Health Care Victory Bittersweet for Capps

Abortion Rights Loom Large in Health Insurance Showdown

For Democratic Congressmember Lois Capps, who represents coastal Santa Barbara County in Washington, D.C., the exceedingly narrow victory health-insurance reform won this past weekend-the most sweeping federal effort since 1964-proved bittersweet in the extreme. Capps, a school nurse before taking office, has been a lifelong champion of health-care reform and a critic of the health insurance system. She termed the 220-215 House vote in favor of the health reform measure as nothing less than “historic,” exclaiming it would provide health coverage to 36 million citizens who now go without. No longer would insurance companies be allowed to ditch customers with pre-existing conditions, she said. Nor would they be allowed to charge women higher rates just because of their gender. And the bill would include the much debated “public option,” a government supported insurance entity that would compete head-to-head with private providers to keep prices down.

Lois Capps
Paul Wellman (file)

But to secure the number of votes necessary from more conservative Democrats, House Speaker Nancy Pelosi was forced to make significant concessions to anti-abortion advocates in Congress-like Michigan Democrat Bart Stupak-that Capps claims will dramatically restrict access to abortion services to millions of low- and moderate-income women. Beginning this summer, the solidly pro-choice Capps had maneuvered energetically to counter Stupak’s more restrictive agenda by crafting what she termed “an abortion neutral compromise.” In a tip-of-the-hat to the pro-life movement, Capps proposed requiring that there be at least one pro-life insurance provider in the big exchange of insurance providers-created by the new bill-that would make themselves available to the millions of new insurance customers.

Currently, 90 percent of all insurance providers offer abortion services. Under Capps’s plan, there would be no direct payment of federal funds for abortions, except in cases of rape, incest, or the imminent peril of the mother. But for the millions of new health insurance consumers who will require some degree of federal subsidy, the Capps amendment would have allowed what her critics describe as indirect payments for abortions. Insurance providers would be allowed to use the premiums paid directly by the consumer-but not by the federal government subsidies-to cover a full range of abortion services. Separate accounts would have to be meticulously maintained so that federal funds never co-mingled with customer insurance premiums. (Existing policies and workplace insurance plans would not be affected.)

Pro-choice advocates claim these prohibitions will effectively preclude anyone who needs any form of government subsidy from obtaining abortion coverage.

While Capps succeeded in enlisting support from several pro-choice moderates, she never won over Stupak nor the National Conference of Catholic Bishops, which had been lobbying intensely on Stupak’s behalf. He didn’t want the insurance exchange created by the bill to include any health plans offering abortion services except in cases of rape, incest, and imminent danger. Stupak claimed that women who wanted expanded coverage could buy “riders” to their insurance policies. Pro-choice advocates claim these prohibitions will effectively preclude anyone who needs any form of government subsidy from obtaining abortion coverage. Women too poor to afford insurance in the first place, they argue, are hardly likely to have the $500 to pay for a “rider” to cover them in the case of unexpected and unwelcome pregnancy.

For awhile, it appeared Capps and her amendment had the votes needed to prevail. After all, Stupak had been defeated in two key committee votes. But he refused to back down, threatening to prevent the health-care measure-the cornerstone of President Barack Obama’s political agenda-from ever coming to a vote. The tide turned in Stupak’s favor last week when Democrats lost badly in two high profile gubernatorial races and when the latest unemployment figures showed the problem was still hovering at double-digit altitudes. Facing a double-barrel blast of grim news, few Democrats had much appetite for a prolonged battle over abortion rights. Neither did House Speaker Pelosi. She reckoned the longer the health-insurance reform vote was delayed, the slimmer its ultimate chances were. Pelosi gave Stupak the vote he sought on his amendment. Even though Capps and the pro-choice caucus of the Democratic Party voted en masse against it, it prevailed. Capps’s amendment was set aside; Stupak’s has become part of the House’s historic health-care package.

Capps has vowed to fight the Stupak measure in the Senate and, should it survive there, to fight it again when the Senate and the House try to reconcile their respective versions of the legislation. In the meantime, Capps warned that “politicians and anti-abortion zealots in Washington, D.C.” will dictate the reproductive health choices available to untold women. Recent procedural efforts by Capps and other pro-choice Democrats to speak out on the issue were met with vehement resistance by Republicans, and while making a one-minute speech, Capps herself was nearly shouted down by Georgia Republican Tom Price, who thundered loudly and repeatedly, “I object!” Price, a leader in the conservative Republican camp, took exception to Capps’s attempt to secure extra time to proclaim without yielding any allotted time to debate, a permitted parliamentary maneuver.


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