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On Nov. 7, the House of Representatives passed by the slimmest margins the most sweeping progressive legislation since the Johnson Administration. The Affordable Health Care For America Act was passed by a meager five votes, the ayes coming in at 220 and the nays coming in at 215. Passage was made possible by an eleventh hour amendment proposed by Democratic Representative Bart Stupak of Michigan that forbids health insurance companies from covering abortions for any individual whose insurance is subsidized by taxpayer dollars. We lament that such a reactionary amendment was required for the passage of this landmark bill, but we also recognize its political necessity.
If the Stupak Amendment is to survive into the final version of the health care bill—after the separate House and Senate bills are reconciled in conference—it would decrease the number of insurers providing coverage of abortions for women, since virtually all insurers would have an incentive to partake in the insurance exchange for individuals eligible for federal subsidies that the bill establishes. All insurance policies bought via this exchange would be prohibited from covering abortions in order to uphold the principle of the 1976 Hyde Amendment forbidding the use of taxpayer dollars to fund abortions.
The Stupak Amendment, like the Hyde Amendment before it, is an outrageous curtailing of lower income women’s right to choose. As Democratic Representative Rosa DeLauro of Connecticut stated it, “What they attempt to do here is just ban coverage, totally ban coverage, and that is a different mindset than maintaining current law. There’s people that don’t want to respect that reasonable approach.”
While pro-life advocates are entitled to promote their cause of banning all abortions, it is unjust to render abortions luxury procedures by making them only accessible to those able to afford insurance without government subsidies or those whose insurance is publicly subsidized and who are willing to pay for abortions out of pocket.
Furthermore, while this amendment was politically imperative in the House, it could prove to be a Pyrrhic victory for Democrats and proponents of health insurance reform should the resurrection of the abortion question scuttle reform efforts in the Senate. Prior to Stupak, the controversy surrounding a potential public health insurance option was the primary cause for concern for moderate Democrats in both chambers of Congress. Now, however, abortion has also been added to the list of potential reasons for moderates to vote against the legislation, complicating reform’s chances of passing in the Senate.Senator Ben Nelson of Nebraska, who is considered to be the most conservative Democrat in the Senate and one of the primary “swing votes” whose whims shall dictate the fate of health insurance reform, said that “you could be sure I would vote against it” if the Senate bill does not contain language as strong as Stupak’s on the issue of publicly funded abortions.
Democrats Kent Conrad of North Dakota and Mary Landrieu of Louisiana, likewise, have also called for anti-abortion measures in the Senate bill, while Senate Majority Leader Harry Reid of Nevada, who is pro-life, has yet to come out in favor or against such an amendment. On the other hand, if the bill is moved too far to the right, it could begin losing support on the left. NARAL Pro-Choice America President Nancy Keenan, for example, has said that she “is not going to stand for a bill that has this kind of language in it,” referring to the language of the Stupak Amendment.
Even in the House, the amendment garnered only an additional six to ten votes, hardly proportional to their cost. Nonetheless, without those six to ten votes, the bill would not have passed, and, as President Obama put it, “this is a health care bill, not an abortion bill,” and in that vein, it must be recognized that reforming America’s health care delivery system is worth whatever reversible price must be paid to enact the required legislation.
Efforts to enact sweeping health care reform date back to the presidency of Harry Truman, and attempts have been made under presidents ranging from Richard Nixon to Bill Clinton, whose disastrous failure to enact reform in 1993 resulted in the Republicans regaining control of the House of Representatives for the first time in four decades. The House’s passage of health insurance reform thus marks the farthest that the reform effort has ever come, for which we congratulate Speaker Nancy Pelosi for her pragmatism and extraordinary political acumen.
Not only did the speaker demonstrate the savvy that garnered her the speaker’s gavel in the first place by wrangling the votes to pass a bill whose epitaph pundits had been composing since the notorious town hall protests of Congress’ August recess, but she also, as columnist Camille Paglia wrote for Salon, “conclusively demonstrated that a woman can be just as gritty, ruthless and arm-twisting in pursuing her agenda as anyone in the long line of fabled male speakers before her.”
However, the process of creating the legislation Pelosi worked so hard to pass is less than perfect and in dire need of reform. The fact that few legislators had actually read the contents of the House bill prior to its passage and the sheer haste of the bill’s composition are detrimental to our system of governance. Legislation that as impactful and permanent as this ought to be carefully deliberated upon and debated, not hastily patched together to meet artificial deadlines.
This imperfect process lends itself to unnecessary politicization and the abuse of earmarks so rampant in Congress. One example of this includes the $10 billion allocated in the House bill for unions, a political earmark that has no place in a bill devoted to reforming our health care delivery system. Another example is the Stupak Amendment. The bill that the House passed is historic and should be considered a major victory, but it would be a tragedy for the Representative’s Stupak’s language to survive into the final version of what would be President Obama’s greatest domestic achievement.
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