Was Money a Factor in the Losing Fight for Abortion Care in Health Reform?

Megan Carpentier

How did back-bench conservative Democrats manage to win restrictions on access to abortion in health reform? One answer may be found in the lobbying disclosures of the pro-choice movement.

In the past several months, the pro-choice movement has faced its toughest challenges during the Obama administration to date: the insertion of language into the House and Senate health reform bills that, if passed, would place the most onerous federal restrictions on women’s access to abortion since Roe v. Wade. Both threats came from Democrats, one set of restrictions placed in the House bill by Congressman Bart Stupak (D-MI) and the other in the Senate bill by Senator Ben Nelson (D-NE).

Throughout the process, pro-choice advocates and supporters tried desperately to reverse the restrictions: calling their members of Congress, donating to organizations that lobby for pro-choice policies, and more recently promoting the candidacy of a pro-choice female candidate—Connie Saltonstall—against Stupak.

But how did those restrictions get into the health reform bills of a Democratic Congress in the first place? There is obviously a range of factors, including what was and was not anticipated. 

The pro-choice movement’s support for health reform was supposed to have hinged on language, negotiated by Congresswoman Lois Capps, to preserve the status quo of the Hyde Amendment, as terrible as it is, a law that is attached to appropriations bills from year to year and which prevents federal funding of abortions except in cases of rape, incest or the life of the mother.  The presumption at the outset was that keeping things under the radar and putting forth the Capps Amendment would ensure passage of health reform without a fight over abortion.

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The presumption proved completely wrong.

Instead, first Stupak and then Nelson amended their respective bills to dramatically restrict the rights of women even to purchase private insurance coverage for abortion care.  And this week the health reform bill passed with the Nelson language intact.

So how did anti-abortion advocates and a back-bench conservative Democrat manage to so successfully persuade a Democratically-controlled (and presumably pro-choice-led) Congress to allow a vote on such a restrictive bill — let alone how did it come to pass? One answer may be found in the lobbying disclosures of the pro-choice movement.

Between 2008 and 2009, pro-choice organizations actually reduced their lobbying expenditures from $1.8 to $1.3 million. Planned Parenthood alone accounted for $385,000 of that $500,000 reduction in lobbying expenses; the rest came mostly from reductions made by NARAL and the Reproductive Health Technologies Project (RHTP).

Planned Parenthood told Rewire, “We think grassroots lobbying was one of the most effective tactics on healthcare reform. We wanted to invest more in [grassroots efforts] and make sure Congress heard from their constituents on this rather than from us.” PPFA in fact received grants from individual donors to conduct a grassroots lobbying campaign but not so much for lobbying Congress directly–though neither the grassroots strategy nor the DC-based lobbying effort was successful in the end in keeping abortion restrictions out of the final bill.

In the meantime, over the same period, specific anti-abortion lobbyists (represented mostly by the National Right to Life Committee and the American Life League) increased their spending from $600,000 to $710,000–a figure that does not include any of the official or unofficial lobbying undertaken by various religious groups, like the U.S. Conference of Catholic Bishops, or grassroots organizing conducted on the issue of health reform and abortion care such as through churches mobilized by the USCCB.

One question is why, with various reproductive health issues on the agenda, from the global gag rule to the provider “conscience” laws, were pro-choice groups drastically reducing their spending on lobbyists in 2009?  Because they finally had a full Democratic majority in power?

This can’t be the whole story: Even NARAL president Nancy Keenan told me in an interview before Stupak went to a vote that “A Democratic majority is not a pro-choice majority.”

Recognition that giving Democrats the reins did not necessarily mean success for a pro-choice agenda should have been clear early on in the Obama Administration. First on the pro-choice agenda was the global gag rule, with which Obama dispensed early on.  But while the end of the global gag rule was an important step, it shouldn’t have been allowed to mollify the pro-choice movement nor make them take a softer line on the administration.

Still, Democratic leaders asked the pro-choice movement to stay out of health reform debates initially to avoid politicizing the reform process, and rather than engaging the fight directly, both pro-choice Democrats and pro-choice groups accepted the Capps compromise language early on — apparently expecting that unilateral disarmament on healthcare reform would convince their opponents to remain out of the debate.

