Saturday, October 3, 2009

Compost: Government Coverage of Abortions in Obamacare Reform

Until recently, the framework for abortions set by the federal government was rather broad. Very few restrictions were placed on the practice (they are, to varying degrees, more regulated at the state level). Recent laws passed - the partial-birth abortion ban and the Laci Peterson law - at least have placed some common sense restrictions on access to abortion.* If the federal government or federal courts are going to make laws regarding when, where, how or if people should have abortions - proponents of easily available abortion need the federal government/courts to at least keep it legal in all 50 states - there should be a rational, reasonable framework.

The framework and the issue of legalized abortion can be debated for ever and ever.

*By common sense, I mean things a great majority of people should be able to agree about. By common sense restrictions: under 18 requires parental notification, no partial-birth abortions, and no late-term abortions.

Abortion is now a big issue in health care reform. Unsurprisingly, the New York Times thinks abortions should be fully covered under any public option included in Obamacare reform. No surprise there. They'd also like it to be covered under Medicaid. Again, no surprise. Any service that can be given to low- and low/middle-income people for free will be supported by the New York Times. The surprising part is that the NYT would like abortion to be covered for anyone receiving subsidies for health insurance via the proposed health insurance exchange. The gist:
These restrictions, which constitute an improper government intrusion into Americans’ private lives, apply to the joint federal-state Medicaid program, the health insurance exchange that covers federal government employees, and health programs for military personnel, American Indians and women in prison, among others. This approach disproportionately harms poor women, who often can’t scrape together enough money for the procedure until delay has made abortions more costly and more risky.

Now abortion opponents want to apply similar restrictions to low- and middle-income Americans who would receive federal subsidies to buy coverage on the new insurance exchanges that would be created by pending health care reform bills.
Wow. Here's the thing. Poor people, and all people for that matter, have the right to buy candy bars. But I'm not going to give them my money to go buy candy bars. There's a lot wrong this, but three things in particular that stand out.

1. There is no right to free or federally subsidized abortions. Abortion is an elective procedure. People choose to have them: hence people identifying as pro-choice. Saying that the government is intruding on anyone's privacy because that person has to pay for their own elective procedure is a complete distortion of the concept of privacy. Saying that the government is intruding on someone's privacy because someone else won't pay for their abortion is ludicrous. People do not have the right to expect someone else to pay for their elective procedures.

Proponents of abortion argue that the right to an abortion is largely about the government not intruding individuals' right to control their body. As an elective procedure, federally subsidized abortions would open up the decision to have the procedure to government review. Democrats will not control the government forever; what happens when conservatives regain power? The review process for approving abortions on publicly funded health insurance could become extremely restrictive, and the change wouldn't necessarily require legislative approval. This isn't a far-fetched scenario, could be the opportunity to limit abortions long sought by conservatives. Also, it would open the door for a plethora of elective procedures to be covered by government funds. Who would want their tax dollars to go towards someone's botox treatments?

2. Most modern liberals would argue against any tax money being used by religious organizations. They opposed Bush's faith-based initiatives which would have allowed religious organizations to be compete with non-profits for government contracts. There is a clear push to make sure that the "wall of separation" prohibits religion from receiving any benefits. There's also a clear push to stop religion from influencing public policy. The latter is a dubious cause - political beliefs are driven by personal and religious beliefs. To dismiss an idea - or prohibit from entering legislative discourse - solely because it is rooted in religiosity tears apart a person's freedoms to religion, thought and speech.

However, most modern liberals have no problem with government placing restrictions on mainstream religions (for instance, the use of public space for religious ceremonies or displays). Nor would they have a problem with tax money (remember, tax money for public services comes from people, not the government) being used for liberal causes or organizations. Below is a handy little chart for how modern liberals view the concept of the "wall of separation." (Green means acceptable to liberals; black means it is not.)

In this case, the NYT wants tax payer money to cover (public option) or subsidize (insurance exchange) abortions for low and middle income people. Those payments would come from taxes and fees collected by the government. I would imagine, since more Americans identify as pro-life than pro-choice, that a majority (and a large majority at that) would oppose their tax money covering another person's abortion. Some of that opposition may be driven by an opposition to frivolous expenditures with their tax money; some of it (likely a significant part) may be inspired by religious beliefs. Liberals would regard the opposition to frivolous government expenditures as the rational argument and provide a counter-argument. Since abortion is an elective procedure it is a frivolous government expenditure. But, they would dismiss the religious objection as irrational.

This is sheer hypocrisy. If religious organizations can't receive financial benefit from the government for charitable work, the objections of religious believers should be considered when the government proposes making frivolous use of tax payers' money. If the NYT thinks it's an intrusion of privacy to deny free money for abortions, it's a definite invasion of privacy and personal belief to take money from a tax payer who opposes abortion and use it for free abortions.

3. The NYT uses careful wording in lamenting the opposition to unlimited financing for abortion: Now abortion opponents want to apply similar restrictions to low- and middle-income Americans who would receive federal subsidies to buy coverage on the new insurance exchanges that would be created by pending health care reform bills. Hidden in there is that along with the insurance exchange, Obamacare proposes to have panels that will set the minimum and maximum levels of coverage. Within that span, they will decide which procedures will be above the minimum and below the maximum. In order to operate on the insurance exchange, private insurance companies would have to meet those standards. And in order to meet those standards, insurance companies would have to cover abortions.

Not only is this a huge intrusion into private business, it's also a huge intrusion into Americans' health care choices. A lot of people would not want to participate in an insurance plan that covers abortion. Even more probably would not want the money paid for their insurance premium to go toward abortions for others on the plan. If the NYT proposals took effect, people would be getting double-dipped to pay for abortions: their tax money would subsidize peoples' receipt or purchase of the public option, and their premium would go toward paying for abortions on the plan. It would inescapable: those who are morally opposed to abortion would have to finance it. Those who are opposed to their tax money being frivolously spent to cover an elective procedure wouldn't have any recourse. Even though modern liberals take pains to make sure the rights and beliefs of minority groups are voiced and considered in legislation, rational fiscal arguments and mainstream religious objections to abortion would be ignored.

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