Pro-life groups, most especially the nation’s Catholic bishops,
were thrilled when the Stupak Amendment passed the House because it
really does bar federal funds from going to pay for abortion coverage.
Of course, the Stupak Amendment produced a backlash among pro-choice
groups, and in the Senate, pro-life senators are in the minority. The
current Senate bill tries to avoid federal funding in subsidized health
insurance by "segregating" the money that comes from the government
from the money contributed by the individual, and only paying for
abortion coverage from the individual’s contribution. The bishops have
said this "segregation" of funds is only an accounting gimmick (money
is fungible) and the non-partisan group Factcheck.org agrees with the
bishops. Now, both sides have dug in and they are talking past each
other, insisting that their way is the only way to achieve the goal
both acknowledge they share. That means it is time to seek a new way
forward, a different approach from that envisioned by either the Stupak
Amendment or by the "segregated" funds approach of the Senate bill.

The most nettlesome difficulty is how to deal with insurance plans
to be purchased with a mix of federal subsidies and private premiums in
the proposed exchanges. Stupak says: If you get a federal subsidy you
can’t buy a plan with abortion coverage. The Senate bill, as noted
above, merely indicates that the federal funds will be segregated from
the private funds. But, if the subsidies are calculated based on a
person’s income, and given to the individual as a voucher to shop with
in the exchange, why should we not let the individual choose whatever
coverage they want? If they prefer a more expensive plan with abortion
coverage, the voucher is not going to increase, so they really are
making their own decision about what to do with their money and de
facto as well as de jure they are buying their abortion coverage with
their own funds. Additionally, the voucher is going to the individual,
not the insurance company directly, so this arrangement does not
constitute federal funding in any way.

Vouchers are currently used to cope with another complicated issue,
helping poor parents pay for tuition at religious schools. There the
difficulty arises from the First Amendment not the Hyde Amendment, but
the idea is the same. In the health care debate, the difficulty arises
from the profound ambivalence of many Americans about abortion: They do
not want the procedure to be illegal but they really don’t want to
encourage it with their tax dollars. The Hyde Amendment, after all, was
never about saving money, it was about expressing this ambivalence
about abortion. The idea of using vouchers was floated this summer, but
not embraced. At the time, a spokesman for the U.S. bishops, Richard
Doerflinger, told Beliefnet.com that the idea of using vouchers was
"such a crazy idea it just might work." That is not an endorsement, but
it is also not a veto. It is time to explore the "crazy idea."

The public option, already in great difficulty because the GOP
succeeded in framing it as a "government take-over," is further
complicated by the abortion issue. Again, Stupak is straightforward:
the public option does not cover abortion, period. In the Senate, the
Secretary of Health and Human Services has to jump through some hoops
to get abortion in the public option, but it is not excluded. It should
be. The public option should be as close as possible to the health care
coverage congressmen receive. (This might also help Democrats sell the
public option. There are worse tag lines than "Because you should have
access to the same insurance your congressman gets!") Although the
hysterics from pro-choice legislators like Cong. Diana DeGette and Sen.
Barbara Boxer about the Stupak Amendment putting women back to the days
of back alley abortions suggest otherwise, the fact is that DeGette and
Boxer do not have abortion coverage in their health care because they
are federal employees. Do either of them really want to equate their
situation with that of women in the 1960s?

Finally, the last difficulty is the easiest to fix. The Stupak
Amendment does not technically bar plans that are purchased in the
exchanges completely with private funds from offering abortion
coverage, but it has that effect because the insurance companies say
the pool of people not receiving federal subsidies would be too small
to offer such a plan. In this sense, pro-choice critics are correct
that Stupak goes beyond Hyde. The law should require that the exchanges
have at least one plan with abortion coverage and one plan without such
coverage. And, because people with federal subsidies would be using
vouchers, you do not have to separate those who are paying with their
own money from the pool of those people receiving subsidies. The pools
would be large enough to ensure both kinds of policies are offered.

Those of us who are lifelong pro-life Democrats were heartened when
President Obama said he sought "common ground" on abortion and pledged
that health care reform would not entail government funding of
abortion. We were willing to look the other way on the Mexico City
policy and we understood that the decision on embryonic stem cells
would have occurred if John McCain had won the election too. As well,
it is difficult to see how passing health care with abortion funding
will help the Democrats: They stand to lose enough seats in next year’s
midterm elections without also replacing a group of pro-life Democratic
legislators with pro-life Republican congressmen. If Speaker Nancy
Pelosi wants to remain Speaker, she needs to have Democrats
representing more conservative districts like NC-14 and VA-5 and MI-1,
currently represented by pro-life Democrats Health Shuler, Tom
Perriello and Bart Stupak, respectively.

Catholic social teaching is unambiguous when it comes to the fact
that health care is a right not a privilege. In today’s political
climate, there is simply no alternative to the current legislation
making its way to the President’s desk. It would be criminal to see
this goal derailed because legislators can’t find a way to achieve what
they all admit they want: health care coverage that does not include
federal funding of abortion, especially when all that is needed is some
creative thinking and a new approach. Instead of getting dug in, both
sides need to reach out.