It was clever of Bart Stupak and his friends to claim that they were merely applying the Hyde Amendment to the health reform bill, as if all they wanted was to maintain the status quo with respect to federal abortion restrictions. In fact, they went a good deal further.
With respect to Medicaid, what Hyde does is to bar federal monies from being used to pay for abortions except in cases of rape, incest, and endangerment to the woman’s life. But states are permitted to provide complete abortion coverage with their own funds, and 17 of them do. It has gone largely unnoticed that the Stupak amendment prohibits the use of state Medicaid matching funds to pay for abortion services–that is, it changes the way Medicaid currently functions for those additional women who would be covered by Medicaid under the legislation.
In addition, the amendment requires that, for those whose insurance is subsidized by the federal government, abortion can only be covered via a “separate supplemental policy”–on the grounds that merely limiting federal subsidies to non-abortion coverage in a given policy (with the individual providing the balance) is just an accounting trick. But if the underlying objection is that the subsidy would then make it possible for women to obtain abortion coverage thanks to federal support, the supplemental policy approach (which would presumably require the basic subsidized policy) would do the same–just at a much higher price. The object of the exercise is simply to make access to abortion more difficult, not to protect pro-life taxpayers from having to pay for abortions. As for the stipulation that insurance companies participating in the exchange program provide policies that do not cover abortions along with those that do, that has nothing to do with the federal funding restrictions of the Hyde Amendment.
How did Stupak & Co. manage to get their way? I go along with Amy Sullivan’s judgment that the Democratic leadership was asleep at the switch. Rather than engage with pro-choice members–and the Catholic bishops conference–early on, Pelosi et al. acted as though this was nothing much to worry about. Over at TNR’s Plank, Bill Galston claims that the result shows the continuing power of Catholicism in the Democratic Party, while Alan Wolfe argues that Catholicism is all over the lot and not the bogey some liberals are now making it out to be. But the point is that, when the fate of a bill hangs in the balance, a few votes one way or the other make the difference. Had the Catholic bishops been prepared to settle for half a loaf, so would Stupak.
Among the losers here must be mentioned the commongroundniks, including the good folks at Catholics in Alliance for the Common Good, who were supposed to be in business to help pro-choicers and pro-lifers find a middle way on abortion in order to achieve social benefits that both sides agreed on. In fact, when crunch time came in the House, the pro-lifers got everything they wanted. As liberals, the commongroundniks have had some success pushing pro-choicers to compromise. But it’s not clear that they have any standing with the pro-life community to do the same. So it will fall to the enraged old-time pro-choice forces to provide push-back to Stupak in the Senate bill. Abortion business, in short, as usual.