Bart Stupak and his backers in the United States Conference of Catholic Bishops and in the broader “pro-life” movement didn’t exactly take the pro-choice movement up on their olive-branch offering, choosing instead to do what it is that lobbyists normally do: push for as much as possible for the cause they represent. And push they did, introducing language in various committees, at first with little success–something for which Planned Parenthood takes due credit. 

But when push came to shove, House Speaker Nancy Pelosi announced that if putting the Stupak anti-choice language to a vote on the House floor and letting it pass was the cost of healthcare reform, so be it. In the end, pro-choice advocates were left with less than a week’s notice to marshal their massive but nascent grassroots campaign to defeat it.

Successful lobbying campaigns, like the one conducted by Stupak’s supporters, aren’t ginned up in a week or even a few months: they’re long, sustained sieges involving grassroots organization, lead time and constant pressure from lobbyists on members of Congress.

The pro-choice movement, having taken a pass on doing anything proactive to get a healthcare bill that recognized abortion as central to healthcare didn’t have the resources or sustained intelligence gathered to mount a last-minute reactive campaign either. And, in either case, they had already made the decision to support healthcare reform writ large, so they were stuck with a dual message: pass healthcare reform, but remove the abortion restrictions. Those kind of mixed messages make for a difficult grassroots campaign, and can make it sound like passing healthcare is of more importance that preserving women’s access to abortion services.

On the Friday before the final vote this weekend, Planned Parenthood spokesman Tait Sye told me: “Planned Parenthood is committed to fixing our broken healthcare system. Congress must fix the Nelson provision as part of healthcare reform and guarantee that reform will not result in women losing benefits they currently have.”

Of course, given the procedural maneuvers through which the House had to go to pass the Senate bill, and given the strength of the mobilization by an anti-choice minority, the only way to fix the Nelson provision now will be to go back at a later date and try to convince the very same Democrats who could not stand up for abortion care as health care during the process to now rescind those restrictions embedded in the bill. With the majority of the reform provisions, including the individual mandate, not set to go into full effect until 2014, Congress will likely wait a considerable amount of time before attempting any changes, and certainly with the 2010 elections so close at hand.

Meanwhile, coverage for abortion care will be eroded. There are certainly uninsured women who will eventually obtain coverage in a somewhat reformed market to the benefit of their health — including their reproductive health.  But there are also women that will likely lose access to their current coverage of abortion care because of this bill and this debate, and others, like the women who work for the Republican National Committee and the state of South Carolina who will lose their coverage more quickly as a result of political decisions.

Pro-choice women rely on (and donate to) groups like Planned Parenthood and NARAL Pro-Choice America to stand up and advocate for their access to abortion, first and foremost, and to hold the feet of supposedly pro-choice politicians to the fire on abortion access even when the going gets tough (and the tough go shopping for healthcare reform votes among rabidly anti-choice Democrats).

But, this time, at least, pro-choice advocates were not as willing as their pro-life counterparts to be the skunks at the garden party “just” to save access to abortion, or perhaps because they feared losing their own access to Democratic politicians who, unfortunately, too easily sacrificed the pro-choice movement for a political victory without putting up much of a fight on behalf of the pro-choice women who elected them. 

Commentary Human Rights

The Democratic National Convention Was a Remarkable Victory for Disabled People

s.e. smith

This year's convention included disabled people every evening, as part of a larger inclusive policy that made 2016 a banner year for disability rights activists.

Read more of our coverage of the Democratic National Convention here.

On Thursday night, Hillary Clinton formally accepted the Democratic Party’s nomination for president. Her speech included many of the elements one expects from a nominee, but there were some standout moments—like when she mentioned disability rights, which she did repeatedly.

Clinton integrated disability into her discussion of her record, talking about her work to ensure that disabled children have the right to go to school and bringing up the health-care needs of disabled youth. Her commentary reinforced the fact that she has always cared about disability issues, particularly in the context of children’s rights.

But she did more than that. She referenced shortages of mental health beds. She explicitly called out disability rights as necessary to defend. And at one point, she did not mention disability, which in itself was radical. When she outlined her plans for gun reform and clearly stated that she wanted to keep guns out of the hands of people who shouldn’t have them, she referenced people with criminal histories and terrorists, but not mentally ill people, who have been fighting a surge in stigma thanks to perennial (and wildly incorrect) assertions that mental illness causes violence. That omission was clearly deliberate, given the meticulous level of crafting that goes into writing one of the most important speeches of a presidential candidate’s career.

