Q&A: the Senate abortion compromise

-- What would the compromise language do?

It uses funding segregation language that has been criticized by pro-lifers for months. The compromise: 1) forces enrollees in private insurance plans receiving government subsidies to write two checks -- one for their premium and the other for elective abortion coverage, and 2) allows states to prohibit abortion coverage in government-subsidized plans (the latter of which, pro-lifers say, already was allowed). Insurance companies would be forced to keep the abortion coverage money separate from the subsidy money it receives from the government.

-- How is it different from the pro-life Stupak amendment that was attached to the House's health care bill?

Very different. The Stupak amendment prohibited elective abortions from being covered in government-subsidized plans. Under the Senate bill, the plans can cover such abortions.

-- Why has there been so much controversy surrounding the issue?

Because current law prohibits the federal government from funding insurance plans that cover elective abortions. Medicaid is prohibited from covering elective abortions, as are insurance plans for federal employees. Congress' own insurance plans, for instance, cannot by law cover elective abortions. The Senate health care bill would be a dramatic change in policy, pro-lifers say.

-- How have pro-lifers reacted to the compromise?

By heavily criticizing it. National Right to Life released a statement Saturday saying the "so-called 'firewall'" between federal money and private money "is merely a bookkeeping gimmick, inconsistent with the long-established principles that govern existing federal health programs." The organization also said "there is nothing in the language to suggest that payment of the abortion charge is optional for any enrollee." Nebraska Right to Life -- which endorsed Nelson in 2006 -- said Nelson "obliterated the hope of pro-life Americans who saw him as the last man standing" in the way of "expansion of government funding." Americans United for Life said the bill's opt-out option for states "makes abortion coverage normative" and "turn on its head the traditional federal approach to abortion." All the major pro-life groups are urging senators to filibuster and defeat the bill. The Weekly Standard posted an article that said even if a state opts out, it would leave, for instance, "Nebraska's voters entirely vulnerable to paying for California's and New York's abortions."

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-- Pro-lifers have said a change in policy could lead to an increase in the abortion rate. How?

If the bill passes, there will be women under the new plans who, for the first time, have abortion coverage. There would be no financial deterrent to an abortion, as there is for them now. The pro-choice Guttmacher Institute this summer reported that about 25 percent of the women in Medicaid who would have had an abortion chose instead to give birth because they were barred from using public money.

-- How have pro-choice groups reacted?

They, too, are opposed. Planned Parenthood President Cecile Richards said the Nelson language "is essentially an abortion rider" that shames women and "creates an unworkable system whereby individuals are required to write two separate checks each month." Richards added that it is "highly unlikely that insurance companies will be willing to follow such an administratively cumbersome system, leaving tens of millions of women without abortion coverage." Nancy Keenan, president of NARAL Pro-Choice America, called the compromise language "outrageous" and "unacceptable." But both women acknowledge the compromise does not go as far as the Stupak amendment.

-- What has Nelson said?

He released a statement saying, "I have strongly held views on the subject and I have fought hard to prevent tax dollars from being used to subsidize abortions. I believe we have accomplished that goal. I have also fought hard to protect the right of states to regulate the kind of insurance that is offered, and to provide health insurance options in every state that do not provide coverage for abortion."

-- What happens now?

If the Senate bill passes, the political battle will move to a joint House-Senate conference committee, which will work out the differences between the two bills. Rep. Bart Stupak (D-Mich.), the pro-life congressmen who sponsored the House amendment, released a statement saying he looks forward "to working with members of the House, Senate and the Obama Administration to find common ground on this issue and draft language that guarantees continuation of current law of no public funding for abortion." He called the compromise language "not acceptable" and added it would be "a dramatic shift in federal policy that would allow the federal government to subsidize insurance policies with abortion coverage." He also said the "segregation of funds to pay for abortion is another departure from current policy prohibiting federal subsidy of abortion coverage."

-- Wouldn't the Hyde amendment apply to the health care bill?

The Hyde amendment, which prevents elective abortions from being covered under Medicaid, would not apply to the new health care bill. The Hyde amendment, as well as the Stupak amendment, allow for exceptions in the cases of rape, incest and to save the mother's life.

-- Has any polling been done on this issue?

A CNN poll in November found American adults are against "using public funds for abortions when the woman cannot afford it" by a 61-37 percent margin.

Michael Foust is an assistant editor of Baptist Press.

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