What the Heck is this New Abortion Debate?

I got a few questions regarding the abortion aspect of the healthcare bill from friends on both sides of the fence regarding this politically charged issue. While I normally avoid this subject like the freeway at rush hour or garlic on a date, I thought before we change the topic altogether I would break it down for you.

First let’s cover the basics so that we are all on the same page.

Abortion in America is a line in the sand issue for politicians and most of their constituents. For many Americans one’s abortion stance is the core issue which determines how they vote for those that represent them. One reason for this is that there is no compromise or middle ground. When it comes to abortion people believe one of two things (well maybe one of three). One is either pro-life and anti-abortion; or pro-choice and supports a woman’s right to choose abortion. The thirds stance, I suppose, would be abstaining from the debate altogether. Generally, conservatives or Republicans are pro-life while liberals or Democrats are pro-choice. There are many nuances and subcategories, such as those who support abortion in extreme circumstances such as rape, incest or when the pregnancy is threatening the life of the mother. For the most part this issue comes down to religious beliefs and women’s rights.

Now that we have that covered, let’s move a little further.

You may have heard of a little something called “Roe v. Wade.” This 1973 case was the landmark decision by the U.S. Supreme Court interpreting the U.S. Constitutional policy on abortion. This ruling by the Supreme Court, which has never been overturned (there have since been subsequent companion decisions), decided that abortion is legal but may be restricted by the states to varying degrees. Many states have passed laws to restrict late term abortions, require parental notification for minors, and mandate the disclosure of abortion risk information to patients prior to treatment.

Ok, we are almost to the healthcare bill, stay with me.

The federal Hyde Amendment, which passed in 1977, bans state use of federal Medicaid dollars (the government health insurance for low-income families, children, pregnant women, the elderly, and persons with disabilities) to pay for abortions unless the pregnancy is the result of rape or incest, or the abortion is "necessary to save the life of the woman." States can use their own funds to cover other medically necessary abortions, which are usually defined by states as those to protect the physical or mental health of the woman, for Medicaid recipients.

California is one of 17 states that fund all or most medically necessary abortions, exceeding the federal requirements. There are 32 states (as of January 1st, 2010) which follow the federal standard and fund only cases involving life endangerment, rape and incest.

Now let’s discuss the healthcare bill.

So why does the healthcare bill passed by the House Sunday evening seem to piss off both pro-life and pro-choice advocates?

As I mentioned yesterday, in order to amass the 216 votes needed to pass the measure before the House, the White House announced President Obama’s intention to issue an Executive Order promising restrictions, backed by enforcement, on federal funding of abortions. His Executive Order will enforce those same restrictions outlined above – no federal funding for abortions except in those extreme circumstances. In making this announcement, Obama managed to upset both the pro-choice proponents who more or less supported his campaign to the White House and the pro-life activists overwhelmingly opposed to aspects of the healthcare bill.

Why did he do this?

With the healthcare bill so close he could taste it Obama recognized the need to lure one of the most vocal opponents within his party, namely, Bart Stupaks an anti-abortion Democrat from Michigan serving in the House. And with the announcement of his Executive Order, Obama was able to accomplish just that, as Stupaks did end up supporting the bill. In doing so, Stupaks found himself in the middle of the controversy as he was heckled on the floor of the House by a U.S. congressmen who shouted “baby killer” at him. (Later,Texas Republican Representative Randy Neugebuaer came forward with an apology and clarified that he yelled ‘it’s a baby killer’ directed at the bill and not Stupaks).

So, why do conservatives oppose the bill with the promise to uphold federal policy?

First of all, Obama is a pro-choice Democrat and anti-abortion advocates do not trust he will not repeal his word.

Beyond that, the controversy has centered on whether the bill will use taxpayer funds to pay for abortions through subsidizing insurance policies that pay for the procedure and through funding federal health clinics that might offer abortions. If you recall from my explanation of the healthcare bill yesterday, while millions will be added to Medicaid those who still lack access to affordable coverage will receive tax benefits to buy their own insurance. Issuing tax credits is not, however, the same thing as expending tax payer funds - it is too close for comfort for many conservatives.

In addition to tax credits, many new government-funded marketplaces or insurances exchanges will be created for both businesses and individuals to buy insurance. Some view this as a place where the government could indirectly fund abortions, though language was added to the bill that those with policies that do not cover abortion must pay a small surcharge to keep the funds separate.