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The nominee’s speech would have been remarkable on its own, but what made it truly outstanding is that it was far from the first appearance of disability at this year’s Democratic National Convention (DNC). The convention included disabled people every evening as part of a larger inclusive policy that made 2016 a banner year for disability rights activists, who are used to being invisible. These kinds of appearances normalized disability, presenting it as a part of some people’s lives and a source of pride, not shame or misery.

On Monday, for example, disability rights activist Anastasia Somoza rolled out to give a sharp, compelling speech that didn’t cast disability in a tragic or exceptional light. She wasn’t the only wheelchair user to appear on the DNC stage—Paralympic athlete Mallory Weggemann led the pledge of allegiance on a different evening. Dynah Haubert, an attorney for Disability Rights Pennsylvania, took the stage on Tuesday. Nor were wheelchair users the only disabled people represented. Ryan Moore, a longtime friend of Clinton’s, spoke about health care and his experiences as a man with spondyloepiphyseal dysplasia congenital syndrome, a form of dwarfism. Connecticut Gov. Dannel Malloy talked about his learning disabilities. Musician Demi Lovato, who has bipolar disorder, took on mental health.

Former Iowa Democratic Sen. Tom Harkin, a nondisabled man who played an instrumental role in the push to pass the Americans with Disabilities Act (ADA) in 1990, taught the crowd sign language during a lively speech about the fight for disability rights on Tuesday, the 26th anniversary of the landmark legislation.

On Wednesday night, former Rep. Gabby Giffords (D-AZ) strode out onto the DNC stage in Philadelphia, smiling and waving at the crowd, to make a few short remarks. “Speaking is difficult for me,” she concluded, “but come January 2017 I want to say these two words: ‘Madam President.'” Her speech was about gun violence—a subject with which she’s intimately familiar after being shot in the head in 2011.

This level of representation is unprecedented. Some speakers, like Somoza, explicitly talked about disability rights, putting the subject in the spotlight in a way it’s never been at previous conventions. Others, like Giffords, came up on stage to talk about something else entirely—and happened to represent disability while they were at it. Similarly, Rep. Tammy Duckworth (D-IL), a decorated combat veteran and double amputee, talked about military policy.

This is a striking contrast from the treatment of disability at previous Democratic National Conventions: When disabled people have appeared, it’s often been in the form of a lackluster performance that objectifies disability, rather than celebrating it, as in 1996 when former actor Christopher Reeve framed disability as a medical tragedy.

Disability rights activists have spent decades fighting for this kind of representation. In 1992, two years after the passage of the ADA, the platform included just three mentions of disability. This year, the subject comes up in 36 instances, woven throughout the platform for an integrated approach to disability as a part of society, rather than as something that needs to be walled off into a tiny section of the platform, tokenized, and then dismissed.

In the intervening years, disabled people in the United States have fought for the enforcement of the ADA, and taken the right to independent living to court in 1999’s Olmsted v. L.C., which was namechecked in the 2000 platform and then forgotten. Disabled people advocated to have their rights in school codified with the Individuals with Disabilities Education Act (IDEA) in 2004, pushed for inclusion in 2010’s Affordable Care Act, and are fighting to pass the Community Choice Act and Disability Integration Act (DIA). Disability rights in the United States has come a long way since 1990’s infamous Capitol Crawl, in which disability rights activists dragged themselves up the steps of the U.S. Capitol, pleading with Congress to pass the ADA.

And as activists have pushed for progress in the courts and in Congress, disability rights have slowly become more prominent in the Democratic party platform. The ADA has been a consistent theme, appearing in every platform since 1992 alongside brief references to civil rights; historically, however, the focus has been on disability as a medical issue. The 1996 platform introduced Medicare, and health care in general, as issues important to the disability community, a refrain that was reiterated in years to come. In numerous years, Democrats addressed concerns about long-term care, in some cases positioning disabled people as objects of care rather than independent people. Disabled veterans have also played a recurring role in the platform’s discussion of military issues. But beyond these topics—again, often approached from a dehumanizing angle—and the occasional lip service to concerns about discrimination and equal rights, until the 2000s, education was the only really consistent disability issue.

