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The Honolulu Advertiser
Posted on: Wednesday, March 17, 2010

Senate health care bill stronger on abortion


By Ruth Marcus

There are any number of good reasons for House Democrats to vote against health care reform. Abortion isn't one of them.

At least, it shouldn't be. There is scant difference between the House bill that anti-abortion advocates deem acceptable and the Senate version they claim would allow federal funds to underwrite abortions.

If anything, both versions would end up restricting abortion coverage more than under current law. Some women whose insurance covers abortion would lose that benefit as their policies move to the new insurance exchanges.

If anything, health care reform would have the impact of reducing the number of abortions. More women will have coverage that includes contraception. Pregnant women would know that their medical care, and that of their child, will be covered.

If anything, government funds are already used to pay for abortion on a massive scale. Employer-sponsored insurance policies, most of which include abortion coverage, benefit from a fat government subsidy: they are provided tax-free.

Compare the language of the Senate and House measures and try to find the supposed differences. Both measures would prevent insurers from being required to cover abortions. Both measures would continue the existing prohibition on federal funds being used to pay for abortions.

So, for example, as Medicaid is expanded to cover more low-income people, federal money will not be used to pay for abortions for Medicaid recipients. (States would remain free to use their own money to cover abortions under Medicaid which undermines the argument that money is fungible and it is not possible to adequately segregate federal funds.)

In addition, as Washington and Lee law professor Timothy Jost points out in his useful analysis of the two measures, the Senate bill is stronger in some ways than the House measure in preventing abortions. It would explicitly allow states to bar insurers participating in the exchanges from offering abortion coverage. It includes $250 million in funding for pregnant teens and teenage mothers. It expands the adoption tax credit and adoption assistance programs.

One relatively new argument against the Senate bill is that the ban on government funding of abortion does not explicitly include community health centers, which would receive billions more in funding. Except: These centers already receive federal funds. They don't perform abortions. And existing regulations prohibit them from performing abortions with federal funds. If the absence of an explicit legislative ban is a problem, why wasn't it raised when, for example, the stimulus bill appropriated another $2 billion for community health centers?

You might ask: If there's no real difference between the two, why don't Democrats simply accept the House language? They can't, at this point. The House has to pass the Senate bill as is. Some changes can be made under the rules of reconciliation, but not on the abortion language.

The Catholic Health Association, which represents Catho-lic hospitals, supports the Senate bill. But Catholic bishops are strongly opposed, and anti-abortion lawmakers who vote for reform will be marked down by the National Right to Life Committee. As Douglas Johnson, the group's legislative director, told The Associated Press, "No Catholic hospital executive has ever turned out hundreds of volunteers to man the phone banks or walk the precincts for an endangered congressman or his challenger."

On this one, sadly, facts may matter less than muscle.