Monday, December 21, 2009

One hell of a “single issue”

The topic of the day is not so much the fact that Democrats in the Senate corralled the 60 votes needed to advance health insurance reform legislation, but the compromises they had to make with conservative and independent members of the caucus in order to get there – namely, ditching the public option (still a piece of the House bill) and increasing restrictions on abortion funding.

It’s the second one I want to talk about. I can’t speak for every pro-choicer out there, but I for one have had to do a lot of soul-searching over the past two months. I’ve had to think about my priorities. Namely, is true reproductive freedom – where contraception and surgical abortion are not merely legal, but available – enough of a deal-breaker for me to support jettisoning reform altogether? Am I truly a “single-issue” voter?

That’s the situation we find ourselves in today. In both the House and the Senate, the reform bills arguably would not have passed without concessions to anti-choice Congresspeople. While it continues to piss me off that health issues almost exclusively concerning women (or at least perceived as such) always seem to be at the top of the list of bargaining chips, I can’t ignore that fact that, if reform fails, women will also be hurt. Among those millions of uninsured Americans are women – pregnant women, women with breast cancer, women working two or three hourly-wage jobs to put food on the table.

Also, it’s plainer to me than ever that my personal position on reproductive care is well to the left of many Americans, and that this is largely due to the average American’s un-engagement with issues of women’s health. So those of us who support full reproductive freedom have the continuing responsibility to move the conversation away from inflammatory (and inaccurate) blow-up pictures of Photoshopped fetuses and educate our communities about how anti-choice laws are bad policy for everyone.

In other words, I’m okay with preserving the status quo on federal funding for abortion if it means we can improve the overall health care for millions of Americans. But the provisions in the House and Senate versions of the reform bill go far beyond that. Since 1976, it’s been illegal for federal funds (through Medicaid and other Department of Health and Human Services programs) to pay for abortions. Yes, this has disproportionally affected low-income women. Yes, there’s not a single abortion provider in nearly 90 percent of U.S. counties.

But that’s not good enough for Congress, apparently. For instance, the Senate bill that narrowly overcame a filibuster last night would affect everyone who gets a stipend to buy insurance (which would be quite a lot of us if the new law mandates that everyone buy coverage). According to RH Reality Check, the bill:

"Requires every enrollee--female or male--in a health plan that offers abortion coverage to write two separate checks for insurance coverage. One of these checks would go to pay the bulk of their premium, the other would go to pay the share of that premium that would ostensibly cover abortion care. Such a check would have to be written separately whether the share of the premium allocated for abortion care is .25 cents, $1.00, or $3.00 of the total premium on a monthly, semi-annual or annual basis. Employers that deduct employee contributions to health care plans from paychecks will also have to do two separate payments to the same company, again no matter how small the payment."

Sooo… It’s not enough that an individual writes a check, and then the insurance company itself divides the premium into pots (which several states already do with their federal Medicaid money in order to comply with the Hyde Amendment). Nope, everyone has to write two separate checks. Which of course will have the effect of reminding every single person writing that premium check once a month that abortion exists, and that people get them – and would do so in a more abstract way than, say, personally knowing a woman who needs an abortion halfway through her pregnancy for medical reasons. Remember that this will affect private insurance companies that currently cover abortion, and which have chosen to do so because their market demands it – so much for the idea that conservatives are A-OK with private enterprise!

It’s a blatant attempt to drum up negative feeling for reproductive health. If you think I’m being paranoid, ask yourself – where’s the separate “pot” for funding prescriptions for Viagra, or medicinal marijuana? Going beyond health care, why aren’t our income tax payments apportioned into the War Fund, or the Death Penalty Fund, or the Federal Subsidies for Factory Farms Fund? My tax dollars go to fund plenty of things of which I personally disapprove.

I am willing to support this initial effort to reform our broken health insurance system, which would benefit women in many ways (eliminating discrimination in premium costs for one thing; ending dropped coverage for actual sick people, another). But the current proposals go far beyond the restrictions on abortion funding we’ve had for more than 30 years. It’s patently unfair for anyone in Congress to hold reproductive health hostage as part of such a critical piece of legislation. If they want to further restrict access to a legal medical procedure, let them write and submit a separate bill.

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