In 2000, however, the Democrats went big, building on eight years under President Bill Clinton, and the influence of his then-first lady. For the first time, disability wasn’t simply lumped under “civil rights.” The platform explicitly called out the need for protection from disability hate crimes, but it also began to introduce the idea that there were other issues of relevance to the disability with a discussion of the digital divide and the obstacles that held disabled people back. Almost 30 years after the passage of the Rehabilitation Act of 1973, which barred disability discrimination by government agencies and contractors, the Democrats were starting to embrace issues like accessibility and independent living, which also played a prominent role in 2000.

It was a hint that the party was starting to think about disability issues in a serious way, especially when in 2008, the Democrats discussed the shameful delay on ratification of the United Nations’ Convention of the Rights of Persons with Disabilities, took on the Community Choice Act, talked about the need to enforce IDEA, and, again for the first time, explicitly addressed voting rights issues. By 2012, they were also calling out discriminatory voter ID laws and their disproportionate effect on the disabled community.

That’s tremendous, though incremental, progress.

And this week, the efforts of a generation of disability rights activists are on display everywhere in Philadelphia, where Daily News columnist Ronnie Polaneczky observed that accessibility is a top priority across the city. The DNC is providing expanded accessible seating, wheelchair charging stations, service dog relief areas, Braille materials, closed captioning, American Sign Language interpreters, medication refrigerators, and more. That’s radical inclusion at work, and the result of incredible efforts by disability rights organizers—including the 400 delegates who disclosed disabilities.

Those same organizers have been hounding the presidential candidates, holding them accountable on disability over and over again. They’ve brought up concerns about independent living, wage disparities, education, access to services, accessibility, hate crimes, reproductive rights, the “marriage penalty” and government benefits, and casual disablism in campaign rhetoric and practices. Advocates leaned on the Clinton campaign until it began captioning its content, for example. RespectAbility sent journalists out on the trail, #CriptheVote organized Twitter, and Rev Up encouraged people to register to vote and get involved. The disability community may be more explicitly politically active this year than ever before, and the DNC has been responding accordingly.

Clearly in consultation with disability rights activists, the Democrats have brought a host of new issues into this year’s platform, acknowledging that disabled people are part of U.S. society. Some of the many issues unique to this year’s platform include: abolition of the subminimum wage, concerns about economic opportunities with an explicitly intersectional discussion of the racial wealth gap, affordable housing, accessibility at the polls, the role of disability in the school-to-prison pipeline, and the need for more accurate Census data.

Notably, in a platform that has loudly called for a Hyde Amendment repeal and pushed for other abortion rights, the Democrats have also reinforced the need for access to reproductive health for disabled people, a revolutionary clause that’s gone virtually unnoticed.

This is a platform—and convention—of aggressive inclusion, and it reflects a victory for disabled people in the United States. It does still lack some components the disability community would like to see, like a shoutout to the DIA, which Clinton supports. This is, however, the start of what looks like a robust and real relationship between the Democrats and the disability rights community.

Roundups Politics

Campaign Week in Review: Clinton’s ‘Military Families Agenda’ Includes Calls for Family Leave, Child Care

Ally Boguhn

As part of her plan, Clinton would move to “ensure that family leave policies meet the needs of our military families so that, for example, new parents, as practical and consistent with mission, can care for their families at a pivotal moment.”

This week on the campaign trail, Democratic presidential candidate Hillary Clinton released her agenda for helping military families, and anti-choice voters remain ambiguous about Donald Trump’s positions on abortion.

Clinton Releases Plan to Expand Family Leave and Access to Child Care for Military Families

Clinton released her “Military Families Agenda” on Tuesday, detailing the former secretary of state’s plan, if elected, to support military personnel and their families.

“Military families, who serve alongside our service members, are vital to the strength of our military and the health of our nation,” reads Clinton’s plan. “Ensuring our military families have the support they need to balance service to the nation with the demands of family life helps our nation attract and retain the most talented service members.”

As part of her plan, Clinton would move to “ensure that family leave policies meet the needs of our military families so that, for example, new parents, as practical and consistent with mission, can care for their families at a pivotal moment.”

