US Rep. Bart Stupak (D) opposes pro-abortion elements in health care bills.

US Rep. Bart Stupak (D) opposes pro-abortion elements in health care bills.

Health care reform bills introduced by Congressional Democrats and backed by the White House include federal taxpayer funding of abortion and open the door to rationing care for the elderly and other vulnerable persons, in order to realize savings in the overall health care system.

These controversial measures have led to a backlash against President Barack Obama’s goal of broadly reforming the U.S. health care system, with polls indicating support for wholesale change at less than 40 per cent. According to a NBC/Wall Street Journal poll, half of respondents said reform measures will use taxpayer dollars to fund abortion and 45 per cent said that it would “allow the government to make decisions about when to stop providing medical care to the elderly.”

Pro-abortion groups see House Bill H.R. 3200 and Ted Kennedy’s Senate bill, the “Affordable Health Choices Act,” as vehicles for expanding abortion access, including funding. Numerous attempts to guarantee abortion will not be covered by government-provided medical care or mandate private insurers to cover abortion have been defeated in committee in both the House of Representatives and Senate. A pair of Congressmen, Joseph Pitts (R, Penn.) and Bart Stupak (D, Mich.) vow to press for a separate vote on abortion when the bills come before the House.

The U.S. Conference of Catholic Bishops stated, “We don’t want health care reform to be the vehicle for mandating abortion.” The National Right to Life Committee has condemned the reform proposals as bailouts for abortionists.

Laurie Rubiner, vice-president of public policy and advocacy for the Planned Parenthood Federation of America, told Politico.com that publicly funded health care options must pay for abortion. “The alternative,” she claimed, “would be slashing benefits for millions of women who currently have (private) coverage for abortion.” The Capps amendment, offered by Lois Capps (D, Calif.) in the energy and commerce committee, removed any ambiguity over whether H.R. 3200 covered abortion by explicitly naming it as a health service. NRLC legislative director Douglas Johnson said if the amendment stands, “the federal government will be running a nationwide abortion-on-demand insurance plan.”

Kennedy’s bill does not mention abortion specifically, but on a party-line vote, the Senate health, education, labour and pensions committee voted down (11-10) a pro-life amendment to prohibit abortion funding.

At the same time, Senator Barbara Mikulski (D, Md.) has sought to ensure that “health clinics” in the legislation include Planned Parenthood facilities. Dr. Jack Willke of the Life Issues Institute noted that decisions to fund medical procedures will be made by a new Medical Advisory Council mandated by the Kennedy bill and that Kathleen Sebelius, the pro-abortion secretary of health and human services, will be responsible for appointing members to the new council.

While lobbying for abortion’s inclusion in health care reform, pro-abortion activists and politicians claim there is no abortion mandate in the current proposals. Yet, on August 5, the Associated Press ran a story that noted current health legislation “would allow a new government-sponsored insurance plan to cover abortions, a decision that would affect millions of women and recast federal policy on the divisive issue.”

The inclusion of abortion within the health care reform proposals is puzzling. As political analyst Jay Cost of the HorseRace Blog noted sarcastically, “No issue bridges the political divide quite like abortion.” Some pro-life Democrats say they won’t vote for health care reform that expands abortion or pays for it. Such defections could prevent the bill from passing.

On the other end of the spectrum of life, there are also concerns about end-of-life care and death panels. One Democratic bill includes a provision for a new Centre for Health Outcomes Research and Evaluation, which will make decisions about rationing access to treatment based on a bureaucrat’s assessment of the value of a human life and the cost of the treatment. Democrats in the joint economic committee voted to defeat a clarification amendment by Senator Mike Enzi (R, Wy.) that would have ensured “quality of life” considerations did not influence decisions about “cost-effectiveness.”

Critics of the ambitious reform bills say that rationing care to prevent seniors from accessing life-saving treatment is the only way the administration will realize the health care savings it is promising at the same time it is seeking to provide universal coverage. Senator Sam Brownback (R, Ks.) said that, “Given the language in the Democrats’ current health care bill, the U.S. now faces the truly frightening prospect of the government dictating end-of-life decisions.”

Senator Charles Grassley (R, Ia.) said that the end-of-life provisions in the bills will be dropped once the Senate finance committee releases its own proposal, but that committee is just one of at least four House and Senate committees considering such legislation. Furthermore, the controversial measures in House Bill 3200 – specifically section 1233 – and beyond the reach of Senate maneuvers, at least for the time being.

Pro-lifers are also worried about the influence of Dr. Ezekiel Emanuel, a health care advisor to Obama and brother of White House chief of staff Rahm Emanuel. He has written in the past about providing treatment to individuals based on their “level of productivity in society” when they “are irreversibly prevented from being or becoming participating citizens in society.” He highlighted patients with dementia as an “obvious example” of the type of people for whom services “should not be guaranteed.”

Former Republican vice-presidential candidate Sarah Palin criticized mandatory counselling sessions with patients regarding end-of-life care by saying that doctors would have the wrong financial incentives to push minimal care to save money for the system.

America’s culture wars have taken centre stage in the debate on health care, and thus far the pro-life cause is undermining efforts to radically reform the system while exposing the agenda of those seeking to expand abortion and restrict end-of-life care.