine.  Everyone who takes the time to write a separate check to get birth control abortion coverage will get this message.   Indeed, this is a message which upsets all the right pro-abortion rights groups.

Public policy is a teacher…and this is about as important as a lesson gets.

Abortion and Health Care Reform: What’s Past is Prologue

March 4, 2010

If it feels like we’ve been here before, its because we have:

A dozen House of Representatives Democrats opposed to abortion are willing to kill President Barack Obama’s healthcare reform plan unless it satisfies their demand for language barring the procedure, Representative Bart Stupak said on Thursday.

“Yes. We’re prepared to take responsibility,” Stupak said on ABC’s “Good Morning America” when asked if he and his 11 Democratic allies were willing to accept the consequences for bringing down healthcare reform over abortion.

“Let’s face it. I want to see healthcare. But we’re not going to bypass the principles of belief that we feel strongly about,” he said.

We’ve been back and forth on the arguments surrounding this complicated set of issues pretty thoroughly on this blog, but let’s just pause for a minute to think again about how extraordinary this situation is.  Pro-Life democrats now hold the power to derail health care reform in their hands and, apparently, are willing to stick to their principles.  The broader democratic party–and the Obama administration–have a question to answer: are they going to let health care die in order to pacify members of their party who not only want to see abortion as a privacy right, but as something that can be covered in a federally managed and subsidized insurance exchange?

The decision they reach will impact not only health care reform (a monstrous issue in itself), but also the very identity of their party.  Will they retreat toward being the party of Planned Parenthood and NARAL, or will they continue to move in the direction of Bob Casey and Bart Stupak?   That is, in the direction of those that want to protect both the very young and those without health insurance?

That is, in the direction of a consistent ethic of life.

Health Care Reform is in Serious Trouble

January 11, 2010

Sadly, I come home to find that Health Care Reform is one special election (ironically, it is that which would replace Senator Kennedy) from being derailed.  The story is all over the news, but here’s this from Talking Points Memo:

The new survey of Massachusetts by Public Policy Polling (D) sends a very alarming message to Democrats: Due to a fall in interest by Democratic voters, the race for the late Ted Kennedy’s Senate seat is a toss-up, and Republican Scott Brown even has a one-point edge over Democrat Martha Coakley.

The numbers: Brown 48%, Coakley 47%, with a ±3.6% margin of error. The election will be held on January 19. Independent candidate Joe Kennedy, a libertarian who is not related to the famous Kennedy family, was not included in the poll. If Brown were to pick up this seat in Democratic Massachusetts, it would surely spell the end of the health care bill — Brown has made it very clear that he would use his power as the 41st Republican Senator to stop the bill.

In addition, the New York Times did a recent profile on the pro-life democrat Bart Stupak in which he claims, including himself, to have 11-12 votes against Health Care Reform in the House unless it has his abortion-language.   And if the health bill doesn’t pass (given that it only passed by three votes in the first place, it is looking less and less likely given that several other pro-abortion rights dems have said they won’t vote for reform if it has such language), he said:

“It’s not the end of the world if it goes down,” he said over dinner. He did not sound downbeat about the prospect of being blamed for blocking the long-sought goal of President Obama and a chain of presidents and legislators before him. “Then you get the message,” he continued. “Fix the abortion language and bring the bill back.”

Alarmingly, it is looking more and more like health care reform failure is a real possibility.   Being unwilling to substantially (and magently) compromise with the opposing party (even on common sense things like tort reform and buying of private insurance across state lines)–or even one’s own pro-life democrats–has a real chance of killing the whole thing.

And if it does, the red/blue-state wars will have claimed another 30-some-million victims.

Health Care Reform on the Brink: Stupak Takes Off the Gloves

December 22, 2009

Well, we’ve been waiting to hear from him, and now he tells us in no uncertain terms:

Rep. Stupak: “So we’re getting a lot of pressure not to say anything, to try to compromise this principle or belief, and we’re just not – that’s just not us, I mean, we’re not going to do that. Members who voted for the Stupak language in the House – especially the Democrats, 64 Democrats that voted for it – feel very strongly about it. It’s been part of who we are, part of our make up. It’s the principle belief that we have. We are not just going to abandon it in the name of health care.”

CNSNews.com: “So, to go back and ask you again, do you have the votes needed to stop the bill, if it comes to that?”

Rep. Stupak: “Well, if all the issues are resolved and we’re down to the pro-life view or, I should say, no public funding for abortion, there’s at least 10 to 12 members who have said repeatedly, unless this language is fixed and current law is maintained and no public funding for abortion, they’re not gonna’  vote for the bill. There’s 10 or 12 of us — they only passed the bill by 3 votes, so they’re going to be short 8 to 9, maybe 6 to 8 votes. So they do not have the votes to pass it in the House.”

He has now said it publicly.  He and several other pro-life democrats are prepared to kill health care reform in order to make sure no federally administered and subsidized insurance  exchange provides abortion coverage.  Is the party itself ready to kill health care reform–and essentially fall on its own political sword–to make NARAL and Planned Parenthood happy?  Who are the democrats and will they get on the side of a consistent ethic of life as public opinion shifts in that direction?

Given the push to get the bill passed by the President’s State of the Union speech in late January, the coming weeks will be interesting indeed!

Health Care: the Final Battle

December 22, 2009

So here we are…the final stage.  Positioning has already started for the conference committee to reconcile the House bill and the coming Senate bill.   At this point there appears to be three areas of concern–let’s deal with each in turn.

