The Republican Approach to Abortion and Health Care -- Fair or Unfair?

In his "chairman's mark" on health care reform, Senate Finance Committee Chairman Max Baucus had rejected the pure pro-choice position -- he limited direct government funding for abortion -- but still included provisions that pro-lifers viewed as supporting abortion.

Republicans have offered several amendments to move the health care bill in a more pro-life direction.

Republican Senators Michael Enzi and Orren Hatch have proposed that:

1) Government tax subsidies could not help people buy insurance that covers abortion. (Enzi and Hatch)

2) Insurers could (as they can now) offer consumers the ability to purchase, with their own money, insurance supplementals that do cover abortion. (Hatch)

3) State insurance exchanges could not be required to offer plans covering abortion. (Enzi)

I'm going to analyze this not from the perspective of whether this is morally good or bad but whether it basically accepts the status quo approach to abortion, which prohibits direct federal funding for abortion but allows some indirect support.

On the first point, they are being consistent to the pro-life position and to the status quo. The Finance committee bill would provide subsidies directly from the Treasury to health plan, so preventing that from covering abortion would be consistent with current practice

On the second, let's remember that even pro-choice Democrats accept the idea that, at least in terms of this health care bill, pro-life citizens shouldn't see their taxdollars going to subsidize abortion. Democrats attempted to do that through a system in which money would be segregated into different accounts so taxpayer dollars wouldn't fund abortion. Hatch took a different approach: while the basic insurance plan wouldn't cover abortion, insurance companies could offer consumers the option of buying, with their own money, a supplemental insurance plan covering abortion.

Though pro-lifers attacked the Democratic approach as a scandalous assault on human life, and Democrats will no doubt attack the Republican approach as a scandalous assault on freedom, they actually are trying to achieve the same goal.

In my opinion, the Republican approach is simpler and cleaner (I actually advocated for something like this a few weeks back.) But it does have flaws. For instance, it may be unrealistic to expect that women will be thinking about the prospect of abortion when they're buying health insurance. Also, oftentimes, the policyholder is not the beneficiary. A woman might buy the supplemental but will a father who has a teenage daughter decide to buy the supplemental?

On the third item, Enzi did something that definitely moves government policy away from the status quo in a markedly pro-life direction. The Senate bill (as well as the key house bill) had a provision that local insurance exchanges be required to offer at least one plan that covers abortion and one that doesn't. Democrats viewed this as an innovation in fair-mindedness. No one would be forced to buy a plan that violates their ethical code.

Enzi deleted the part saying that exchanges would have to offer abortion-covering plans -- but left in the clause saying they'd be forced to offer no-abortion-coverage plans! This is a definite departure from current practice and a push of state laws in the pro-life direction.