FRC Action, the political arm of the Family Research Council, has been running TV ads featuring an elderly couple discussing the issue in a format similar to the insurance industry's "Harry and Louise" ads used against the Clinton national health care plan in the early 90s. "They won't pay for my surgery but we're forced to pay for abortions," says the white-haired man in the FRC Action ad.
The message combines the two issues that have become the most controversial talking points in the months-long debate over health care reform. Obama and Democrats supporting reform legislation have repeatedly denounced as a scare tactic the charge that the leading House bill would establish panels of experts to determine on a case-by case basis which life-sustaining treatments would be funded and which would not. Speculation about "death panels," as former Alaska governor Sarah Palin has called them, has been fueled in part by Section 1233 of House Bill 3200, which would authorize payment for end-of-life counseling for Medicare patients. Obama has said that the provision merely allows reimbursements under Medicare for senior citizens who want legal assistance in drawing up living wills and in making decisions about what kind of life-sustaining care they want in the end.
"It gives an option that people who can afford fancy lawyers already experience," Obama said. But some opponents suspect a pre-determined outcome to a government-sponsored, end-of-life counseling program aimed at reducing the cost of healthcare. "Is it any wonder," asked Palin, "that senior citizens might view such consultations as attempts to convince them to help reduce health care costs by accepting minimal end-of-life care?"
On abortion, Obama has only recently addressed the question of whether taxpayer dollars would support that "end-of-life" decision under the health care reform he seeks. As recently as July 21, he evaded the issue when CBS News anchor Katie Couric asked: "Do you favor a government option that would cover abortions?" "What I think is important, at this stage is not to try to micromanage what benefits are covered," Obama replied. "Because I think we're still trying to get a framework. And my main focus is making sure that people have the options of high quality care at the lowest possible price."
But last week, in teleconference with religious leaders and members of faith-based organizations, Obama issued what sounded like a flat denial. After denying that illegal aliens would be covered under the "public option" in the reform plan, the president said:
"Some are also saying that coverage for abortions would be mandated under reform. Also false. When it comes to the current ban on using tax dollars for abortions, nothing will change under reform." But the nonpartisan FactCheck.org noted a subtle, unspoken distinction in the president's disavowal.
"The truth is that bills now before Congress don't require federal money to be used for supporting abortion coverage," writes FactCheck's Brooks Jackson. "So the president is right to that limited extent. But it's equally true that House and Senate legislation would allow a new 'public' insurance plan to cover abortions, despite language added to the House bill that technically forbids using public funds to pay for them. Obama has said in the past that 'reproductive services' would be covered by his public plan, so it's likely that any new federal insurance plan would cover abortion unless Congress expressly prohibits that. Low- and moderate-income persons who would choose the 'public plan' would qualify for federal subsidies to purchase it. Private plans that cover abortion also could be purchased with the help of federal subsidies."
In fact, House legislation authorizes the Secretary of Health and Human Services to decide whether abortions will be covered under the government health care program. Since the current Secretary, former Kansas Governor Kathleen Sebelius, and President Obama are both "pro-choice," it seems a safe bet that the whole range of "reproductive services" will be covered by any plan approved by the Secretary.
While efforts in both the House and Senate to explicitly ban funding for abortion under the healthcare plan have all been defeated, an amendment to HB 3200, sponsored by Rep. Louis Capps (D-Calif.) calls for the establishment of separate accounts for premiums and federal susidies, with only the premium money used to pay for abortions. But critics call that a bookkeeping maneuver that does not protect unwilling taxpayers from contributing, directly or indirectly, to the funding of the abortion industry.
"They're making a distinction that doesn't really make much sense," said Douglas Johnson, legislative director of the National Right to Life Committee. "You have a federal agency collecting these monies, getting bills from the abortionists and sending checks to the abortionists drawn on a federal account. And they want to make a hyper-technical distinction that these are not tax funds? The federal government is running the whole scheme from start to finish."
"Funds paid into these plans are fungible and federal taxpayer dollars will subsidize the operating budget and provider networks that expand access to abortions," Roman Catholic Archbishop Justin Rigali of Philadelphia, chairman of the Committee on Pro-Life Activities for the US Conference of Catholic Bishops, wrote in a letter to House members. While the Catholic bishops have for decades supported a government program to provide healthcare for those who can't afford it, they remain opposed to any use of public funds for abortion. "Government will force low-income Americans to subsidize abortions for others (and abortion coverage for themselves) even if they find abortion morally abhorrent," wrote Rigali.
Since Obama has said some opponents of the reform he is backing are "bearing false witness" against it, Family Research Council Action President Tony Perkins called on the president to clearly oppose abortion coverage.
"We readily acknowledge," he said, "that if you do a word search of the 1,000-plus page bill, you will not find the word 'abortion.' You also will not find the word 'tonsillectomy,' nor will you find the word 'bypass.' But will you find 'essential health care services,' and when you follow the trail to how this administration defines that, they include reproductive health care, which this administration readily admits includes abortion."