Abortion and heath care reform: the Medicaid solution

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So far as I can tell (from Wapo’s account), the key to bringing Ben Nelson on board for the health care bill was Medicaid. On the sausage-making front, Nebraska’s senior senator managed carve out a special Medicaid subsidy for…Nebraska. On abortion, the arrangement whereby states can opt out of permitting abortion coverage in the insurance exchanges parallels the existing Medicaid arrangement, whereby states can (with their own funds) opt in to providing full abortion coverage. Federalism is a beautiful thing.

Not surprisingly, the right-to-lifers are not happy with the compromise, and Bart Stupak has promised to try to block it. My guess is that the Catholic bishops will end up opposing the final bill. There will be a lot of talk about how, as a matter of principle, the church cannot collaborate with evil. But as the rhetoric rolls forward, It’s worth bearing in mind that the bishops’ fervid embrace of the Stupak amendment is a prudential decision that also involves collaboration with evil. That’s because, as they understand it, abortion in a case of rape or incest is just as much murder as any other elective decision to terminate a pregnancy. “Abide with Hyde” is practical politics, not moral theology.