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Democratic Dissenters

How many House votes will Obamacare lose because of its abortion subsidy?

Sep 21, 2009, Vol. 15, No. 01 • By JOHN MCCORMACK
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Representative Bart Stupak isn't the type to yell "You lie!" while the president is addressing a joint session of Congress. But according to the soft-spoken pro-life Michigan Democrat, Barack Obama isn't telling the full truth when he says, as he did last Wednesday night, "no federal dollars will be used to fund abortions" in the congressional health care plan.

"There certainly is public funding for abortion" in the House bill, Stupak told me the day after Obama's speech. The bill would allow both the public health insurance plan and federally subsidized private plans to cover elective abortions. Stupak has asked repeatedly for a meeting--or even a few minutes on the phone--with Obama to clear up any misunderstanding, but the White House hasn't granted his requests. "I just jumped Rahm Emanuel again this morning" to ask for a meeting, Stupak said Thursday.

The White House might want to reconsider its cold shoulder, because Stupak may have enough votes to keep the health care bill from making it to the floor of the House. Stupak says that if Nancy Pelosi and Rules Committee chairman Louise Slaughter do not allow an up-or-down vote on his amendment to explicitly ban coverage for elective abortions in the bill, he's going to lead a coalition of Democrats to vote with the Republicans "to try to take down the rule." That would keep the bill from moving out of the committee to the floor.

Stupak has worked the issue diligently and is convinced that he has almost 40 Democrats willing to vote against the rule. Combined with united Republican opposition, and a defection or two from the fiscally conservative "blue dog" Democratic caucus, that would be enough votes to block the bill.

So far, the Democratic leadership isn't promising Stupak an up-or-down vote on his amendment. Slaughter won't commit to allowing a vote, and Nancy Pelosi was similarly noncommittal when asked last Thursday. Abortion funding is already "out of the health care bill," she told me.

"She knows better than that,"
Stupak said. Indeed, she must. Under an amendment written by pro-choice Democrat Lois Capps, the Health and Human Services secretary is explicitly authorized to include abortion coverage in the public health insurance plan. The amendment mandates that the public plan cover abortion if the Hyde amendment, which bans federal funding of abortions through Medicaid except in cases of rape, incest, and life of the mother, is repealed. Obama's HHS secretary Kathleen Sebelius will almost certainly include abortion coverage.

To buy into the public plan, each person would have to pay member dues (premiums), including "not less than $1 per month" into a special U.S. Treasury account that would be used to pay abortion fees. The Capps amendment, which was approved 30-28 in committee, requires at least one (federally subsidized) insurance plan covering elective abortions (and one not covering abortions) to be offered to those purchasing health insurance in the private health insurance "exchange."

Supporters of the amendment argue that it bans federal funding of abortion because it specifies that abortions should be paid for through an individual's premiums rather than through federal subsidies. So, say that an individual contributes $500 to purchase a health-insurance plan, and the government contributes $3,000. When the bill comes due from an abortionist, he will theoretically be paid out of the $500 in premiums rather than the $3,000 of taxpayer-money.

Douglas Johnson, the National Right to Life Committee's legislative director, calls it a "bookkeeping scheme" and an "idiosyncratic definition of 'public funds' that would never be accepted for five minutes if the issue weren't abortion."

Rachel Laser of the pro-choice group Third Way argues that the Stupak amendment would deny abortion coverage to many women who currently have it if they are dropped from their employer-based plans and need to purchase the government-run or government-subsidized plans. She says that "87 percent of [employer-based] insurance plans do offer abortion coverage." This much-reported number comes from a study by the (pro-abortion) Alan Guttmacher Institute. But the figure is misleading--it reflects only abortion coverage provided "when considered medically necessary or appropriate by the health care provider." As Kathleen Sebelius testified during her confirmation hearing, "Most private plans do not cover abortion services except in limited instances." According to a 2001 study by experts at the Guttmacher Institute, only 13 percent of women purchasing abortions use private insurance to do so.