Health-Care Reform Efforts Marred by Abortion Dispute

Wednesday, July 22, 2009

President Obama, who has vowed to find common ground on culture-war issues, finds himself in the middle of a classic Washington dispute over abortion that is further undermining support among conservative Democrats for his ambitious health-care reform efforts.
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Health-Care Reform Efforts Marred by Abortion Dispute
The Government's Approach on Abortion
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Abortion is not explicitly mentioned in any of the major health-care bills now under consideration in Congress. But abortion opponents charge that the legislation would make abortion both more widely available and more common by requiring insurance plans to pay for the procedures and providing government funding to subsidize plans that pay for them.
White House press secretary Robert Gibbs said this week that decisions on specific benefits such as abortion coverage should be "left to medical experts in the field," referring to a proposed advisory board that would recommend minimum levels of coverage for private insurers.
The dispute presents another unwelcome distraction for the White House and a political opportunity for Republicans, who are seizing on the issue as part of a broader attempt to kill health reform legislation that they believe is too intrusive and costly. A group of conservative Democrats led by Rep. Tim Ryan (Ohio) proposed a compromise Tuesday that would neither require nor bar private insurers from offering the procedure as long as no federal funding is used; another group of Democrats and Republicans is holding a news conference today to call for an explicit ban on funding.
The conflict comes as two House Democrats on either side of the abortion divide prepare to introduce legislation later this week aimed at encouraging pregnancy prevention and greater government support for young mothers. The measure from Ryan, who opposes abortion, and Rep. Rosa DeLauro (D-Conn.), who supports abortion rights, has attracted an unusual array of supporters ranging from Planned Parenthood to evangelical leaders such as the Rev. Joel Hunter of Orlando.
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The developments underscore the emotional and often intractable nature of the abortion debate, which also flared during the confirmation hearings for Supreme Court nominee Sonia Sotomayor this month. Obama has repeatedly called for finding "common ground" between the two sides by advocating policies to reduce the number of abortions and unintended pregnancies, a message he amplified as part of a widely watched address at Notre Dame University and during a recent Vatican visit with Pope Benedict XVII.
But the health-care reform legislation has reignited allegations from antiabortion groups that such pledges are an attempt by Obama and his allies to paper over their support for abortion rights with policies that will do little to reduce use of the procedure.
"This is a president who says he wants to reduce abortions," said Douglas Johnson, legislative director for the National Right to Life Committee. "But the actual policies that this administration is promoting will result in massive public subsidies for abortion and result in a massive increase in the number of abortions."
Democratic leaders and abortion rights groups say those concerns are exaggerated, and some accuse abortion opponents of attempting to use the health-care debate to further restrict legal access to abortion under private insurance plans. "This is the kind of divisiveness that the public has grown very tired of," said Nancy Keenan, president of NARAL Pro-Choice America, which has endorsed the Ryan-DeLauro bill. "We think those benefits should be decided by experts and not politicians."
Rep. Bart Stupak (D-Mich.), who believes House legislation contains "a hidden abortion mandate," said he is in talks with House Energy and Commerce Chairman Henry A. Waxman (D-Calif.) in an attempt to find compromise language that will mollify him and other abortion opponents. He and other lawmakers are holding a news conference on the topic today.
"It's been a long held conviction by many members that taxpayer dollars should not be used for abortion," Stupak said in an interview, referring to restrictions first enacted in 1976 for Medicaid funds. "They're open for discussions."
In their separate proposal to House Speaker Nancy Pelosi (D-Calif.), Ryan and four other Democrats say that allowing insurers to chart their own abortion policies as long as taxpayer money isn't used for the procedure represents "a common ground solution" that effectively maintains current law on abortion funding. Their proposal would also stipulate that current state restrictions on the procedure would still apply.
Adam Sonfield, a senior policy associate at the Guttmacher Institute, a nonpartisan reproductive health research group, said such a solution will "probably disappoint a lot of people on both sides, but it's probably something that people on both sides can live with."
The prevention bill being proposed by Ryan and DeLauro would establish a series of new and expanded initiatives focused on contraceptives and other prevention measures, including restoration of Medicaid coverage for family planning services. The bill, to be announced formally on Thursday, also includes a series of grants and policies aimed at helping young mothers, including expanded maternity care options and more financial assistance for adoptions.
Backers say the Ryan-DeLauro bill has been carefully scrubbed for months to remove policies that might alienate either side, such as eliminating financial support for the morning-after pill. Hunter, senior pastor of Orlando's Northland megachurch, said the proposal "isn't going to end the disagreement or the alarm that comes up on both sides. But I think it is the first of its kind to take such an incendiary culture-war issue and really make progress. It's a start."
Ryan, who opposes abortion but has come under attack from some antiabortion groups for supporting the use of contraceptives, said he also believes the bill will help calm the current dispute over how to address the procedure in health-care legislation. "I'm hopeful this will spill over into the health-care debate and encourage both sides to find common ground there as well," Ryan said in an interview.
The White House has not endorsed any specific legislation on reducing abortions. But Melody Barnes, Obama's domestic policy adviser, said in an interview that the Ryan-DeLauro proposal represents "a very positive development." She also said the administration, which has been holding meetings between advocates on both sides of the abortion debate throughout the summer, expects to issue its own package of proposals later in the year.
"The president started this process with the desire to find common ground and to work with people across the political spectrum," Barnes said, adding: "The bottom line is to put concrete ideas on the table."


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