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Category: Politics, Health, Reproductive Rights

Taking the Fall for Health Care Reform?

| November 9, 2009

The price for health care reform in the House is women’s right to choose—and, adding insult to injury, the deal was negotiated by the first woman to serve as House speaker.

Well, now it’s known: it was reproductive rights that were thrown under the train.

During last summer’s chaotic Town Hall meetings, feverish opponents to health care reform set off alarms by saying the proposals would force end-of-life decisions that would “throw grandma under the train.”

That was nonsense.

But it turns out that women’s reproductive rights were traded for votes of anti-abortion House Democrats in order to pass a health care reform bill Saturday night. It was a showdown shocker between the Catholic bishops and women’s rights—and the bishops won.

The House bill would provide the most sweeping expansion of federal prohibitions on abortion since 1976, when the Hyde Amendment was enacted that has since banned federal funds for abortion in the military, the Foreign Service, the Peace Corps, Medicaid and other federally connected health care services.

Under an amendment added by House members to the health care reform bill Saturday night, the Hyde Amendment would be applied to the entire health care bill—including provisions affecting the private sector—for the first time. This means that private insurance companies participating in the health care insurance exchanges would be prohibited from covering abortion, even if a woman pays for the coverage privately.

The first woman House speaker, Nancy Pelosi, a pro-choice Catholic with decades of experience in counting votes, made the deal.

She had not had the votes to pass health care reform, with virtually all Republicans opposing it, once more than two dozen anti-abortion Democrats said they also would oppose the final bill unless abortion bans were tightened substantially.

Months ago, Representative Lois Capps, D-CA, a nurse who helped shape many of the women’s health initiatives contained in the House bill, had shaped a compromise on abortion funding that had been accepted by all sides—it was assumed at the time.

Her amendment would have banned any federal funds from being used to pay for abortions by private insurers in the new health care exchange. Participating insurers could offer abortion coverage that women could buy with their own money. Since most of today’s health care policies cover abortion, that would have preserved current abortion coverage for millions of women, Capps said.

The Obama Administration backed that approach. Capps and other sponsors said the health care insurance exchange would include at least one insurance plan that permitted no coverage of abortion and at least one that did, with private money paying for abortion plans.

Fewer than two weeks ago, however, the U.S. Conference of Catholic Bishops said that was not acceptable and began spreading the word to grass roots Catholics to lobby House members to oppose health care reform unless anti-abortion bans were tightened. Only in recent days did they insist on applying the Hyde amendment to health care plans.

Proposals to do that, sponsored by Representatives Bart Stupak, D-MI, and Joe Pitts, R-PA, had been defeated in committees. Now, on the eve of the vote, the bishops and Stupak pushed to have the Hyde-expansion considered again—before the full House, as part of the debate on the overall health care bill.

For hours late Friday night, Pelosi tried to broker a compromise between Stupak and the House pro-choice leaders, including her usual allies, Representatives Rosa DeLauro, D-CT, and Diane DeGette, D-CO. They were outraged, emotional and ultimately broke off negotiations—but not before Pelosi ally George Miller, chairman of the House Education and Labor Committee, told the women that whether they liked it or not, the House was majority anti-abortion today, not pro-choice, according to

At that point, Pelosi had to choose to either let the health care bill go down in defeat or agree to the demands of the bishops and Stupak. She took the controversial move of giving the anti-abortion activists the green light for an up-or-down vote on the Stupak amendment.

That passed by a 240-194 vote, reinforcing Miller’s point. It got the votes of 64 of the 258 Democrats.

The House then passed health care reform by a five-vote margin, 220-215.

Many analysts praised Pelosi for her hard-nosed commitment to pass health care reform, even at the cost of alienating—to put it mildly—her pro-choice friends. They said she had shown she could make whatever deals were required to move ahead the most significant health care reform since the enactment of Medicare in 1965.

There is no question that the bill contains significant provisions that would disproportionately affect women’s health: barring insurers from refusing coverage for preexisting conditions such as cancer and putting in place many more preventive care programs.

But women’s rights activists were stunned at the unexpected coup by anti-abortion forces after more than 30 years of a legal standoff.

Pelosi’s victory statement that “no longer is being a woman a pre-existing condition” sounded tone deaf, at best, given the vote to accept the Stupak amendment.

Pro-choice House members were furious and said so.

DeLauro called abortion “a matter of conscience on both sides of the debate,” adding that the Stupak amendment takes away the “freedom of conscience from American women” and prohibits them from abortion coverage “even if they pay for it with their own money.”

Representative Barbara Lee, D-CA, said she had been reared in the Catholic Church and respected Stupak but called his amendment “simply outrageous” for inserting the church’s “religious views into our public policy….We’re a democracy, not a theocracy.”

Capps reiterated that her compromise would have barred federal funds from financing abortion “but that isn’t good enough for those who want to restrict abortion altogether.”

The Stupak amendment would block low-income women from any abortion coverage under health reform because they are likely to get federal credits to subsidize their insurance. But Representative DeGette said that by blocking “a legal medical procedure from all plans that are in the insurance exchange,” the impact will be much broader. “And let me tell you, it will affect the middle class.”

The Senate is nearing debate on its own version of health care reform. If it passes a bill, the differing House and Senate versions will have to be reconciled by a House-Senate conference.

Jubilant anti-abortion groups said they would push to put language similar to the Stupak amendment in any Senate bill.

Major women’s rights groups, meanwhile, began putting pressure on the White House while rallying their troops to protest the House-passed bill.

Terry O’Neill, newly elected president of the National Organization for Women, called on President Obama to refuse to sign any health care bill “that restricts women's access to affordable, quality reproductive health care.”

She noted that the Stupak amendment would prevent women receiving tax subsidies “from using their own money to purchase private insurance that covers abortion,” would block women participating in the insurance exchange run by private insurers “from using one hundred percent of their own money to purchase private insurance that covers abortion,” and would bar low-income women from getting access to abortion at all.

Nancy Northup, president of the Center for Reproductive Rights, called the House vote “a stunning assault on women’s health and rights.

In a matter of hours, our elected officials have fallen hook, line and sinker for the anti-choice position, dispensing with a credible compromise on abortion and adopting a bill that would leave millions of women worse off than they already are today.”

Planned Parenthood’s Cecile Richards called on Obama to live up to his campaign promise that health care reform would not take away any benefits. “Women won’t stand for legislation that takes away their current benefits and leaves them worse off after health care reform than they are today,” Richards said.