Pro-choice advocates have been "forced … into a corner" by legislative maneuvering and should fight to "regain momentum," a Guttmacher Institute official says in a rally-the-troops article.
"Antiabortion advocates have unveiled a radical agenda aimed at eliminating abortion coverage from any health insurance plan that in any way touches a public dollar, whether directly or even indirectly, under the tax code," said Susan A. Cohen, director of government affairs for the Guttmacher Institute.
This "goes far beyond the Hyde amendment," and advocates will need to fight harder to ensure that abortion is a covered health care service under the federal government's Medicaid program, in state health care "exchanges" and in private insurance policies, she said in an analysis in the fall 2010 issue of the Guttmacher Policy Review.
Pro-life leader Marjorie Dannenfelser said that if Ms. Cohen accuses the pro-life movement of having a strategy to disconnect abortion from taxpayer funds, "I plead guilty. She is right."
"Poll after poll shows that Americans do not want their tax dollars funding abortions, yet the Obama administration and its allies in Congress have expanded taxpayer funding of abortion both here and abroad in unprecedented ways," said Ms. Dannenfelser, president of the Susan B. Anthony List, which supports pro-life issues and candidates.
The abortion issue should soon come back full force, she said. "There's really no question that [the midterm elections] will strengthen the pro-life power in the House and Senate. The question is what will we all do with it."
Ms. Cohen's analysis, "Insurance Coverage of Abortion: The Battle to Date and the Battle to Come," starts with a review of how abortion was handled in this year's debate over health care reform.
"The whole purpose of health care reform was to expand coverage of basic health services, which logically should include the full range of reproductive health services, including abortion," she wrote, noting that abortion is not rare — one in three U.S. women undergo the procedure by age 45.
When President Obama signed the Patient Protection and Affordable Care Act into law in March, it had a "meticulously designed set of rules to segregate [health insurance] premium payments so that no federal funds will go toward paying claims for abortion," Ms. Cohen wrote, referring to language written primarily by Sen. Ben Nelson, a pro-life Democrat from Nebraska.
However, pro-life leaders insisted that the Nelson amendment "is still tantamount to federal funding of abortion," and they have now laid out their "road map" to remove abortion from mainstream health care coverage, she said, referring to a bill sponsored by Rep. Christopher H. Smith, New Jersey Republican.
The No Taxpayer Funding for Abortion Act, introduced this summer by veteran pro-life leader Mr. Smith and 183 co-sponsors, will be used to "demagogue against abortion" in health care, Ms. Cohen predicted.
Other pro-choice groups have denounced the Smith bill.
The Smith bill "reaches even further than Hyde," said the Center for Reproductive Rights, referring to the Hyde amendment, a federal rider that since 1976 has disallowed direct federal spending on most abortions.
"Because of the Hyde amendment, more than 1 million women have been denied the ability to make their own decisions about bringing a child into the world," Stephanie Poggi, executive director of the National Network of Abortion Funds, said in a Center for Reproductive Rights report on how the Hyde amendment harms lower-income women.
If the federal Medicaid program was blocked from paying for any abortions, Ms. Poggi added, her network — which raises $3 million a year to help 21,000 lower-income women pay for their abortions — couldn't possibly handle "the enormous need" that would be created.
The Smith bill goes into "uncharted territory," Ms. Cohen said in her Guttmacher article: It would prevent employers from taking a tax deduction for insurance plans that include abortion coverage, disallow people to use pretax dollars to pay insurance premiums with abortion coverage or to pay for abortions under a flexible health spending account.
Even abortion foes should be able to see that these represent a "strained view" of government "funding," Ms. Cohen wrote. "But with the Democratic Party on the run leading up to the midterm elections and the disinformation campaign against the health care law being used as a rallying tool on the right, it is not surprising that antiabortion activists feel emboldened."
In fact, the Smith bill is so sweeping, Ms. Cohen added, that it could be a "a clear political, communications and legal road map" for the anti-abortion movement.
Indeed, the Smith bill will be "the first order of business," said Ms. Dannenfelser, noting that the House Republicans' "Pledge to America" promised to "establish a government-wide prohibition on taxpayer funding of abortion and subsidies for insurance coverage that includes abortion," and to "enact into law conscience protections for health care providers, including doctors, nurses, and hospitals."
The Smith bill does both those things, Ms. Dannenfelser said.
Ms. Cohen also said in her Guttmacher article that abortion battles will break out in state legislatures and even in private insurance companies.
Five states — Arizona, Louisiana, Mississippi, Missouri and Tennessee — have banned abortion coverage in state health exchange plans, even though those exchanges won't be operational until 2014.
"We anticipate more of these [exchange ban] bills will be introduced in 2011," said Dionne Scott, a spokeswoman for the Center for Reproductive Rights, which recently issued a summary of 2010 state legislative trends on abortion.
Given such negative pushback, it is "an open question" whether insurers will even attempt to offer abortion coverage, Ms. Cohen said.
Ms. Dannenfelser countered that while the Smith bill may well be a road map for federal pro-life strategies, there's no such thing for states. There are too many variables in too many states for some single strategy, she said.
However, given the strong pro-life bent of the American people, as evidenced by polls, there's no reason to not press hard on the "first priority" of any pro-life organization, which is to "detach any taxpayer money from abortion services," Ms. Dannenfelser said.
There's been "a sea change in our ability" to influence abortion debates and "we are seizing the moment," she added.
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