Obama's Failed Promise

I'm glad health-care reform passed. It's difficult not to be moved by the figure 31 million—the number of uninsured people who will have access to less-expensive coverage after reform. But we should all understand that the bill was passed at the expense of poor women's reproductive rights. Middle-class and rich women—the wives, daughters, and mistresses of politicians—can always travel to get an abortion or pay out of pocket if they have to. Poor women cannot, and as 60 percent of American women who seek abortion already have kids they struggle to care for, it is children alive today who will suffer.

The final health-care reform bill represents a huge loss for the pro-choice movement, and one largely dealt by Democrats.

The final health-care reform bill represents a huge loss for the pro-choice movement, and one largely dealt by Democrats. Just a year ago, feminist organizations were ecstatic about the election of a pro-choice president, one who had promised on the campaign trail to end the Hyde Amendment, which prevents federal Medicaid dollars from contributing to the cost of poor women's abortions.

• More Daily Beast writers on the health-care vote.Now, in a Faustian bargain with Rep. Bart Stupak of Michigan and other Democrats who oppose abortion rights, President Obama will issue an executive order enshrining the Hyde Amendment. Language in the bill inserted by Sen. Ben Nelson of Nebraska expands Hyde's reach into the new private insurance exchanges in which the uninsured or under-insured will purchase coverage. Because only about 13 percent of abortions are billed directly to insurers, it is sometimes assumed that abortion is a relatively inelastic good—that women who really want one will get one, come hell or high water. But that assumption is false. A 1999 study of poor women in North Carolina found that about one-third of them had carried pregnancies to term only because Medicaid funding for abortions was unavailable during certain parts of the year. An abortion can cost between $350 and $1,000—equal to several months of rent or groceries—so the price can be prohibitive. The result of unaffordable abortion is another mouth a working-class mother cannot afford to feed, house, or educate during a time of record unemployment.

That's the kind of "choice" we have in America today—limited to those who can afford to pay. I'd like to say I'm hopeful that feminist groups and progressive allies can reverse this trend, but I'm not. Confronted with the GOP filibuster threat, the Democratic Party wholly failed to deliver on its promise to support reproductive rights for rich and poor women alike, and there isn't any other viable political movement to turn to.

Dana Goldstein is an associate editor and writer at The Daily Beast. Her work on politics, women's issues, and education has appeared in The American Prospect, Slate, BusinessWeek, The New Republic, and The Nation.