In recent days, the opposition to health reform legislation has been cranking up a pro-life meme, to the effect that the legislation will mandate government funding of abortions. I’ve addressed the elements of the charge here, and proposed a federalized solution to the issue here. But because the meme is being pushed so hard–as in this ad from Family Research Family Action–it’s worth making clear the extent to which “the government” is already paying for abortions.
Since 1993, the Hyde Amendment restricting federal funding of abortion has required that Medicaid pay for abortions in cases of rape and incest, and when the life of the pregnant woman is endangered. Beyond that, 17 states comprising over one-third of the U.S. population, provide funds of their own to cover abortions in all or most circumstances. An additional six states supplement the federal Medicaid mandate to cover abortions in some circumstances. Here‘s a precise enumeration, and here‘s a brief summary of the Medicaid funding situation in the states:
under Hyde Amendment Only: Alabama,
Arkansas, Colorado, Delaware,
District of Columbia, Florida,
Georgia, Idaho, Kansas, Kentucky,
Louisiana, Maine, Michigan,
Missouri, Nebraska, Nevada,
New Hampshire, North Dakota,
Ohio, Oklahoma, Pennsylvania,
Rhode Island, South Carolina,
Tennessee, Texas, Vermont, and
Amendment and Additional Health
(physical health), Iowa (fetal
(fetal abnormality), Utah
(physical health and fetal
abnormality), Virginia (fetal
abnormality), and Wisconsin
or Most Health Circumstances: Alaska,
Arizona, California, Connecticut,
Hawaii, Illinois, Maryland,
Massachusetts, Minnesota, Montana,
New Jersey, New Mexico, New
York, Oregon, Vermont, Washington,
and West Virginia.
with the Hyde Amendment: South
Dakota (life endangerment only).
In short, public funds underwrite abortion services everywhere in the U.S. in certain circumstances and in states comprising close to half the population in others. The point to emphasize is that by deciding what to cover and not to cover under Medicaid, the federal government and the states have all established minimum standards of treatment with respect to abortion. Health reform should, it seems to me, aim to maintain the status quo with respect to abortion, which means keeping these minimum standards intact.
Thus, the Hyde Amendment rules for Medicaid, which is to be modestly expanded, should remain as they are. And such additional Medicaid abortion coverage as states provide should be included in the public subsidy program for those who are eligible–with the states that currently underwrite abortions not funded by the feds providing that subsidy as well.