Is Obamacare Pro-Life?

Antiabortion activists have bashed the Democrats’ health-care plan. But as Michelle Goldberg reports, the pro-choice crowd may actually have the most to lose.

There were plenty of outrageous signs at the conservative rally in Washington on September 12, but most were DIY affairs, reflecting nothing but an individual’s poor taste. Not so the placards that read, “Bury Obamacare With Kennedy.” They were produced by the American Life League—evidence of the antiabortion movement’s deep, zealous opposition to the Democrats’ plans for health-care reform.

On the National Right to Life Web site, beneath the flashing headline “condition red,” is the warning, “President Obama and top Democratic congressional leaders are pushing hard for health-care bills that would result in federal government funding of abortion on demand!” Wednesday night, Rep. Michele Bachmann took to the House floor to warn that, should health-care reform pass, teenagers might be able to procure secret abortions at school-based “sex clinics.” To listen to conservatives, one would think health-care reform represents the greatest expansion of abortion rights since Roe v. Wade.

“I’d rather be counting ways we’re improving women’s access to legal abortion. Instead we’re counting votes to make sure women don’t lose what they already have,” says Nancy Keenan, president of NARAL.

If only. In fact, right now, the pro-choice movement has more to lose than its opponents. Early on, pro-choice activists hoped that a reformed health-care system would cover abortion—the most common surgical procedure in the United States—just like any other medical service. But when conservative Democrats balked, the party pressured the pro-choice movement not to let health reform get stymied by abortion politics. So pro-choice leaders agreed to a compromise, in the form of an amendment by Congresswoman Lois Capps (D-CA), which basically maintains the status quo on government abortion funding.

That status quo is fairly restrictive. Right now, abortion is covered in more than 80 percent of private health plans, but not in any of the health plans available to federal government employees. Federal funds also can’t be used to provide abortions under Medicaid, except in cases of rape, incest, or medical emergency.

Benjamin Sarlin: The Democrats’ Joe Wilson?The Capps amendment essentially says that, when it comes to government-subsidized private insurance, there will be neither an abortion ban nor an abortion mandate. The insurance exchanges envisioned by reformers will have to include at least one plan that includes abortion coverage and one that does not. The plans that do provide abortion coverage have to do so with separate funds that will be kept sequestered from government money. Going beyond current law, the Capps amendment says that no private plan participating in the exchanges can discriminate against health-care workers who refuse to provide abortion services.

From the pro-choice point of view, none of this is a particularly great deal. “I’d rather be counting ways we’re improving women’s access to legal abortion. Instead we’re counting votes to make sure women don’t lose what they already have,” says Nancy Keenan, president of NARAL. “It’s workable,” adds Vicky Saporta, president of the National Abortion Federation. “It’s not ideally what we would have liked to see. We certainly can’t amend it any further.”

Of course, that’s just what the antiabortion movement wants to do. It’s trying to ban subsidies from being used to purchase plans that include abortion coverage at all. That would create a big incentive for insurance companies to drop such coverage, leaving women nationwide worse off than they are now. So far, these attempts have been defeated, but there are still opportunities for Republicans to try again. Antiabortion forces won a small victory this week, when the Senate Finance Committee reinstated $50 million in funding for abstinence-only sex education that Obama had removed from the budget. Democrats Blanche Lincoln and Kent Conrad joined Republicans on the measure, proving that a Democratic majority is not always a reliably pro-choice one.

There’s actually a fantastic irony here. If the antiabortion movement really cared more about curtailing abortion coverage than about defeating Democrats, it might have thrown its weight behind a single-payer system, which would be subject to the existing ban on federal funding of abortion. Similarly, it might have supported a public option, which is likely to be bound by similar restrictions. The ban could always be lifted, of course, but the antiabortion movement would still have a lot more leverage with the government than it does with the private market. After all, from the insurance industry’s point of view, coverage for abortion services is cost-effective; it’s a lot cheaper than covering a pregnancy and birth. For politicians subject to religious demagoguery and beholden to an ambivalent electorate, abortion coverage is much more of a losing proposition.

Indeed, given the desperation of moderate Democrats for bipartisan cover, the antiabortion movement could have extracted all sorts of compromises in return for its cooperation. Instead, it adopted a policy of total opposition. That’s why, ultimately, the pro-choice community is confident that it won’t lose too much ground in health reform—even though it won’t gain any, either. “For them to just be obstructionist, I don’t understand, quite frankly, the strategy in that,” says Saporta. It’s almost enough to make one think that on the right, abortion isn’t really the issue at all.

Michelle Goldberg is the author of The Means of Reproduction: Sex, Power and the Future of the World and Kingdom Coming: The Rise of Christian Nationalism. She is a senior correspondent for The American Prospect, and her work has appeared in The New Republic, The Nation, the Los Angeles Times, Glamour, and many other publications.