Abortion rights have been sold out for health care reform.
House Speaker Nancy Pelosi couldn't round up enough votes for her party's health care bill without pro-life Democrats. So on Friday night, she agreed to let the House vote on an amendment to restrict abortion coverage under subsidized insurance plans. Everybody knew the amendment would pass. To get the bill through, Pelosi traded away abortion.
Naral Pro-Choice America is furious. It points out that more than 85 percent of private health insurance plans cover abortion. By forbidding such plans from competing in the new, lucrative federally supervised insurance exchanges, the bill would force them to drop abortion coverage. This would eliminate such coverage even for policyholders who pay their own way—"a radical departure from the status quo," the group complains.
The Planned Parenthood Federation of America seems even angrier. On Saturday, it announced its opposition to the House bill. According to PPFA President Cecile Richards, the bill strips women of abortion coverage even "in the private health insurance market" and leaves them "worse off after health care reform than they are today, violating President Obama's promise to the American people that no one would be forced to lose her or his present coverage under health reform."
Welcome to socialism.
I don't mean to exaggerate the House and Senate bills. They don't nationalize medicine or set up a single-payer system. As socialism goes, they're modest. But they do mandate, standardize, and subsidize health insurance. They mix public with private. And when you do that, you invite public-sector problems into matters that used to be nobody's business.
One of these problems is that people don't like their tax money being used for procedures that offend them. You may think that's stupid. You may point out that your tax money is used for wars you don't like. But you don't have two or three dozen swing votes in the House. Pro-life Democrats do. They don't have the clout to ban abortion, but they have the clout to keep tax money from paying for it.
Until health care reform came along, this wasn't your problem. It was a problem for women who depended on public programs like Medicaid. But you wanted a better world. You wanted health insurance for everyone, and you wanted the government to help pay for it. Congratulations. You've brought the tax moralists into your life.
Pro-lifers say the health insurance abortion restriction, known as the Stupak amendment, is just an extension of the Medicaid abortion restriction, known as the Hyde amendment. Pro-choicers say the Stupak amendment is much more invasive. The pro-choicers are right. But pro-lifers didn't create that difference. Democrats did. By mixing public and private health care, they complicated the separation of taxation from abortion. If pro-lifers can't keep their money out of the insurance exchanges, they'll fight to keep the insurance exchanges out of abortion.
There's something poignant about the last-minute outrage of the pro-choice groups. The complaints they're leveling—that people had more choices in the private market, that the House bill radically upsets this market, and that it violates Obama's promise not to deprive anyone of their existing coverage—are hardly novel. Republicans have issued such warnings all year. But liberals didn't pay attention until the coverage in jeopardy was abortion.
I'm not saying we shouldn't socialize health insurance. I'm pretty comfortable with the House and Senate bills. But let's give up the two lies we tell ourselves about such legislation. One is that it won't cost us much money. The other is that it won't cost us much choice. When you throw in your lot with other people and agree to play by the same rules, you surrender some of your freedom and risk losing some of your options. Sometimes it's coverage of an MRI or a hip replacement. Sometimes it's coverage of abortion. If that's the price of health care reform, are you willing to pay it?