1.  Financing.  For how will the bill be paid?  The House bill increases taxes on persons in the upper tax brackets, while the Senate bill taxes those with very good health care plans.  The former makes conservatives upset while the latter makes some liberals upset–especially given that many unions have negotiated for precisely the kinds of plans that would be taxed.  However, this is not the kind of issue that will hold back the bill–and I wonder if the Senate actually did this to use as a bargaining chip on which to compromise in conference committee to get what they really want.

2.  The public option or expanded medicare buy-in.  The House bill has it, but the Senate bill does not.  Senators on both sides said they wouldn’t vote for it with/without one…but, one side flipped-floped on this issue and the other didn’t…so we clearly see for which side it means more.  In addition, Obama himself will be a negotiating member of the conference committee and for several months now his support for the public option has been lukewarm at best–just yesterday calling it ‘symbolic.’

3.  Abortion.  This is the big one.  Pro-life groups like National Right to Life and the more influential (because, unlike other pro-life organizations, they actually want to see the bill passed) US Catholic Bishops have pointed out that the Senate’s abortion language is unacceptable.  In addition to forcing the federal government to manage, and taxpayer money to subsidize, an insurance exchange which covers abortions, the Senate bill will require purchasers of such plans to pay a distinct fee or surcharge which is extracted solely to help pay for other people’s abortions. David Brody suggests that the Senate will be forced accept the House language on abortion because pro-life democrat Bart Stupak has enough determined fellow democratic pro-lifers who are willing to kill the bill over this, and the other side does not.

My prediction? I think the senate will compromise on how the bill is financed in order to remove the public option.  However, I think there will be blood on the floor over abortion language…but I hopefully predict that Stupak and company will steel their spines and force a bill that is comprehensively pro-life…something that will also signal the beginning of the end of the democratic party’s being beholden to the abortion-rights crowd.

Some wonder how a bill that is seemingly so unpopular could be passed.  Well, the honest answer is that so many democrats–including the President–are so convinced that covering the uninsured is a moral imperative that they are willing to sacrifice their futures to get it.  While this is something I very much admire, there is evidence that it might not be this dramatic.  For the reason the numbers keep falling is not because more people want less of this kind of reform, it is because they want it to go farther.  Good news for those of us who want to see those who cannot afford insurance and those who have preexisting conditions to get needed care.

“It Had All Come Down to Abortion”

December 20, 2009

Sadly, so many important and complex ethical issues today seem to be seen through the lens of the abortion wars (yet another reason it is so important to have discourse on this topic far, far differently than we currently do), and health care reform is another one of them.  It was not just a central issue, but THE issue down the stretch.  Indeed, as Politico reports, “It had all come down to abortion”:

After a break for lunch, Reid turned to abortion.  Nelson and Chief of Staff Tim Becker, who had flown in from Nebraska, set up shop in one room of Reid’s suite. Sen. Barbara Boxer (D-Calif.) and her aides settled into another wing with Sen. Patty Murray (D-Wash.), the two senators there to represent Democrats who favor abortion rights.  The opposing senators never spoke with each other or sat at the same table. They negotiated through Reid and Schumer.

Through the afternoon and early evening, they appeared deadlocked. Both sides, in consultation with advocacy groups, rejected various offers.  They couldn’t get beyond differences between the so-called Stupak amendment in the House bill, which would require women who receive federal subsidies for insurance to seek out a separate abortion rider, and a proposal by Sen. Bob Casey (D-Pa.) requiring policyholders to opt-out of abortion coverage. “I don’t know if we can do this,” Nelson said he told Reid at one point. “I’m running out of ideas.”

As he spent the day munching on almonds, peanuts and potato chips, Nelson said he eventually had what he described as a breakthrough. He turned over a piece of paper, and drew a line down the center.  “Why don’t we have two policies?” Nelson asked. “One with and one without.”  Nelson proposed that every state insurance exchange offer at least one plan that does not cover abortion, and policyholders could choose a plan with or without abortion coverage, unless states choose to ban it. Also, people who receive federal subsidies would need to write two separate checks as a way to ensure that none of the federal dollars went toward the abortion premium.

But this was not a new idea, and the pro-life groups who had supported Nelson (and had previously rejected similar ideas) were aghast.  As National Right to Life pointed out, “This seems to envision a system under which the OPM director would administer multi-state plans that cover elective abortions, and perhaps even possess authority to require such plans to cover elective abortions, as long as the director also ensured that there was one plan that did not cover abortions (except types of abortions also funded by the federal Medicaid program).”  The idea that the federal government would subsidize and manage (and perhaps require) health insurance companies that cover abortions is unprecedented, and Senator Nelson looks like a small time legislative sell out for this 11th hour move.

But with the senate vote likely to pass tonight, this sets up a huge and dramatic conference committee process between the House and Senate in the next couple weeks.  Pro-Life Democratic Representative Bark Stupak has already said that his pro-life democrat cohort will not support the Nelson compromise which means, if they are serious, the Senate bill cannot pass the House.  I know I’ve beat a dead horse on this blog already about this issue, but it is worth repeating again and again: the political winds have shifted; being liberal no longer means supporting abortion rights…and it certainly doesn’t mean supporting federal funding and managing of abortion.  Democrats now appear to have a huge choice to make: either pass a bill that will cover 30+ million of our most vulnerable citizens, end refusal of coverage based on preexisting conditions, and save billions of dollars in the long run–or reject the call of history and of their president and cave into the pro-abortion rights extremists of their party…leaving the bill to suffer a humiliating and unnecessary defeat.  If they choose the latter, they sacrifice not only those vulnerable uninsured counting on them to succeed, but also their political future and that of their president. If they choose the former, they get on the right side of history and score a huge victory for authentic reform.

Oh, and they go a long way to ending the horrifically destructive practice of viewing virtually every issue through the lens of the abortion wars.