On choices

Or, The Stupak, It Burns

Okay, so on Saturday night, the House of Representatives told the women of America to get comfortable under that bus, because universal health care is actually going to be defined as universal except for some women, because their ladyparts sometimes require procedures that we find icky. It may sound like I'm being dramatic, but I'll tell you, it feels pretty darn dramatic. It feels like our elected representatives are willing to screw over poor women and women who couldn't afford insurance without getting it through their employer and women who may get pregnant accidentally and women who may get pregnant intentionally--in other words, every women with a functioning uterus--in the name of affordable health care for the other 49.1 percent of U.S. citizens.

The Stupak Amendment to HR 3962 bans abortion coverage for any private or public health plan receiving federal subsidies--in essence every plan available on the Exchange. Not for any amount of money, not for any woman. Not even for a woman paying her entire premium herself. Not in a box, not with a fox. Thus women who depend on their employers for insurance or women who must pay for their insurance themselves will be left paying out of pocket for what can be a very expensive procedure. Exceptions will be made, of course, for rape, incest, and the life--life, not health--of the mother, so if you're lucky enough to have preeclampsia, you can just wait until the seizures start and then the government will take care of you.

For some reason, Bart Stupak and friends think it's perfectly reasonable that reproductive health services are the only ones that can be left completely out in the cold. They don't, for instance, try to explicitly remove heart disease from the bill, even though it costs taxpayers more annually than women's health services and usually arises from preventable lifestyle choices. Sorry, chubbo, you're paying for your angioplasty out of pocket! Next time you'll think twice before reaching for that rack of ribs. You should have coughed up for that extra heart-disease policy when you had the chance.

Three arguments that I will not entertain:

1. There are more important things to worry about right now! This bill would provide health insurance to 96 percent of Americans; can't you just compromise for their sake?

Well, no, I can't. Among those 96 percent are nearly 150 million women who may someday need reproductive health coverage. Congress would never try to pass a bill explicitly requiring insurers to deny coverage for obesity, and if they did, Americans would be up in arms. They would never try to pass a bill explicitly denying coverage for sickle-cell anemia. Yet when it's women getting the fuzzy end of the universal health-care lollipop, we're expected to sit back quietly, in the name of compromise, and hope that we'll someday get our chance to politely request the benefits that are offered to everyone else without thought or question. Hell, it's the sitting back quietly and politely that's gotten us into this situation.

2. The Hyde Amendment already says that federal dollars can't be used for abortions. It's not like women are any worse off.

First of all, let me note that even if women weren't any worse off, they'd be no worse off than a bad position. The Hyde Amendment was bad from the start, and women have been fighting against it from the start. It's like saying, "Oh, he's just trapped in the forest with a broken femur. It's not like it's raining or anything." No, it sure isn't raining, but that doesn't mean he's okay out there with his broken femur, and it doesn't mean someone doesn't need to go in there and help him.

That said, no, in fact, women are worse off. The Hyde Amendment, lousy as it is, only says that federal dollars can't be used for abortions. The Stupak Amendment extends that to all insurance sold through the Exchange, even to women who themselves pay their entire premiums without using federal dollars. Whereas before, it was only poor women on Medicaid who were left out in the cold, now it's any woman who can't afford to pay $1,500 for a D&E after her much-wanted baby is discovered to have hydrocephalus. Sure, she could have bought an abortion rider, but she probably didn't expect to ever need an abortion, any more than a person would buy a bus-hitting rider in anticipation of being hit by a bus.

3. I think that abortion is murder, and I don't want my tax dollars to fund murder.

Of course you don't. Neither does the pacifist who believes that war is murder--and yet still has to watch her tax dollars fund war. Neither does the person who believes that the death penalty is murder--and yet still has to watch his tax dollars fund executions. But in 1976, our government ruled that people who oppose abortion have the special privilege of dictating how their taxes are used. Since by current numbers, 57 percent of Americans oppose the Iraq war while only 45 percent oppose abortion, you'd think Congress would be rushing to shield tax dollars from the military rather than from reproductive health, but somehow that isn't the case.

The upshot echoes what President Obama said in an interview with ABC--"This is a health-care bill, not an abortion bill." On the surface, it sounds kind of dismissive, like we're discussing health care now and abortion will have to wait. But taken in context, it has meaning. It means that abortion isn't a separate issue. It means that health care isn't health care without care for every aspect of health, serving every citizen. Discussing abortion as a separate issue ignores the fact that, like diabetes and cancer, reproductive health is an integral aspect of health care crucial to keeping America healthy.