Jim Wallis’ endless apologia pro Stupakia sua on Huffpost is an awe-inspiring exercise in injured innocence. According to him, the collapse of a compromise on abortion in the House health care bill was all the fault of the House leadership (which disrespected pro-life moderates) and pro-choice activists (who just couldn’t see past their zealotry). Were there partisans on the other side to be named and blamed? Not so far as Wallis is concerned.

Now as Sarah Posner’s fine blow-by-blow on Religion Dispatches makes clear, the abortion issue was badly handled by the pro-choice forces. But as usual, Wallis portrays himself, Rodney King-like, as just trying help people get along. No, in fact they can’t all get along. If you’re going to be for compromise in order to get health care passed, you’ve got to take a stand, and tell your interlocutors what to rally around.

To its credit, Third Way has done just that, criticizing the Stupak-Pitts Amendment (as it is now called) for violating the principles of abortion neutrality embraced in word by many, and backing the failed (but perhaps to be revived in the Senate) Ellsworth Amendment. (See memo, after jump) Michael Sean Winters, vigorous pro-lifer that he is, recognizes that Stupak-Pitts went too far, and supports dialing it back for the greater good. Does Sojourners do the same? Tell us, Jim. And while you’re at it, how about shouldering a little responsibility for what happened, O Prophet of the Common Ground?

THE THIRD WAY CULTURE PROGRAM
November 13, 2009
TO: Interested Parties
FROM: Rachel Laser, Culture Program Director; and David Kendall, Senior Fellow
for Health Policy
RE: Abortion Coverage in the House-Passed Version of Health Care Reform
As we noted in advance of the House vote on health care reform, the Ellsworth
Amendment would have moved the bill in a pro-life direction, but it still would
have achieved abortion neutrality. The Stupak-Pitts Amendment, which was
included in the final version of the House bill, is not abortion neutral, and it would
disrupt the delicate federal balance already in place.
We believe that by upsetting this balance, health care reform is now in
jeopardy. Below, we explain the three ways in which the Stupak-Pitts Amendment
is not abortion neutral and why the pro-life Ellsworth Amendment represents a far
better approach that adheres to common ground.
The Stupak-Pitts Amendment Violates Abortion Neutrality in
Three Ways
1. The Stupak-Pitts Amendment changes a decades-long balance of existing
federal law on abortion coverage.
The Hyde Amendment, which has been on the books for over 30 years, prevents
federal funds from being used to pay for abortion in the Medicaid program, except
for cases of life endangerment, rape or incest. The Stupak-Pitts Amendment goes
much further, by preventing even private premiums from being used to pay for
abortion in the Exchange. The Stupak-Pitts Amendment prohibits health insurance
plans in the Exchange that receive any federal funding from covering abortion,
even with segregated private funds. Because all Exchange plans will likely receive
federal tax dollars through subsidies to individuals, individuals will not be able to
purchase health insurance that covers abortion, even with their own premiums. The
fact that the millions of Americans participating in the Exchange will not have
abortion coverage is also a dramatic change from the status quo, since the majority
of Americans with health insurance have plans that include abortion coverage. 1
The logic of the Stupak-Pitts Amendment also rejects the current noncontroversial
scheme whereby year after year, hundreds of billions of dollars are
consistently used to subsidize health insurance policies that cover abortion. Until
the Stupak-Pitts Amendment emerged, none of this funding was deemed
controversial in any way by pro-life stalwarts from President Ronald Reagan to
President George W. Bush.
Third Way Memo 2
The employer deductibility of health coverage has yielded trillions of dollars in
federal tax subsidies for insurance plans, whether or not they covered abortion.
Flexible Savings Accounts (which started in 1978 and grew in popularity under
President Reagan) allow for individuals to deduct the direct cost of abortions from
their taxable income. Health Savings Accounts (which started under President Bush)
allow for tax-favored savings to be used to pay for abortions.
Each of these tax subsidies has, at one time or another, received the support of
nearly all members of Congress–whether ardently and unequivocally pro-life or
pro-choice. Yet as far as we can tell there has never even been a debate about
whether these subsidies could cover plans that offer abortion coverage, even
though most do.
2. The Stupak-Pitts Amendment changes longstanding policies regarding the
segregation of funds.
Supporters of the Stupak-Pitts Amendment dismiss efforts at finding a
compromise on abortion in health care reform through the segregation of funds as
an “accounting trick.” Whether or not one believes this argument, supporters of the
Stupak-Pitts Amendment must now reconcile this view with longstanding policies
that allow the segregation of funds in order to let religious organizations accept
federal money.
The reasoning of the Stupak-Pitts Amendment would call into question
countless activities by religious organizations that rely on federal funds, including
Head Start, homelessness relief, food banks, substance abuse counseling, prison
fellowship, afterschool programs for troubled youths, adoption services, ESL
programs for immigrants, and veterans’ services.2 Of course, in the context of
abortion, the segregation of funds is also accepted in Medicaid, where 17 states
supplement the federal program with abortion coverage.
3. The Stupak-Pitts Amendment means no plans in the Exchange would offer
abortion coverage.
Even though there is a provision in the Stupak-Pitts Amendment that would
allow the purchase of separate supplemental coverage of abortion, it is implausible
that insurance companies would offer this coverage. Unintended pregnancies are
unplanned by definition, so demand would likely be low. And unlike other medical
procedures, abortions are relatively inexpensive. That is why in the five states
where abortion coverage is prohibited except through such “riders,” there are only
isolated examples of insurers actually offering such coverage, and even then only
as part of a small group package, rather than to individuals.
The Ellsworth Amendment: A Common Ground Solution
Representative Brad Ellsworth, who has a 100% rating with National Right to
Life, has drafted a compromise solution, which built off of an earlier plan from
(100% pro-choice) Representative Lois Capps. Unlike the Stupak-Pitts Amendment,
the Ellsworth Amendment meets the test of abortion neutrality.
Third Way Memo 3
The Ellsworth Amendment strengthens the pre-existing protections against
federal funding for abortion in the House bill by:
• Ensuring that no future federal dollars can ever be designated to fund
abortions in the Exchange;
• Making permanent strict Hyde limitations on the pro-life plans in the
Exchange;
• Increasing protections for pro-life insurance plans by adding a nondiscrimination
requirement; and,
• Strengthening the guarantee of segregation of funds by requiring
compliance with three separate standards of accounting.
The Ellsworth Amendment was not endorsed by any of the major pro-life or
pro-choice groups. That’s probably the best indication that it achieves common
ground. For more information about the Ellsworth Amendment, see our memo
Achieving Abortion Neutrality in Health Care Reform.
Endnotes
1 Guttmacher Institute, “Memo on Insurance Coverage of Abortion,” July 22, 2009. Available at
http://www.guttmacher.org/media/inthenews/2009/07/22/index.html.
2 Religious organizations can receive federal funding for many social services programs, but as a
requirement of the Constitution’s Establishment Clause, they must segregate those funds from the
money they use for religious activities such as worship, religious instruction and proselytization. One
example is the Community Services Block Grant, a program administered by the Department of Health
and Human Services. Under this program, “religious organizations are required to keep any Federal
funds they receive for services segregated in a separate account from non-Federal funds.” 42 U.S.C. 9901.