Health care reform once again becomes a battle of values

Values, the “relatively stable cultural perceptions of what is considered to be good or bad,” have always been at the core of American national health care debates. As far back as 1945, President Harry S. Truman argued for a national health insurance plan, saying: “The health of American children, like their education, should be recognized as a definite public responsibility.” Although the work began by Truman was credited with the eventual 1965 adoption of Medicare and Medicaid, he also became the ideological test subject of the forthcoming McCarthy era, his plan labeled as “socialized medicine” and his staffers as “followers of the Moscow party line.”

Although six decades have passed since Truman began the debate, echoes of his arguments, as well as those of his opponents, continue to reverberate across the country. But the back-and-forth between supporters of universal health care and those who call the idea ‘socialist’ has evolved. A consensus is emerging in support of reform, and the Truman-era specter of socialism doesn’t pack the same political punch.

In response, conservatives are injecting a new values-based argument into the mix, arguing that hidden within the current national debate on health care reform is a proxy battle between supporters and opponents of abortion rights.

Every year since 1976, Congress has approved the Hyde Amendment, which bars the use of federal ‘Title X’ funds to pay for abortions except in cases of rape, incest or endangerment of the woman’s life. Although roughly 90 percent of all private insurance plans cover abortion services, there are additional federal mandates barring funds for abortion for women in the military, women using American Indian health services and women covered by government-run insurance plans.

Regardless, conservative abortion opponents are stoking concerns that the current debate over health care reform could result in a bill that, without a specific exclusion, might usurp federal mandates barring the use of government funds for abortion services.

Just hours before he addressed Republican activists in eastern Iowa last Friday, U.S. Rep. Mike Pence (R-Indiana) stood on the floor of the U.S. House and argued, as he has previously, that taxpayer dollars should not be distributed to Planned Parenthood of America, a family planning organization that provides abortion services, among many other things. Though federal law already prohibits federal money from directly funding abortions, Pence argued that all of Planned Parenthood’s funding should be stripped no matter what services the money is earmarked for, because funding any part of Planned Parenthood allows the organization to free up other resources to pay for abortions.

Pence’s proposal, offered as an amendment to an appropriations bill, was soundly defeated on a 247-183 vote. As expected, the vote went primarily along party lines with Democrats voting against and Republican voting in favor.

That is not always how the issue breaks down. Some Democrats, like U.S. Rep. Bart Stupak (D-Michigan), are working with the GOP to ensure that any new health care reform measures enacted by congress do not end up subsidizing abortion services at Planned Parenthood or anywhere else.

“I was disappointed that Congressman Stupak did not vote for my amendment denying federal funding to Planned Parenthood,” Pence told The Iowa Independent following his public remarks Friday night.

Stupak, who co-chairs the Congressional Pro-Life Caucus, was co-author of a letter, signed by 19 Democratic members of Congress and delivered to House Speaker Nancy Pelosi in late June, that called for an explicit exclusion of abortion services in any health care reform. Stupak has also threatened to stall debate on health care reform in the House if the reform bill does not include such an exclusion.

Pence is skeptical of those efforts. “I think [Friday's] vote bodes ill for pro-life Democrats in the Congress who are hoping that a government-run health insurance plan will not cover abortion services,” he said. “We brought a bill to the floor that essentially said no federal funding will go to Planned Parenthood in Title X, and we were only able to get 183 votes in the House.”

The 1,018-page health reform bill currently before the House makes no mention of abortion or any other specific medical services. This has prompted some anti-abortion advocates to claim that the bill contains a hidden “abortion mandate.”

“I think pro-life Americans and my pro-life Democratic colleagues should be very concerned about the president’s insistence on creating a government-run insurance option,” Pence said. “My belief is that — if they offer a new government-run insurance option for all Americans — that it is almost inevitable that it will eventually cover abortion.”

Pence’s sentiments echoed the fears expressed by many activists last week during a national anti-abortion webcast called “Stop the Abortion Mandate.”

“What you probably haven’t heard is that the health care bill being advanced by Democrats is the abortion industry’s dream come true. In fact it is the most disturbing piece of pro-abortion legislation in recent memory,” James Dobson of Focus on the Family told webcast participants.

Speakers who took part in the webcast painted a grim picture for those who oppose abortion: Passage of health care reform not containing a specific exclusion for reproductive health services will result in the closure of Catholic hospitals, the refusal of “pro-life” individuals to enter the medical field and the collapse of Crisis Pregnancy Centers due to the lack of medical personnel who oppose abortion.

“This is quite literally a defining moment for us,” said Charmaine Yoest, president and chief executive of Americans United for Life. “If the abortion lobby succeeds in defining abortion as health care, it will have shifted the entire debate.”

Despite national news of potential health care compromises, presenters on the anti-abortion webcast made clear that such negotiations were unwelcome and mostly imagined.

“Do not depend on the mainstream news media to keep you accurately informed about developments on this critical issue,” said Douglas Johnson, legislative director for the National Right to Life Committee.

“Just today a major cable network gave airtime to a congressman named Tim Ryan of Ohio who is working closely with abortion advocacy groups such as Planned Parenthood and Third Way. This network allowed Congressman Ryan to pose as spokesperson for our side of the issue, misrepresent the content of the Obama bills and lie about our policy goals.”

Ryan, a Democrat who opposes abortion rights, and U.S. Rep. Rosa DeLauro, a Connecticut Democrat who supports abortion rights, partnered to sponsor the bill titled “Preventing Unintended Pregnancies, Reducing the Need for Abortion, and Supporting Parents Act,” which creates a national adoption campaign, tax incentives for adoption and increased availability of ultrasound equipment.

Although the bill has been able to attract a wide variety of supporters from both the “pro-choice” and “pro-life” movements, socially conservative activists reject it in part because it provides funding for birth control and comprehensive sex education.

Jim Sedlak, vice president of the American Life League and executive director of STOPP International, described by the webcast moderator as “an expert on Planned Parenthood,” described why the current battle actually goes far beyond what the public identifies as abortion to encompass nearly all reproductive health services.

“Over the last 15 years, [Planned Parenthood] has figured out that what it needs to do is put abortion and abortifacient birth control products into national health care,” he said. “They are the operator of the largest abortion chain in the nation … plus they kill millions more with their abortifacient birth control. We don’t want abortion as a part of health care. We don’t want abortifacient birth control as a part of health care.”

Sedlak and his supporters consider emergency contraception, birth control pills and some other contraceptives as equivalent to abortion, leaving little room for compromise. Any health care reform bill that pays for coverage of virtually any women’s reproductive health services, regardless of their legality and widespread acceptance, will be morally unacceptable to them.

Among Iowa’s elected officials, Republican Sen. Chuck Grassley plays perhaps the most important role in the ongoing national health care reform debate. A staunch opponent of abortion rights, he signaled in March that any sort of government funding for abortion services was one of the only ideas that he would never accept in negotiations.

“Senator Grassley is opposed to mandating abortion coverage in health care legislation,” Jill Kozeny, a spokeswoman for Grassley told Newsweek. What the article does not detail, and what Grassley has yet to tell the public, is whether his definition of abortion services includes contraceptives.

Health care reform has eluded a generation of politicians already, so no one expected President Barack Obama’s proposed public health insurance option to be an easy lift in Washington, D.C. Under the added weight of a riled-up anti-abortion movement, it could be even harder than expected.