The abortion issue has reduced the health care debate to confusion. Let's try to put it in focus.
When Congressman Joe Wilson (R-SC) shouted "You lie!" to President Barack Obama's denial, in his address to Congress, that his health care reforms "would insure illegal immigrants," Obama retorted, "It's not true." Wilson later properly apologized to the president for disrupting the session but he reaffirmed his accusation. In the very next sentence of his speech, however, the president lent credibility to Wilson's accusation by claiming that "under our plan, no federal dollars will be used to fund abortions." Amherst Professor Hadley Arkes fairly described that statement as "a manifest lie." (www.catholicthing.org, Sept. 15). Let's evaluate it by looking at the main health care bill, H.R. 3200, which Obama has endorsed.
The Capps Amendment to H.R. 3200, approved by the House Energy and Commerce Committee by a 30-28 vote, states: "The public health insurance option shall provide coverage for ... abortions for which the expenditure of Federal funds appropriated for the Department of Health and Human Services is permitted." That limitation refers to the Hyde Amendment, a rider to the annual Labor/Health and Human Services Appropriation, which prohibits use of those funds to pay for abortions except to save the life of the mother or where the pregnancy is the result of rape or incest. The Hyde Amendment, however, is not itself a restriction on the use of funds under H.R. 3200 which itself appropriates the funds for its own operation. The Capps Amendment further states that "Nothing in this Act shall be construed as preventing the public health insurance option from providing for or prohibiting coverage of ... abortions for which the expenditure of Federal funds appropriated for the Department of Health and Human Services is not permitted." That refers to elective abortions other than those for life of the mother, rape or incest.
The Capps Amendment further requires that, among the health benefit plans "offered in each premium rating area of the Health Insurance Exchange ... there is at least one such plan that provides coverage" and "at least one such plan that does not provide coverage" of the abortion services permitted, and also those forbidden, by the Hyde Amendment.
Obama has proposed no "plan" of his own separate from the bills he has endorsed, including chiefly H.R. 3200 and other bills which allow federal funding of abortion. The question remains: Is he correct in claiming that, "under our plan, no federal dollars" will be used to fund abortions? The Capps Amendment is complicated. It provides that the federally funded subsidy for individual public option health care premiums known as an "affordability credit," H.R. 3200, Sec. 241, "may not be used for payment for" abortions for which the Hyde Amendment forbids federal payment. However, the Health Care Commissioner "shall estimate the basic per enrollee, per month cost, determined on an average actuarial basis, for including coverage" for such elective abortions. The premium charged to all enrollees in the federally operated public option would be increased by the proportional amount (at least $1 a month) required to pay for all those elective abortions. The abortionists would bill the federal agency for such abortions performed on subscribers to the public option. The abortionists would be paid by checks drawn on the United States Treasury. Everyone subscribing to public option health insurance would be required to pay the premium surcharge to support all the abortions for which the Treasury would pay the abortionists. The dollars paid to the federal government under that surcharge would obviously become "federal dollars" which would then be disbursed by the Treasury to the abortionists. Obama's flat statement to Congress and the American people that "under our plan no federal dollars will be used to fund abortions," is either evidence of an inconceivable ignorance of what is in H.R. 3200 and similar bills or it is knowingly false, that is, to borrow the words of Congressman Joe Wilson, "You lie!"
The nation's Catholic bishops, including principally Cardinal Justin Rigali and Bishop William Murphy of Rockville Center, New York, view health care "as a basic right" and "have long supported health care reform that respects human life and dignity from conception to natural death; provides access to quality health care for all, with a special concern for immigrants and the poor; preserves pluralism, with respect to rights of conscience; and restrains costs while sharing them equitably." The bishops rightly insist that payment for abortion must be excluded from any health care reform.
It would be a mistake, however, to conclude that merely excluding abortion coverage would make the proposed "reforms" acceptable. Other problems are involved. One is the definition of abortion. Many so-called contraceptive pills can operate as abortifacients. The "morning after pill," which can cause abortion, is sold over-the-counter as an "emergency contraceptive." A prohibition of funding for "abortion" would not prevent funding of such abortifacient "contraceptives." On another point, consider H.R. 3200, Sec. 1713, page 768, which provides funding for "home visits by trained nurses to families with a first-time pregnant woman, or a child (under 2 years of age), who is eligible for medical assistance." One of the preconditions for such home visits is that they "are effective" in "[i]mproving maternal or child health and pregnancy outcomes or increasing birth intervals between pregnancies." A federal functionary, therefore, would come into a low-income home to improve "pregnancy outcomes," one of which could be abortion, and to "increase birth intervals between pregnancies." By the time the bureaucrats get through writing the regulations for this, it could operate as a covert version of China's "one-child policy."
In a joint statement, "Principles of Catholic Social Teaching and Health Care Reform," the Kansas City bishops, Archbishop Joseph F. Naumann and Bishop Robert W. Finn, analyzed both the inadequacies and strengths of our current health care system. Significantly, they emphasized that the principle of subsidiarity requires that "health care ought to be determined at the lowest level rather than at the higher strata of society ... The writings of recent Popes have warned that the neglect of subsidiarity can lead to an excessive centralization of human services, which in turn leads to excessive costs, and loss of personal responsibility and quality of care."
"The right of every individual to access health care," said Naumann and Finn, "does not necessarily suppose an obligation on the part of the government to provide it. Yet in our American culture, Catholic teaching about the 'right' to healthcare is sometimes confused with the structures of 'entitlement.' The teaching of the Universal Church has never been to suggest a government socialization of medical services. Rather, the Church has asserted the rights of every individual to have access to those things most necessary for sustaining and caring for human life, while at the same time insisting on the personal responsibility of each individual to care properly for his or her own health."
Here, as elsewhere, the social and moral teachings of the Church offer principles supportive of human dignity, freedom and common sense as well as the right to life.
Professor Emeritus Rice is on the Law School faculty. He may be reached at rice.1@nd.edu or 574-633-4415.
The views expressed in this column are those of the author and not necessarily those of The Observer.
