Hullabaloo

Tuesday, July 14, 2009

 
"Whatever the merits are..."

by dday

For the second day in a row, Chris Matthews ranted about the prospect of a potential public health insurance option covering abortion services, and his lineup of talking heads agreed that this was "the last thing Obama needed" and that Obama was a hypocrite because he met the Pope last week.

MATTHEWS: What do you make of the 19 House Democrats who said there can't be any abortion funding in this bill? There can't be any national health insurance payments for abortion. What do you make of that choice? And by the way, Bob Casey of Pennsylvania today voted, yesterday voted with the Republicans to ban any money from this bill that's supposed to be for national health to go for abortions?

NAVARETTE: It's the last thing Obama needs. The issue's complicated and divisive and controversial enough without bringing abortion into it. The American people are giving mixed signals. They say they don't want to pay for the program but they do want to cut costs, and they want to pay for some kind of reform, but don't get in the way of my doctor and the tests he might order. So they're all over the map. Clearly, politicians are trying to be responsive to that. It's a tough enough issue without trying to bring abortion into it. Obama's in a tough spot, I don't think he gets this through.

MATTHEWS: Well, I think he did, I think he will, but he's gonna deal with this thing. What do you think, Roger, because this could be the straw that breaks the camel's back. Because when I see it coming, it came from nowhere. I started reading about it this weekend in the Weekly Standard, and I watched Hatch last night on this show stating that he pushed to ban it. The law says, it has said since the 70s, under a Democratic Congress, no federal money pays for abortions. It has been the law of the land, and now they're trying to change it.

SIMON: Whatever the merits are, as Ruben said, as you are saying just now, this is just a fight that President Obama does not need. There are other problems with the health care bill. First of all, what is it going to look like, are you going to have a true public option, how are you going to pay for this trillion dollar program. You don't need to add in a hot-button issue like abortion. To most Americans, abortion is a settled issue.

MATTHEWS: You mean the right to an abortion. But not payment for it.

SIMON: That's right. Safe, legal and rare, and don't bother us about it.

MATTHEWS: By the way, the night he tells the Pope, he goes over to see the Pope and says they're going to reduce the number of abortions, and then that same week he pushes to subsidize abortion? You can't do that!

SIMON: I think last week is a week the White House would like to have back.

I wonder if Tweety came up with that phrase, "subsidize abortions," himself, or whether he read it in his beloved Weekly Standard. I expect we'll hear it a lot in the weeks to come.

And I also want to looks at Roger Simon's "Whatever the merits are," which is a classic pundit phrase, where they don't want to deal with the reality of a situation, so they burrow into the politics. Let me tell you what the "merits" are of including a legal medical service like abortion into a public insurance plan. Actually, let Dana Goldstein tell you.

So when opponents of abortion rights say they'd like to "maintain current policy," what they likely mean is that Hyde should also apply to any potential public health insurance plan, thus maintaining the federal government's ban on abortion funding. This would make a public plan much less attractive to women of reproductive age. A full 90 percent of current private health plans cover abortion services, and 89 percent cover contraception. According to a poll by the Mellman Group on behalf of the National Women's Law Center, 71 percent of Americans support coverage for reproductive health, including contraception, under a public plan. Sixty-six percent support coverage for abortion in a public plan. Americans hope that a public plan will provide services comparable to what they can purchase on the private market. They don't see health reform as grounds for a culture war.

Let's go further than this. 17 states cover abortion under Medicaid by using their portion of state funding to pay for it (another reason why letting the federal government fully fund Medicaid might be a problem). The Matthews/conservative version of a public plan would be worse than Medicaid in those 17 states. In addition, the entire premise of Matthews' critique, ripped from the pages of The Weekly Standard, is just wrong. As the just-released House Tri-Committee bill describes, the public insurance option is completely self-sustaining and pays for everything out of its own premiums. There's public money involved in the sense that the Health and Human Services Secretary would have to hire administrators, but basically this is a self-funded insurance program.

SELF-SUFFICIENCY
Public option must be financially self-sustaining, as private plans are.

Public option will need to build start-up costs and contingency funds into its rates and adjust premiums annually in order to assure its financial viability, as private plans do.

As Goldstein notes, the Hyde Amendment, that law from the 70s that Tweety cites, "is not under threat from any of the proposed House or Senate health reform bills." Meaning that Medicaid and other public health programs will continue to deny legal abortion services as part of their coverage. It's sad that Democrats are already conceding that, but Republicans want more. Not only do they want reproductive choice banned from a self-sustaining public option, they want it banned from any private insurance company that offers coverage inside these "insurance exchanges" designed to provide small businesses and individuals more choice and greater purchasing power to receive health insurance. As said before, 90% of all private insurers include abortion services in their coverage. Anti-choice Republicans don't just want to follow existing law, they want to create new policy that says anyone the federal government does business with cannot offer abortion services as part of their coverage to consumers. The Hyde Amendment already discriminates against poor women who cannot afford health insurance; the anti-choicers would extend that.

Under Tweety Bird's construction, Obama walked into a minefield by trying to "subsidize abortion." That's absurd. And the merits of the policy, contra Roger Simon, are important and shouldn't be set aside because old men consider them icky:

If the public plan does not cover reproductive health services, it will be a weak public plan. And a weak public plan, by failing to attract a constituency, is bad for the overall goals of progressive health reform; it will mean that our employer-based system is not fundamentally transformed. Could this be the true goal of most Congressional Republicans? Hmm....

And since we have a religion-industrial complex telling Democrats constantly to give ground on this issue, and a leadership willing to oblige them, they now have to choose between making their reform bill demonstrably worse and making Chris Matthews uncomfortable. Sadly, I fear they'll opt for the latter former. I'm very sorry that the continuing discrimination against women's rights to their own medical choices is a tough policy under which to find middle ground, but that's no reason to disable health care reform by hamstringing it.

By the way, you know who I didn't see in that Hardball discussion? A woman. Funny how that is...



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dday 7/14/2009 05:00:00 PM |