Abortion and Health Care Reform

Coverage for abortions has been raised as a point of contention in the planning for a new national health care system. It needn't be.

The U.S. government traditionally has not paid for abortions or services related to abortions. There are a large percentage of U.S. citizens who feel abortion is immoral and don't want their taxes used for it. There are a large percentage of people who don't want their taxes used for nuclear weapons, land mines, cluster bombs, torture in secret prisons, the Iraq invasion, etc., but once the horse is out of the barn and something has been paid for once, it's hard to change those policies. The anti-abortion movement doesn't want to end up in the same position.

However, when the issue is payment for abortion in the context of payment for ALL medical services, it becomes a non-issue. Most employer health plans cover abortions, and no one is quitting their jobs over it. The fact is that abortion is much cheaper than pregnancy, childbirth and neonatal care, with all their potential medical disasters. A health plan that excludes coverage for abortion isn't going to cost any less than one that includes it. It could even cost more, if you were to assume that none of the people who lacked health insurance coverage went ahead with their abortions by paying out of pocket.

Any national health plan that includes the choice of employer plans does not need to address the issue. People who choose a private health plan can simply privately contract with the same plan for an additional rider to cover abortions. It would probably have a nominal cost or be free.

People who chose a public option for coverage would not have the possibility of purchasing the rider, so they would have to get it from a private company or continue to pay cash for the procedure. Since private companies would not be on the line for the cost of those people's pregnancy complications or premature babies in ICN's, they would rightly charge them extra for the abortion coverage. Charitable organizations which support abortion options might set up private funds for low income women, which people could support with private donations (which would be tax deductible so long as that division of the charitable organization did not engage in any political activity).

It's interesting that the people opposed to including a public option for health coverage, and who are aghast at the idea of a single-payer health plan, are by and large the same ones who don't want abortions covered with federal funds. By excluding any public option, they're actually making it much easier for everyone to have full coverage for abortions. By supporting the status quo (for the length of time the status quo continues to be tenable without reform), they are in effect continuing to give the majority of women coverage for abortion services.

Maybe they ought to think this through a little more?