Pro-Life Debate: Repeal ObamaCare or Just Fix Abortion Funding

Opinion   |   Steven Ertelt   |   Nov 19, 2010   |   6:03PM   |   Washington, DC

Two pro-life thinkers are engaged in a heady debate about whether to repeal  abortion-funding ObamaCare or merely fix the law to stop its abortion-funding components.

Richard Stith, a professor of law at Valparaiso University School of Law, initially argued at the Catholic blog first Things that the ObamaCare law ought to be kept in place because it provides health care coverage for those who don’t have it, but said it should be modified to stop abortion funding.

Stith takes somewhat of a pro-life statist or pro-government argument:

Some pro-life leaders have advocated repeal of “Obamacare,” because it requires the public in various ways to fund abortion. Although I agree with their assessment of the law, I disagree with their proposed remedy. The pro-life cause would be far better served to keep the current law, provided that it be amended to include something like the original addition proposed by Congressman Stupak that fully excluded elective abortion from all state plans, except as an individual rider, consciously chosen by the insured person.

My disagreement stems not just from the fact that the healthcare law includes various pro-life provisions, such as new help for pregnant women, which may make them less likely to choose abortion. I think that even if these good aspects of the legislation are outweighed by its bad aspects, that is, if the net effect of the legislation at the moment is to advance abortion, it should not be repealed.

In order to explain my position, let’s step back a moment to remember the situation prior to the new law, when health care was, except for the poor, much more market driven. The market was not favorable to life.

James C. Capretta, a fellow at the Ethics and Public Policy Center, responds with his more market-based approach. He first gives an astute summary of Stith’s arguments:

His logic goes something like this. In the healthcare marketplace of today (before the new law’s provisions take effect), private insurance, including plans organized by employers, more often than not covers elective abortions. Under the new law, the government will start running a larger share of the insurance marketplace in 2014, and subsidize it explicitly with tax dollars. That means more Americans who are now in today’s private insurance market will get their coverage in the future through a system organized by the government.

The theory of course is that, if ending insurance subsidy funding of abortions is the goal, then perhaps a government-run system with a tight prohibition on abortion funding might reduce abortions significantly by stopping insurance-funded abortions altogether.

Capretta responds:

Stith has a point. It’s true that many Americans are unknowingly subsidizing elective abortions through their private health insurance premiums today. They often have no choice in the matter, as their employers are making the decisions about what’s covered and what’s not in employment-based plans. Stith’s perspective is certainly a legitimate position for a pro-lifer to take, given where things stand.

But is it the only legitimate position for pro-lifers? The answer is most definitely “no.”

The issue of how a healthcare system addresses abortion provision is of course of paramount concern. Indeed, it is a necessary condition of an acceptable program that it not force Americans to subsidize the elective abortions of others. That is a non-negotiable first principle that pro-lifers have rightly made their top priority.

But for many Americans, including many pro-lifers, that is a necessary but not sufficient criterion for determining the acceptability of a reform program. There’s much, much more to consider. For many pro-lifers, even if the new healthcare law were amended to include the Hyde Amendment (against funding abortion) and Weldon Amendment (conscience protections), the amended law would still be so flawed, because of what it would do to the American economy as well as American health care, that the only remedy is its full repeal and replacement with economically sound reform that is also pro-life. Of course, pro-lifers are under no obligation to share this point of view. It is not a precondition for pro-life sentiments. But neither are pro-lifers under any obligation to accept at face value the supposed benefits of the new law when reason tells them otherwise.

Stith responded today at First Things to the Capretta rebuttal:

I appreciate Jim Capretta’s response to my First Things article, and especially his emphasis on the legitimacy of disagreement among pro-life people.

Where state action is involved, community decisions can be legally addressed and limited. If abortion and euthanasia are returned completely to the private market, given our widely pro-death courts and culture, I fear that they could easily continue to creep into our psyches without a good way to combat them. Only legal prohibitions would sometimes remain as a possibility. But the Supreme Court has made prohibitions nearly impossible with regard to abortion and, in any event, I am not sure prohibition is always the best way to seek cultural change, at least in our libertarian society.

Better, perhaps, to teach the wrongfulness of abortion via its exclusion from public funding, and even better, via government campaigns against it along the lines of the anti-smoking campaign.

Ultimately I find myself favoring Capretta’s approach over that of my friend Professor Stith.

When government gets involved in something, money invariably plays a part and lawmakers of both political parties have proven unable to stop the money train. We know Planned Parenthood, NARAL and their friends would continue to lobby for taxpayer funding of abortions in a government-run health care scheme and Americans would likely be forced to pay for funding with every swing of the political pendulum much the same way they do when the Mexico City Policy is turned on or off by various presidents or as in the case of the current fight over the Burris amendment and abortions at military bases.

This would leave American taxpayers’ pocketbooks subject to the whim of whichever Congress and White House can put laws in place or repeal them to fund or not fund abortions. On the other hand, a market-based approach allowing for more insurance companies to provide more products — much the same way we see the influx of auto insurance companies today — would allow pro-life Americans the chance to find suitable health insurance from a range of companies, some of which would not (and do not now) pay for abortions.

I think my view and that of Capretta is buttressed by the fact that the abortion industry itself (the Guttmacher Institute) finds most women pay for abortions out of pocket, with insurance companies picking up the costs of just 12 percent.

Some 57 percent of women paid for their abortions, 13 percent received help from a nonprofit pro-abortion group that pays for poor women’s abortions, and 20 percent got their abortions covered under Medicaid, as some states allow state tax dollars to pay for abortions. Of the women who did have private insurance at the time of their abortion, 63% still paid for their abortions out of pocket.

So having a government-run scheme would create what is now a generally non-existent problem of most Americans supposedly paying for abortions via their insurance premiums. Ergo, the best approach, in my opinion, is the market-based one whereby ObamaCare is repealed, insurance choice and availability outside the government purview is promoted, and Americans fight a much more manageable battle to stop abortion funding via the Hyde Amendment (which has done us well for decades) and other means as we have before instead of within a massive government program.

I’d also argue that Stith takes us away from where the battle should be.

Putting the debate back in the funding realm gets us off the question of protecting human life under law, which still ought to be our end goal. Whether the libertarian society favors it or not, unborn children deserve legal protection (which I know Stith believes) but having to fight a government-run health care system forces the pro-life movement off-task and off-message. We’re forced to wage such a huge battle on that front that we wouldn’t have the ability to change the Supreme Court via a pro-life President and pro-life Senate to put us in the position of reversing Roe.

The sooner the pro-life movement can stop playing defense, the faster we can get back on offense and move the ball down the road to ending abortion.

Also, this debate says nothing of the problems associated with rationing, and a massive government-run system would cause more problems than dealing with various insurance companies facing public pressure (competition) to cover medical treatment.

Finally, great job for both gentlemen in showing the rest of the pro-life movement how to have a scholarly debate on pro-life strategy without kindergarten name calling. Well done.