Bridging the Divide on Health Care for Women

Laurie Rubiner

We need to expand access to affordable, quality health care, and should find a way to make it a reality. Planned Parenthood is ready to work. We invite others to join us so that Americans no longer suffer under a broken health care system.

This article first appeared in Daily Kos.

There have been some whoppers this summer. Nothing like an effort to make health insurance more affordable and available to all Americans to bring out the conspiracy theorists. Among my "favorite" whoppers:

(1) Grandma is going to go before a government death panel (I wonder if the government death panel will be modeled on the death panels of profit-motivated insurance bureaucrats that deny people lifesaving treatments every day in this country?);

(2) According to a recent Republican National Committee mailer, the Democratic government is going to check your political party registration, and if you’re a Republican you’ll be denied health care;

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(3) Catholic bishops are persuading their parishioners that health care reform will mean that every single American is going to have to pay for their neighbors’ abortion.  Perhaps the most egregious of all in this debate has been New York Times columnist Ross Douthat, who decided to start a sibling rivalry in heaven between the late Senator Ted Kennedy and his late sister Eunice Shriver over their respective views on abortion. Let’s hope that in time, Mr. Douthat will look back on this most inhumane column and regret what he wrote.

With all this hyperbole, we have lost sight of the original goal of health reform: to expand access to health care, improve quality, and reduce costs — not to litigate abortion rights, no matter how much anti-choice groups may want to use it for that purpose. And Planned Parenthood knows firsthand that women in particular need access to more health care, better quality health care, and more affordable health care. After all, women are affected far more than men by the costs of our health care system — they pay more for health care, use the health care system more, and make the health care decisions for their families.

Abortion is a legal medical procedure in this country, and therefore Planned Parenthood believes it should be part of the health care system. That said, we acknowledge that there are some compromises that need to be made to move health care reform forward. For many years there has been a ban on the use of federal funds to pay for abortions. While we vehemently disagree with this policy because it denies care to the lowest-income women who need affordable health care access, we understand that this is the law of the land and until we have the political ability to change it, we have to compromise. We are willing to do that if it means more women can access the affordable, quality health care they deserve.

In late August, Rep. Lois Capps (D-CA) offered an amendment as a straightforward response to concerns raised by anti-choice groups. While no other medical procedure is singled out for exclusion in any of the bills, in order to move reform forward, anti-choice organizations needed an assurance that the medical commission cannot guarantee abortion coverage in every Exchange plan. That’s why we did not oppose the Capps amendment that provides them with that assurance. It explicitly states that abortion will neither be mandated nor prohibited. It also mandates that every region will have at least one insurance plan that offers abortion coverage and one that does not, so people have a choice.

But fair compromise is not enough for opponents of women’s health. They now insist that if there is a public option that there be a strict and total ban on abortion coverage.

Their argument? First, they mislead. They argue that the public option is just like Medicaid — financed by public dollars and, therefore, should be prohibited from offering any abortion coverage at all. The public option will be just like a private plan, financed by private premiums.

Their second argument — even if it’s financed with private dollars it’s administered by government employees so, therefore, it is government run. Following that line of reasoning, we are going to have to reexamine a lot of government programs that touch the line between church and state. Pell grants — administered by government employees and that allow students to take the government money to religious educational institutions — will need to be reexamined for eligibility.

Their third argument — if the public option allows abortion coverage, people cannot choose the public option without having their own personal funds go toward a plan that pays for abortion coverage. That is exactly why the Capps amendment allows you to choose another plan and guarantees that there will always be a plan that does not include abortion. Imagine if we went down the road of individuals being able to dictate which health care services their private insurer offers other customers, of every individual being able to tell their employer that they don’t want their premiums going toward individuals or health care they object to — gays and lesbians, obesity, smoking…you name it. Insurance would be discriminatory and simply unworkable.

For true advocates of the public plan, there is another reason why we should not ban abortion in the public plan. Defenders of the public plan have cried foul, arguing that it will follow the same rules as the private plans and that the private plans simply don’t want fair competition.  If we start to impose separate rules on the public plan, different from the private plans, then it really is like government run health insurance, isn’t it? So, is it really going to be fair competition or not?  You can’t have it both ways.

I am trying really hard to understand what it is anti-choice hard-liners want, other than to simply kill health care reform. I wish someone would explain to me where their middle ground really is, and stop shifting it every time I think I’m standing still.  I really want to understand what they want for the women we serve everyday at Planned Parenthood — because our more than 850 health centers provide care every year to more than three million people, most of whom are below 150 percent of the poverty line. As a matter of fact, more than 90 percent of it is preventive and primary care.

I truly believe that if we share the goal of expanding access to affordable, quality health care, then we should find a way to make that goal a reality. Planned Parenthood is at the table ready to work, and we invite others to join us so that America can stop suffering under a broken health care system and start benefiting from the health care options we deserve.

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