Abortion and Health Care Reform

Pulling Together After a Missed Teachable Moment

abortion-and-health-care-reform-flash

Gratitude and gloom colored my view of the debate over health care reform.

On St. Patrick’s Day 2009, I learned that my chronic leukemia had morphed into a much more formidable lymphoma. It was not, statistically speaking, the cancer one would choose, especially as a husband and a father with two teenaged sons and a 20-year-old daughter. But I had sound health insurance, which allowed me the best treatment at one of the nation’s best hospitals. I was, therefore, especially grateful when reminded about the tens of millions of other Americans who lack medical insurance altogether.

The gloom descended when legislative dynamics seemed to pit the demands of Social Justice against the rights of the Unborn. The conflict was no surprise. Years ago, in sadness and frustration, I left the Democratic Party, unable to abide any longer its mindless pro-choice orthodoxy. At the same time, I had no illusions about the Republican Party’s building the “Culture of Life” which George W. Bush talked about (after electorally exploiting his Texas record of capital executions but before misleading us into Iraq). And politics is politics.

No, the conflict brought no surprise. But the Uninsured vs. the Unborn had the makings of especially stark tragedy.

My sense of tragedy, I confess, was heightened at times by a laughably self-centered fear as to what major political event I would last witness (earthside). Specifically, I feared departing while watching a major affront to the seamless garment — the commitment to a consistent pro-life philosophy.

I held and hold the seamless garment precious. It sustained me during my seventeen years defending death row inmates and capital defendants in Alabama and New York. It animated my writing. It accompanied me into any voting booth I entered. It has served as my tent, my flag and my sail.

Given the depth of voter opposition to publicly funded abortion, how difficult would it have been for a unified pro-life community to lock in, as part of a universal coverage agreement, the kind of steel-trap language the Stupak Amendment contained?

And what a symbolic, as well as substantive, victory it would have been. Protection of the less advantaged from illness, while safeguarding the unborn — what a rebuke to those pro-choice wags who caricature us as caring for life only from conception to birth.

Sadly, party allegiance trumped pro-life principle.

Now I envisioned mockery of the seamless garment by either the further indefinite postponement of universal health coverage or the enactment of reform that would increase the number of abortions in America. At my most pathetically maudlin, I fancied myself akin to members of the San Patricio Brigade, the Irish soldiers who switched sides in the Mexican-American War. Moments before hanging they had to witness the Mexican Army’s final capitulation.

But it wasn’t all in my morose imaginings. Objectively, at the intersection of health care reform and abortion there indeed awaited not just two potential tragedies but three. The first, the defeat of health care reform, has been averted. (Harvard Medical School researchers have estimated that lack of universal coverage has meant 45,000 unnecessary deaths annually.) The second, an increase in the number of abortions, could still unfold. (In contentious yet civil exchange last May on abortion and the Obama presidency, Douglas Kmiec and Robert George seemed to agree that federal funding could potentially increase abortions annually by the hundreds of thousands.) Whether that second tragedy does unfold, though, depends on whether we learn from the third tragedy, which has already occurred, the tragedy of the missed teachable moment.

A missed teachable moment

We need to look mainly ahead not back, but let’s be honest. Had the pro-life community pulled together across party, interchurch and intrachurch lines, it’s a certain bet that 100%-guaranteed-belts-and-suspenders “abortion neutral” reform (to use the United States Conference of Catholic Bishops’ term) would have been obtained.

Yes, Barack Obama campaigned on a hardcore pro-choice platform, but he has backed away from, for instance, the Freedom of Choice Act. More, both the White House and the Congressional leadership sorely wanted a bipartisan bill. Given the depth of voter opposition to publicly funded abortion, how difficult would it have been for a unified pro-life community to lock in, as part of a universal coverage agreement, the kind of steel-trap language the Stupak Amendment contained?

And what a symbolic, as well as substantive, victory it would have been. Protection of the less advantaged from illness, while safeguarding the unborn — what a rebuke to those pro-choice wags who caricature us as caring for life only from conception to birth.

