Insuring abortion


The religious right is up in arms about the place of abortion in the health insurance reform bills making their way through Congress. Today, an all-star cast of pro-lifers will appear on a webcast headlined as “Stop the Abortion Mandate Now.” Not surprisingly, several separate issue are being conflated to create an abortion healthcare bogeyman. They ought to be kept separate.

First, there’s the fear that abortion services would be included in the package of benefits required of all health insurance programs. That would be a true “abortion mandate.” There seems little likelihood of such a mandate beyond the exceptions for rape, incest, and the life of the pregnant woman provided under the current version of the Hyde Amendment governing Medicaid coverage. Most private insurance plans now offer the option of abortion coverage, but many employers don’t choose it. It’s not part of what most Americans assume should be covered.

Second, there is a question of whether abortion services would be included in the “public option.” This should not in itself be a problem for pro-lifers. The principle behind prohibiting public funding of abortion is that it compels some taxpayers to pay for something they conscientiously oppose. To be sure, we have no problem doing that when it comes, for example, to carrying out the death penalty conducting wars. Regardless, it’s irrelevant here. The insurance plans will pay benefits out of the same mix of funds provided by the insured themselves and public subsidies. Those who do not want to underwrite abortions would need to choose an insurer that offered no abortion services.

Third, there is a bona fide issue when it comes to the public subsidies that would help those with insufficient incomes pay their premiums. The problem here is that banning the use of such subsidies for any abortion services could have the effect of making it impossible for some taxpayers to obtain coverage for abortion that actually is offered by private insurers. One way to solve this issue is to treat government heath insurance subsidies as vouchers. Just as families can now use government vouchers to subsidize their children’s attendance at religious primary and secondary schools (thus avoiding direct government subsidy of those religions), so it seems reasonable to use the same mechanism to let them obtain abortions. Not that this argument will cut much ice with the pro-life community…