Yesterday Gov. Kathleen Sebelius
underwent her first confirmation hearing to become Health and Human
Services Secretary, testifying before the Senate committee on Health, Education, Labor,
and Pensions (HELP). The hearings largely avoided issues of reproductive health, but near the end of the hearing, Sen. Tom Coburn (R-OK),
a self-described "pro-life obstetrician," asked Sebelius about the so-called conscience clause, implemented at the end of President
Bush’s days in office. The Obama administration has announced plans to rescind
the regulation after a comment period, but Coburn wanted to know, "I
would like is reassurance that we’ll at least get a heads up on what
that’s going to be prior to unilateral announcement. Can you give us
that assurance?" 

Sebelius, a Democrat who has
worked in elected office for years in a state where registered Republicans
far outnumber registered Democrats by about two to one, responded in a way that suggests she has taken a more conservative stance on this than the broader reproductive
rights community has.

"I can tell you right now
that the President supports and I support a clearly defined conscience
clause for providers and institutions. I always have. It’s been in place
in Kansas the entire time I’ve been in elected office," Sebelius
said at the hearing. "I know there was some concern about the regulation
that was proposed and implemented at the very end of the previous administration
that it was overly broad and frankly overly vague. So I don’t think
from the discussions that I’ve had that there is any intention of interfering
with the underlying legal basis." 

The hearing comes on the heels
of Sebelius’s recent singing into law a piece of anti-choice
legislation that will require women seeking abortions to be given the option of getting an ultrasound
or hearing the fetus’ heartbeat. The law also puts state funds toward
producing literature and a video on abortion. Sebelius vetoed a similar bill a year ago; it seems likely that she signed this one to avoid an dust-up with anti-choicers just moments before her confirmation hearings.  Her approval of this bill, in conjunction with her comments about the HHS rule, raise questions about
exactly how pro-choice Sebelius is and whether she’ll prioritize health
care reform over reproductive rights — a question the reproductive health community had for previous nominee Sen.
Tom Daschle, too.

Still, Sebelius has a long history
of working with Planned Parenthood in Kansas, even attending a fundraising
dinner (PDF) held by the organization in 2007,
as well as an event held by Planned Parenthood just before the inauguration.
The anti-choice right has also focused on her association with Dr. George
Tiller, a doctor that has performed late-term abortions who won a fundraising
dinner with Sebelius. (Tiller was acquitted of all 19 counts of misdemeanor in
a state court last Friday. Abortions in Kansas also declined by about
10 percent while
Sebelius was in office.)

Much of the hearing
focused not on reproductive health but rather on health care reform.
"I am
and will remain staunchly pro-life, and will advocate for the lives
of the unborn," ranking member Sen. Michael Enzi (R-WY) said at the hearing; yet Enzi said he preferred to focus on health care
reform, something that he said is "not Republican or Democratic issue" but
"an American issue." 

In an exchange with the former
Republican nominee for President, Sen. Jon McCain asked if Sebelius
would support a plan that would include a public insurance option. Sebelius,
confirming that she supported President Barack Obama’s plan,
said she would support a public
insurance option
that would compete with private insurance plans. This is widely viewed
by many progressive health care policy experts as one of the best ways
to increase competition on health insurance and bring costs down. Although
Sebelius didn’t advocate a particular kind of public insurance option,
she said she, like the President, supported having one to increase access
to health care. 

It’s true that the list of
concerns for health care reform is long. Much of the debate will change
depending on which plan is chosen for implementation. New proposals seem to surface almost monthly, including one billed
by former presidential candidate Sen. Bob Dole, who appeared before
the committee to testify in support of fellow Kansan Sebelius. "I
can’t think of a tougher job to step into now than the secretary of
HHS," Dole said. He is working in conjunction with other former senators
Daschle, Howard Baker, and George Mitchell to produce health care forums
and a proposed plan to contribute to the health care debate. 

Health care reform has certainly
been identified as a priority for the Obama administration, especially
to counteract the long-term skyrocketing costs that are projected. It’s
clear that investment in health care reform will reduce costs in the
long run.  

But it’s unclear if Sebelius,
who comes from a background as a legislator, a governor, and an insurance
regulator, will first look to overall reforms before looking at expanding
access to reproductive services, including abortion. Sebelius is used
to working with Republicans, and even former Sen. Sam Brownback, a staunch
anti-choice conservative, has endorsed her nomination for HHS Secretary.
She’s also earned the support of other Kansas-proud Republicans, like
Dole and Sen. Pat Roberts.  

It will be essential that pro-choice
women’s advocacy groups and pro-choice health care reform groups keep
pressure on Sebelius if confirmed as HHS Secretary as well as on Congress
and the administration. Health care reform is such a multi-faceted
issue that dozens of groups are already clamoring to get their perspective
included. Let’s hope Sebelius’ bipartisan tendencies won’t interfere
with the right to reproductive choice.