Sadly, party allegiance trumped pro-life principle, pretty much throughout. Among Republicans, only one brave representative, Anh “Joseph” Cao (a former Jesuit from New Orleans), staked out a consistently pro-life stance by gaving support to the original House bill, which contained the Stupak Amendment. Senate Majority Leader Harry Reid, though long boasting pro-life convictions, vocally opposed the Nelson-Hatch-Casey Amendment, which the USCCB judged necessary to ensure abortion neutrality.

Sadder still was the mixed performance of Church leaders. The USCCB, to these ears at least, seemed pitch perfect most of the time. The question of whether the USCCB was wrong or right in opposing the House’s adoption of the Senate bill yields, for now, to good faith disagreement.

The USCCB was terrific, yet individual bishops disappointed. More than a couple seemed MIA. Worse, some appeared more intent on advancing Fox News talking points than explicating moral premises or unpacking prudential judgments. Visit some of the diocesan and archdiocesan web sites that still carry the past year’s statements by various shepherds. Sample the messages of let’s-not-rush-reform, the overemphasis of subsidiarity at the expense of solidarity, and the heavy-handed insinuations as to (government not insurance company) rationing and (government never insurance company) bureaucracy. Don’t miss, too, the subtle crediting of the “death panel” nonsense. You will wonder whether in some church circles the RNC playbook and Rush Limbaugh had edged out Benedict’s Caritas in Veritate and the Catechism.

But what is done is done; opportunities lost are lost. Work awaits.

Work awaits

But what is done is done; opportunities lost are lost. Work awaits.

Whether health care reform will result in an increase in abortions, on account of purported loopholes, or decrease, on account of better health services (including prenatal care), will likely turn on the vigilance of the whole pro-life community.

Whether health care reform will result in an increase in abortions, on account of purported loopholes, or decrease, on account of better health services (including prenatal care), will likely turn on the vigilance of the whole pro-life community.

In a better world, final heath care reform would have contained the Stupak Amendment. Pro-life Democrats would not even have had to consider compromising and accepting in trade Obama’s executive order forbidding federal funds going toward abortion. Those who dismiss that order as empty, however, overlook, among other things, its recognition that “it is necessary to establish an adequate enforcement mechanism to ensure that Federal funds are not used for abortion services.” The pro-life community should be on this like white on rice.

Billions of dollars will go for community health centers. The USCCB fears that, statutorily, these funds could pay for elective abortions, notwithstanding contrary representations. While pledges remain fresh, pro-lifers need to ensure the prompt adoption of the promised “enforcement mechanism” that will guard against such spending. More, we need to make plain that our collective attention will never drift from the danger of such spending. Never.

Perhaps more subtle is the problem of federally subsidized insurance plans that allow for abortion coverage. All purchasers of such policies must pay a separate fee to cover abortion. Whether this actually keeps tax money from making abortion more available will depend on how closely insurance companies are monitored. Will they be kept from reaching outside this separate fee pool to reimburse for abortion services?

This still leaves the problem of the pro-life family for whom the abortion-covering plan offers necessary coverage, coverage not encompassed by available plans excluding abortion. These families should not have to choose between contributing to a discrete abortion-services pool and ensuring that husbands and wives, daughters and sons, have access to the range of services required by their particular circumstances. It would be a sad reform indeed that extends first-time coverage to millions of families while putting in a vice the consciences of other families.

The number of pro-life families who will face this dilemma defies prediction. Still, we can say confidently that these situations will be fixable through unified pro-life pressure. Again, overwhelmingly, Americans, independent of opinions on abortion itself, condemn making people pay for abortion in violation of their personal beliefs. Armed with real-life instances of such injustice, the pro-life community can mobilize such sentiment and ensure whatever reforms the Reform may require.

Of course, this will require the pro-life solidarity so lamentably absent on the last go-round.