Though the Senate health reform bill released Wednesday didn’t contain the extreme abortion coverage restriction attached to the House bill, the bitter fight over abortion funding in healthcare reform isn’t over. Senator Orrin Hatch has already promised to offer his own version of the House’s Stupak amendment when the bill comes to the floor, and even if the bill makes it out of the Senate without it, another fight over the restrictions is all but inevitable when two bills go to conference.
The Senate bill offers prochoice advocates hope of reversing the disastrous House vote. But to keep Stupak’s restrictions out of a Senate bill and, most importantly, the final legislation, it’s necessary to understand why the well-organized and well-funded women’s health movement wasn’t able to avert the “Saturday night massacre” in the first place.
Consideration of the Stupak amendment, which would strip abortion coverage even from women who pay for premiums through the health insurance exchange with their own money if they use any federal subsidy at all, shouldn’t have come as a shock. Similar amendments had been afloat in both the House and Senate earlier this summer. And throughout that time, Stupak and his antiabortion colleagues had been threatening to do exactly as they did. What’s more, despite prochoice gains in the last two election cycles, the House still doesn’t have a prochoice majority. And indeed, a number of prochoice leaders report being unsurprised that antichoice House Democrats forced a vote on the extreme measure.
Even so, at least some of the Stupak problem was about how women’s advocates played the game: extremely nicely. Women’s groups were measured in their politics, trying hard to get along and keeping their gripes and dissatisfactions to themselves. But such good behavior rarely does well in Washington. And against the kind of strong-arm techniques that the bishops and antichoice Democrats wielded, it didn’t stand a chance.
Stupak is even more of an insult to prochoice groups when you consider what they really wanted: to have abortion be treated as an integral part of healthcare. Rather than being paid for with dollars that are practically fingerprinted at every turn, abortion, in this view, would be more like a vasectomy–a routine, if personally delicate, outpatient procedure. But hoping not to muddy the overall health reform process, advocates tried, at first, to leave abortion politics out of the legislation. The tack was eminently reasonable; health reform, after all, was a much bigger issue. Why did abortion have to get mentioned at all?
By the end of June, they had their answer. Nineteen Democrats, including Bart Stupak, sent a letter to Pelosi announcing they would not “we cannot support any healthcare reform proposal unless it explicitly excludes abortion from the scope of any government-defined or subsidized health insurance plan,” making it clear that the high-minded effort to keep a fight over abortion out of healthcare reform hadn’t worked. Stupak’s demand meant changing the status quo on abortion and indeed his amendment would ultimately result in many women losing abortion coverage they already have. It would also likely erode abortion coverage throughout the entire insurance industry, public and private, according to a a report from the George Washington University School of Public Health.