Clinton also vowed to improve access to child care for both active duty and reserve service members “both on- and off-base, including options for drop-in services, part-time child care, and the provision of extended-hours care, especially at Child Development Centers, while streamlining the process for re-registering children following a permanent change of station (PCS).” ​She did not say exactly what these improvements would entail.

“Service members should be able to focus on critical jobs without worrying about the availability and cost of childcare,” continues Clinton’s proposal.

Paid family leave has been a critical issue for Democrats on the campaign trail, and both Clinton and rival Democratic candidate Sen. Bernie Sanders (I-VT) rolled out clarifications and additional details about their proposals on the issue in January. Though the two candidates support similar federal policies, they would pay for them in different ways, with Clinton proposing raising taxes on the wealthy and Sanders pushing a payroll tax on workers and their employers.

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Clinton released a plan in early May to address the rising cost of child care in the United States, proposing that the federal government cap child-care costs at 10 percent of a family’s income, though the candidate’s campaign has yet to release details on how it would be implemented and funded.

Analysis conducted by the Economic Policy Institute (EPI) in 2015 found that increasingly, “child care is out of reach for working families,” and in in 33 states and Washington, D.C., child-care costs were higher than the average cost of in-state tuition at public universities.

Anti-Choice Voters Unsure About Trump’s Stance on Abortion

Recent polling found that the majority of voters who describe themselves as “pro-life” aren’t sure about whether they agree with presumptive Republican nominee Trump’s position on abortion.

The poll, conducted by Gallup during the first week of May, found that 63 percent of anti-choice respondents were unable to say whether they agreed or disagreed with Trump’s stance on abortion. Almost equal shares of anti-choice respondents said they agreed or disagreed with the Republican candidate: 19 percent agreed while 18 percent disagreed.

The majority of overall respondents—56 percent—had “no opinion” on whether they agreed with Trump on abortion or not. Just 13 percent of those polled agreed.

Meanwhile, 38 percent of those polled who considered themselves “pro-choice” said they agreed with Clinton’s position on abortion while 47 percent had “no opinion.” Twenty-two percent of all people surveyed said they agreed with Clinton, while 32 percent disagreed and 46 percent had no opinion.

Gallup’s findings follow months of ambiguity from both Republicans and the anti-choice community about Trump’s position on reproductive rights. Though Trump has consistently pushed his opposition to abortion on the campaign trail, his past statements on “punishing” abortion patients should abortion become illegal, and willingness to change the GOP platform on abortion to include exceptions for cases of rape, incest, and life endangerment have landed him in hot water with some conservatives.

Anti-choice activists, however, are slowly starting to warm to the presumptive Republican nominee. Troy Newman, president of the radical group Operation Rescue, signaled he may be willing to back Trump in a blog post in May instructing the candidate to “earn” the anti-choice vote. Priests for Life and the Susan B. Anthony List officials both backed Trump in statements to the Washington Times, though they had previously spoken out against the Republican.

What Else We’re Reading

Eric Alterman explains in a piece for the Nation that the media’s willingness to provide a false equivalency to both sides of every issue “makes no sense when one side has little regard for the truth.”

“I don’t want to sound too much like a chauvinist, but when I come home and dinner’s not ready, I go through the roof,” said Trump in a 1994 interview with ABC News when discussing his romantic relationships. “I think that putting a wife to work is a very dangerous thing …. If you’re in business for yourself, I really think it’s a bad idea.”

Sanders spotlighted Native American communities while campaigning in California ahead of the state’s primary. “This campaign is listening to a people whose pain is rarely heard—that is the Native American people,” said Sanders at a Sunday campaign rally. “All of you know the Native American people were lied to. They were cheated. Treaties they negotiated were broken from before this country even became a country. And we owe the Native American people a debt of gratitude we can never fully repay.”

Fusion’s Jennifer Gerson Uffalussy questions why Trump has said so little about the the Zika virus.

CNN embedded in a chyron a fact-check on Trump’s false claims about nuclear weapons.

Ohio removed thousands of voters from the state’s voter registration rolls because those voters had not cast ballots since 2008, in a move that could reportedly help Republicans in the state. Though states do occasionally cleanse their rolls, “only a handful [of states] remove voters simply because they don’t vote on a regular basis,” reports Reuters.


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