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US News & World Report, September 14, 2009

Abortion Debate Could Make or Break Healthcare Reform; Catholics hold a lot of power in the healthcare debate

By Dan Gilgoff

Antiabortion groups like the Family Research Council and Focus on the Family Action have spent the last month pummeling Democratic healthcare reform proposals over abortion coverage. They've attacked the House Democrats' healthcare bill, for instance, for leaving the door open to abortion coverage in the public health insurance option and for using federal funds to underwrite private healthcare plans that cover abortion. But conservative Christian groups have also made little secret of their opposition to the very idea of a greater government role in healthcare, the abortion controversy aside. A recent E-mail update from the Family Research Council blasted President Obama's push for healthcare reform without ever mentioning abortion. "The American people," it said, ". . . don't want healthcare delivered with the empathy of the IRS, the efficiency of FEMA, or the mismanagement of the post office."

One of the most prominent voices in the antiabortion movement, however, has carved out a much different position in the healthcare debate. The U.S. Conference of Catholic Bishops, while fiercely opposed to abortion rights, has lobbied for decades for universal healthcare coverage as a fundamental right. "We think the right to have basic healthcare is corollary to the right to life," says Richard Doerflinger, associate director of the Secretariat for Pro-Life Activities at the bishops conference, which represents the Roman Catholic Church's roughly 270 American bishops. "And that society has some obligation to help provide it."

That antiabortion, pro-universal healthcare stance—and the fact that a full quarter of the U.S. population is Catholic—make the bishops and the wider Catholic community a key swing constituency in the escalating healthcare reform battle. If they can allay Catholic concerns on abortion, Obama and the Democrats stand to enlist the church as a powerful ally in the fight. But if the bishops and other Catholic institutions wind up opposing the Democrats' healthcare plan because of its abortion provisions, they can help bring down the whole effort. Says Doerflinger: "People on both sides of the issue want us to join their coalition."

In recent weeks, the bishops have become increasingly vocal in alleging that the Democratic healthcare reform proposals include government-funded abortion. In a letter sent to members of the House of Representatives last month, Philadelphia Archbishop Justin Rigali, who leads the bishops' Committee on Pro-Life Activities, lambasted the House healthcare bill as "seriously deficient" in meeting its goal of maintaining the status quo on federal abortion policy. The letter knocked the measure for allowing abortion coverage in the public health insurance option and dismissed its purported ban on federal funds for abortion in private plans as "an illusion."

Shortly after releasing the letter, the bishops launched a website on healthcare reform that emphasizes abortion concerns. And Catholic groups that have helped lead the charge on federal healthcare reform, like Catholic Charities USA and the Catholic Health Association, have recently posted disclaimers on their websites noting that they've yet to back a specific proposal—and reaffirming their commitment to "health reform that respects the life and dignity of every person, from conception to natural death."

The White House and many Democrats, meanwhile, say conservative charges about what healthcare reform will mean for abortion are myths. "You've heard that this is all going to mean government funding of abortion," Obama said during a recent conference call with religious supporters on healthcare. "Not true." Liberal Catholic activists, meanwhile, grouse that the Catholic Church's concerns about abortion in healthcare reform have drowned out its larger message of healthcare for all.

But a group of roughly 20 conservative House Democrats, led by Michigan Rep. Bart Stupak, are warning that abortion concerns must be resolved before they'll vote for healthcare reform. Even liberal Catholics are lobbying Democrats to give those participating in the public option the power to opt out of a plan that covers abortion—and to prevent their premium payments from financing abortions for others. Other progressive Catholics object to the House bill for giving the Department of Health and Human Services authority to determine whether or not the public option covers abortion. "It gives carte blanche to Health and Human Services to say what abortions are covered," complains Stephen Schneck, a Catholic University of America professor close to the White House. "That's not going to cut it."

Even with such changes, the bishops may object to the Democratic healthcare plan if it subsidizes private plans that include abortion coverage for lower-income workers. The bishops want those plans to offer a separate rider for workers who want abortion coverage. But abortion rights supporters will most likely object on the grounds that such a rider threatens to roll back abortion coverage for women who already have health insurance that covers the procedure.

Of course, Democrats may wind up passing a plan with controversial abortion provisions over objections from the bishops and other Catholics. That would have political costs. "Moderate Catholics are big constituencies in states like Pennsylvania and Ohio," says Schneck. But opposing the final healthcare reform plan on abortion grounds could have political consequences for the church, too. As middle-class whites leave Catholicism and are replaced by immigrants, working-class concerns like health insurance are more important than ever to the church's American flock.

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