Friday, March 4, 2011

The problem of abortion in health care -- and how to solve it

The following is written by Doug Johnson, Legislative Director at National Right to Life.

Innumerable polls show that the great majority of Americans reject the notion that abortion should be regarded as a routine part of "healthcare." For example, a 2010 Zogby/O'Leary poll found that 76 percent of Americans said that federal funds should never pay for abortion or should pay only to save the life of the mother.

Until the 2009-2010 Congress, federal law for the most part reflected this majority opinion. The Hyde Amendment, for example, annually prohibits any funds that flow through the Health and Human Services (HHS) appropriations bill from funding either abortions or managed care plans that cover abortion (except to save the life of the mother or in cases of rape and incest). Another example: For decades, the hundreds of private health plans that participate in the Federal Employees Health Benefits (FEHB) program have been prohibited from covering elective abortions.

During the 111th Congress, the House of Representatives initially acted to apply these same principles to legislation to restructure the healthcare system. In November, 2009, the House voted 240 to 194 in favor of the Stupak-Pitts Amendment, which would have prohibited federal subsidies for elective abortion in any component of the healthcare legislation.

Regrettably, the bill later muscled into law by President Obama, Speaker Pelosi and Senate Majority Leader Reid -- the "Patient Protection and Affordable Care Act" (PPACA) -- contained no such language. Instead, we find an array of abortion-expanding provisions, concealed behind a hodge-podge of artful exercises in misdirection, bookkeeping gimmicks, loopholes, and provisions that are rigged to expire.

President Obama tried to further cloak the abortion-expansive provisions of the bill with a hollow executive order -- a document that was dismissed by the president of Planned Parenthood as a "symbolic gesture."

Last July, while implementing the very first major component of the law, the Pre-Existing Condition Insurance Plan program, HHS happily approved state-submitted plans that explicitly covered elective abortions. When National Right to Life threw a spotlight on this development, the administration made a discretionary decision to exclude abortion from the program, although nothing in the PPACA prohibited such abortion coverage.

Laura Murphy of the American Civil Liberties Union said, "What is disappointing is that there is nothing in the law that requires the Obama administration to impose this broad and highly restrictive abortion ban." Nancy-Ann DeParle, the head of the White House Office of Health Reform, assured the pro-abortion activists that the discretionary decision to exclude abortion from the PCIP program "is not a precedent for other programs or policies" under the PPACA.

You can bet on that. The PPACA explicitly authorizes refundable "tax credits" (essentially, entitlement payments that are not related to actual tax liability) to purchase health plans that will cover all abortions -- a sharp break from the principles of the Hyde Amendment. The PPACA authorizes the Office of Personnel Management to administer "multi-state" plans that are implicitly authorized to cover elective abortions. The PPACA provides $9.5 billion in funding for community health centers, which pro-abortion activists have targeted as new abortion-providing sites, without any restriction on the use of these funds for abortion. And the list goes on.

These abortion-expansive provisions would be corrected by enactment of the Protect Life Act (H.R. 358), sponsored by Rep. Joe Pitts (R-Pa.). The bill is closely patterned on the Stupak-Pitts Amendment -- indeed, Prof. Sara Rosenbaum of the George Washington University School of Public Health, testifying against the bill, acknowledged, "I would say this bill would bring health reform into line with what originally was Stupak-Pitts."

The bill also contains important safeguards to prevent health care providers from being penalized for refusing to participate in providing abortions. Such protections are badly needed in the face of accelerating campaigns by groups such as the ACLU and the National Health Law Program to force individual and institutional healthcare providers to choose between providing abortions or abandoning the healing arts.

What is ultimately needed, however, is a clear, comprehensive, uniform policy to prevent federal subsidies for abortion. This would be provided by enactment of the No Taxpayer Funding for Abortion Act (H.R. 3), introduced by Rep. Chris Smith (R-NJ) and Dan Lipinski (D-Il.), currently with 208 cosponsors. The House Judiciary Committee will mark up H.R. 3 on March 3.

Opponents of these bills have frantically sought to manufacture diversionary issues, such as the claim that the Smith-Lipinski bill contains tax hikes (imaginary), or that the Pitts bill would somehow discourage insurers from covering treatments for injuries caused by abortions (utterly baseless). The core policies contained in these bills have already been in effect for decades for the FEHB program, Medicaid, the military and most other federal health programs, and experience belies the imaginative claims to the opponents.

During the initial congressional debates over federal funding of abortion during the 1970s, the pro-abortion side engaged in similar scare tactics -- claiming, for example, that the Hyde Amendment would result in a huge increase in abortion-related morbidity and mortality. Instead, there was no measurable increase at all -- but, as I noted in recent congressional testimony, another dramatic effect did occur: Well over one million Americans are alive today, who otherwise would have died in federally funded abortions.

According to the Guttmacher Institute, this is a "tragic result." But anyone who advocates "abortion reduction" -- a goal to which even President Obama has given lip service -- should embrace the Pitts and Smith-Lipinski bills to codify and extend the principles and the lifesaving effects of the Hyde Amendment.