ProLife ProPatria -

The U.S. House of Representatives, using a parliamentary move, has just passed the Senate Patient Protection and Affordable Care Act.  With or without the separate package of amendments forwarded to the Senate in the reconciliation process, this bill is law the moment the President signs it.  Much ink has been spilt over the question of whether abortion is directly (or even indirectly) funded by this bill.  Republicans and pro-life advocates argue that the bill allows for direct funding of abortions with taxpayer dollars while Democrats steadfastly deny this.  Muddling through the 1700+ pages of this difficult-to-understand and extraordinarily complex bill, it seems that the difference in interpretation between Democrats and Republicans on this issue comes down to how much faith you have in the President and the Secretary of Health and Human Services.

Here’s how it works.  The first concern is the principle of “segregation of funds.”  In the new health insurance “exchanges” that will be set up, presumably in a fashion that would allow an individual (or a business) to compare policies based on standard and universal terms in “plain language,” separate plans will be offered that either include or do not include abortion coverage.  Every exchange in every market must have at least one plan that includes abortion and one plan that excludes it (so at minimum, we have federally-mandated abortion coverage).  For a plan that includes abortion, a premium of at least one dollar a month must be charged and “segregated” from other funds (Sec. 1303).  These segregated funds can only be used to pay for abortion services.  This is precisely the same principle that has been at work in the United States for years in its funding of Planned Parenthood with taxpayer dollars: Congress demands that Planned Parenthood “segregate” federal funds from other resources and that federal dollars go only to health services, but not to abortions.

The second concern is that the Secretary of Health and Human Services is under a mandate to create a federally-subsidized insurance product that will be offered on the insurance exchanges.  This federal program is not a “public option,” because it will be run by as a non-profit entity by a consortium of private institutions.  Thus, the federal government is not directly operating an insurance option.  The same principle applies with Fannie Mae and Freddie Mac (the instigators of our financial crisis in the United States).  These corporations are operated as not-for-profit organizations, but they are subsidized (almost entirely) by the federal government.

Presumably, this non-profit federally-subsidized insurance product will not offer abortion coverage.  Unfortunately, we simply do not know much about it.  The Secretary of Health and Human Services is to create this product, but there are scant guidelines from Congress; thus, she has wide latitude.  One could suppose that, given the established legal precedent in this country, court cases will be brought to bear immediately that will reaffirm previous decisions and force the government plan to cover abortion services.  But, this is merely well-reasoned speculation.

Finally, any direct appropriation in a Congressional bill is not covered by the Hyde Amendment which prohibits the use of federal dollars for abortion services, except in the case of rape, incest, or concern for the life of the mother.  This means that any time an amount of money is directly allocated in the bill, there is no restriction as to how that money is used.  Immediately, $7 billion has been appropriated to “community health centers,” which have not traditionally performed abortions but are not prohibited from doing so.  Additionally, $5 billion has been allocated to the Secretary of Health and Human Services to facilitate subsidizing a high-risk pool of uninsured Americans. Without getting into what a high-risk pool is, quite simply, this $5 billion can be legally used to subsidize plans that cover abortion.  Any other direct appropriations from Congress can do the same.

So what does this all mean?  We have three cases.  The first is an issue of classification.  “Segregating” funds is as unconvincing in the health care bill as it is in the federal support of Planned Parenthood.  If federal funds pay for one program, the institution’s own funds are freed up to pay for another.  So, our taxes pay for pap smears while freeing up Planned Parenthood funds to pay for abortions.  This is not morally comforting.

The second case, the creation of a federally-subsidized health insurance option, seems to depend on the courts.  This portion of the bill does not directly support abortion, but it does effectively support it.  It is certainly not unreasonable to assume that a court will overturn the restrictions on abortive care, claiming that it is an essential part of healthcare and thus should be covered.

The most disturbing portion of the bill involves the direct appropriations.  To believe the federal government will not pay for abortions, one must trust the Secretary of Health and Human Services to stand on a pro-life principle she has publicly and explicitly refuted.  She has at her immediate disposal $12 billion, which can be allocated legally and without restriction to insurance plans and health services that provide abortion.

So, can Democrats claim that the bill does not provide for abortion?  In a way, they can.  The bill provides ways for othersto provide for abortion.  One degree of separation seems to be enough for talk-show punditry, but it does not make a compelling case for life.  We cannot say with certainty that this bill will lead to an increase in abortions, but all indications suggest that it will.  Most disturbingly, the tax dollars of individuals who object to the wholesale slaughter of children will be used to do precisely that.

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