Lastly is the issue of community clinics which will receive around $7 billion under the bill. As Obama pointed out in his Executive Order, existing law prohibits the use of federal funding to provide abortion services, except in the instances mentioned in the Hyde Amendment (in the case of rape, incest or when the life of the woman is endangered).

So, how does this piss of pro-choice advocates?

Some women’s rights groups such as the National Organization for Women (NOW) were not happy with the President’s effort to “appease a handful of anti-choice Democrats who have held up healthcare reform in an effort to restrict women's access to abortion.” In other words, according to them, this is neither the time nor the place for this debate. While the bill only states the current policy, and Obama only offered assurance that he will enforce said policy, one can argue that essentially nothing has changed the status quo on the issue. Strong pro-choice advocates saw this as an opportunity for the President to move the status quo and expand abortion rights, which is why they are also angry with the bill.

Other groups, such as Planned Parenthood, do support the bill and even sent communications encouraging constituents (including a friend of mine) to write to their representative if they voted against the bill. The president of the organization stated that the Executive Order and the support of the anti-choice congressmen “diverted attention from the central goal of health care reform - controlling costs and extending coverage."

So, in closing, I would say that the bill does indeed piss off both extremes and possibly moderate pro-life supporters, as it sheds light on the issue appeasing neither extreme. For the most part, as it does retain current policy on abortion, moderate Americans are able to look past this debate and see the bill for what it is (love it or hate it, the real changes it will make are else where in the bill).

What the Heck is Happening with the Healthcare Reform Bill Today?

With all the talk on healthcare reform, Obama, abortion, the Senate, the House of Representatives, and even Massachusetts, how can anyone stay in the know? Let me break it down for you.

What happened today?

In a rare Sunday session, the U.S. House of Representatives (the House) voted on a few things.

They first voted on the rules of debate, which were adopted 224 to 206 votes. This vote allows formal debate to begin on the healthcare bill. (Note: in the House a measure needs 216 votes to pass.) This vote demonstrates that the House will (likely) have the 216 votes needed to pass the healthcare bill.

Now, what is the healthcare bill? Basically, the measure would require most Americans to purchase healthcare insurance and offer government subsidies for those who cannot afford it. According to projections, if passed this bill will extend coverage to 32 million Americans, leaving only 5% of non-elderly citizens uninsured.

How? First, millions will be added to the government health program for the poor (Medicaid), then those who lack access to affordable care through their workplace would receive tax credits to purchase their own insurance. This bill requires (for the first time) that all Americans obtain health insurance - non-compliance would result in a penalty of at least $695/year. Likewise, employers would be required to offer coverage or face a $2,000/year penalty per worker.

The measure also includes provisions barring insurers from denying coverage to people with preexisting medical conditions or dropping policyholders who become ill. Within a year, insurers would not be able to deny coverage to children because of pre-existing conditions, impose lifetime limits on coverage and drop people from coverage when they get sick.

Let's talk about abortion. In an attempt to convince conservative democrats to support the bill in the House, the White House today agreed to underscore and enforce the federal ban on funding for abortion. President Obama will sign an Executive Order to this effect if/when the bill is passed.

In this Sunday session there are two measures before the House dealing with Obama's top domestic priority, healthcare reform. The first is the Senate's version of healthcare bill, which passed that chamber on Christmas Eve 2009.

The second measure is the House's new healthcare legislation, which revises the Senate bill. This measure can otherwise be described as the "critical differences." The reconciliation bill makes several key changes to the Senate measure. It would increase the Medicare payroll tax on those who earn more than $200,000 a year for single filer and $250,000 for joint filers. In addition, beginning in 2013, such earners would pay 3.8 percent on dividend, interest and other unearned income. The bill also provides more help with insurance premiums for lower- and middle-income consumers and expands Medicaid funding to states.

If passed the first bill (the Senate bill) would head to the president for his anticipated signature. The second would immediately return to the Senate for final reconciliation of the House and Senate differences.

Late Sunday evening the first measure (the Senate bill) passed in the House 219 to 212 votes. The 219 “yea” votes were from Democrats, while all 178 Republican representatives and 34 Democrats voted "no."