Reproductive health and the public option
by Thomas Dollar
The better part of this country’s political energy this summer has been consumed by the debate over health insurance reform. As one of the 47 million uninsured Americans, I have been following this debate quite closely—especially the contentious proposal to provide a public health insurance option. Opponents of the public option have employed a “kitchen sink” approach to defeating it, stoking people’s fears of death panels, rationing, and—the classic trump card—Socialism. This not being enough, opponents have tossed another controversial issue into the mix: abortion.
Since 1976, the Hyde Amendment (brainchild of the late Rep. Henry Hyde, famed adulterer, Clinton impeacher, and Savings and Loan profiteer) has banned Federal funding of abortions, except in cases of rape, incest and endangerment of the woman’s life. Most states also place these same restrictions on their own Medicaid funding. Still, most private health insurers cover comprehensive reproductive health care (in some states by law)—including abortions. If the public option is meant to be a meaningful alternative to private health insurance, it would have to offer the same medical coverage as private plans—including reproductive care. The public option would not be a Federally funded plan like Medicare. Like private plans, it would be funded through by employer contributions and insurance premiums. Not one dime of Federal money would go to pay for abortions (or anything else). Cecile Richards, President of Planned Parenthood, points out that “individuals who oppose abortion will not be forced to pay for abortion services.” The president has said the same.
So why do the falsehoods persist? In part it’s to add another poison pill to kill meaningful health insurance reform. But it also represents a larger shift among anti-abortion activists, who are increasingly targeting contraception and other non-abortion reproductive health care. Though the vast majority of Americans approves of contraception (even most of those who call themselves “pro-life”), coverage of birth control has come under attack. The Federal Deficit Reduction Act of 2005 already sent subsidized birth control to the chopping block (though this “budgetary oversight” has recently been corrected). Last fall, voters in Colorado defeated ballot initiatives that would have defined personhood under the state consitution—with all the rights and guarantees thereof—as beginning at the moment of conception. Unfazed by this defeat, its backers are pushing a similar initiative in Florida. This law would prohibit not only abortion, but the morning-after pill and the regular old Pill too. (Under a strict interpretation, it would also criminalize menstruation, as up to two-thirds of fertilized eggs never implant. One wonders how they intend to enforce this.) These initiatives blatantly conflict with the US Constitution (not to mention basic standards of reasonability), but are meant to erode reproductive health care with a barrage of attacks. Cutting reproductive health coverage out of a public insurance program would go one step further toward a health system that delegitimizes women’s health care as non-essential.
President Obama and pro-choice members of Congress face a great deal of pressure to make compromises to pass some sort of health insurance reform. But reform should not come at the expense of reproductive health care, and no compromise should be made to placate people who won’t vote for any reform bill anyway. The Planned Parenthood Action Center has more information on the different bills wending their way through Congress, and what you can do to help safeguard reproductive health care.
Whatever happens with health insurance reform, it won’t resolve the problem of the Hyde Amendment. Having legalized abortion is completely meaningless if women cannot access it. The Hyde Amendment establishes a two-tiered health system: freedom of choice for wealthy women with private insurance, tough luck for low-income women and women in the military. (As Justice Ginsburg noted last spring, women of means can always get an abortion if they want to—here and everywhere else.) Congress renews the Hyde Amendment every year, and pro-choice members of Congress have so far been unsuccessful in removing it from budget negotiations. But with a pro-choice president and majorities in both houses of Congress, there is hope for positive change. The proposed Freedom of Choice Act (FOCA) would overturn the so-called “Partial Birth Abortion Act” and codify Roe v. Wade into Federal law. Obama has expressed his support from FOCA, but so far the loudest voices on the issue have been in opposition.
I understand that some people object to their tax money being used to pay for abortions. I object to my tax money being used for lethal injections, cluster bombs, and subsidized logging in the Tongass National Forest. But individual taxpayers are not given a line-item veto over Federal appropriations. The Supreme Court has ruled that our Constitution’s guarantee of due process gives women the right to make fundamental decisions about their bodies. That right means nothing if it’s not backed up by a health care system—public and private—that covers reproductive care.