Clift: The Health-Care Debate Turns to Abortion

Much has been made in the coverage of Sen. Ted Kennedy's death about his religious faith and how he would often slip away in the middle of the afternoon to sit alone in the pews of a Catholic church on Capitol Hill. In his final months, a priest from his parish on Cape Cod came to the Kennedy house each Sunday to hold a private mass in the living room. And just two weeks before he succumbed to brain cancer, the Massachusetts senator was well enough to lead the family in prayer after the death of his sister Eunice.

Kennedy's strong Catholicism coexisted with his commitment to preserving a woman's right to choose, and is one more in a long list of reasons why he will be missed as the health-care-reform battle crescendos this fall. Along with anxiety about rationing care at the end of life and fear that illegal immigrants will gain benefits they don't deserve, the anti-reform movement is gearing up to make abortion the next big donnybrook.

All the familiar protest figures are suiting up for their first big battle since the family feud over Terri Schiavo's right to die devolved into a national debate over what's euphemistically termed "the culture of life." Operation Rescue founder Randall Terry and a band of noisy supporters disrupted a town-hall meeting this week in Virginia, shouting down featured speaker Howard Dean, a physician, and calling him a baby-killer. The Rev. Pat Mahoney, who led the protests at Schiavo's Florida hospice, showed up in Martha's Vineyard looking for some media action. "It's hard to imagine we've progressed as a nation," says Planned Parenthood president Cecile Richards. "I hope we're just seeing the bitter end of this thing."

She may be right in that the protesters didn't get much attention. Kennedy's death created a pause in the rancor over health-care reform. But it's foolhardy to think the opposition forces that gained such traction over the summer are going to withdraw. They'll be back to spread misconceptions about possible provisions in a government-run public option for people to get health-care insurance. What Richards describes as "the knife's edge" in the debate is finding a realistic way to separate federal dollars so they do not fund abortion services. She says there is precedent, citing public hospitals that receive state funds and perform abortions, and are able to erect a firewall.

It has been the law for more than 30 years to disallow federal money to pay for abortions through the Medicaid program as part of the health services it provides for low-income women. The late Henry Hyde, a conservative lawmaker from Illinois, sponsored the amendment that bears his name. There has been no serious effort in the last three decades to dislodge the Hyde amendment, and it is certainly not part of the current health-care debate. But that hasn't stopped critics from suspecting that Democrats are looking for a back-door way to fund abortions. California Rep. Lois Capps, in an attempt to keep the issue of abortion from derailing health care, offered what's known as the Capps amendment, which says insurance companies are neither prohibited from offering nor mandated to offer abortion services, language that preserves the status quo of the free marketplace and that would govern any insurance exchange that offered a public option.

Critics immediately decried it as "phony common ground," charging that it opens the door to federally funded abortion. The confusion arises when people conflate a public option with Medicaid, which is publicly funded. The public option under the reform proposals debated on Capitol Hill would be open to people paying with their own dollars, and for those women abortion services ought to be covered, just as they are under 80 percent of private insurance plans. "The challenge is how to create a whole new infrastructure that doesn't take women backward," says Richards.

Most of the health services that Planned Parenthood provides have to do with family planning and cancer screening. With state budgets strapped, clinics everywhere are operating above capacity, with women literally having to decide between spending their money for birth control or bus fare. "It's heartbreaking," says Richards. "Women don't get up every day thinking where they're going to get an abortion, but how they're going to get health care. This is less about ideology than practical health care."

Critics of health-care reform too often drown out the serious voices that should be heard advocating for reform. Planned Parenthood is one of the oldest and most respected organizations representing women's interests. It has an approval rating of 68 percent, which suggests that it would be a good ally in the face-off over health care. One in four women in America has been to Planned Parenthood at some point in her lifetime. Throughout the summer, with Ted Kennedy sidelined and Democrats too scared to mention abortion for fear of riling up the right, angry minorities have had the debate pretty much to themselves. Now that Kennedy's voice is stilled, others must be heard, or the dream of universal health care that he championed will die.