Editore"s Note
Tilting at Windmills

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March 6, 2010

'STUPAK HAPPENS TO BE WRONG'.... Arguably the single biggest threat to health care reform is Rep. Bart Stupak (D-Mich.) and his dozen Democratic allies, who are threatening to kill the legislation over indirect, circuitous funding of abortion.

Efforts to work with Stupak are ongoing, but it's worth emphasizing a relevant detail: Stupak is just wrong about the underlying policy dispute. Whether he knows he's wrong, and he's just hoping to kill health care reform, is unclear. But the accuracy of Stupak's claims aren't in dispute: the facts aren't on his side.

ABC News did a nice job fact-checking Stupak's argument this week, and Slate's Tim Noah (a Monthly alum) published the definitive takedown a couple of days ago, explaining that some areas of the debate are open to interpretation and debate, but this isn't one of them: "Stupak happens to be wrong."

Ideally, this would be enough. Democratic leaders would explain the truth to Stupak and his allies, making the case on the merits -- the Senate compromise language, endorsed by center-right Dems who oppose abortion rights, already does what Stupak & Co. want, which is to prevent public funding of abortion.

But Stupak has been reluctant to listen to reason, and continues to make claims that simply fail to stand up to scrutiny. The new goal is to strike a related deal that would address Stupak's concerns in a separate-but-connected bill. That may or may not be enough.

If reform is going to pass, however, the votes are going to have to come from somewhere. Stupak claims to have a dozen "yes" votes in his pocket, all of whom will bolt and side with Republicans. Without them, Pelosi would need a dozen Blue Dogs who opposed reform in November to switch, which may prove too high a hurdle.

In the meantime, though, it's worth re-emphasizing reality -- Stupak's argument is factually in error. That will make negotiations with him more complicated -- lawmakers who stick to a mistake after it's been exposed as a mistake can be challenging to deal with -- but that's where we find ourselves.

Steve Benen 11:15 AM Permalink | Trackbacks | Comments (85)

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So, Stupak and the alleged 10 others are either 1) delusional, 2) trying to protect their egos, or 3) have other agendas.

Without discounting the possibility of 1 and 2, if 3 is the case, what is their agenda, and is it so important and compelling that they are willing to look delusional and/or egotistical to accomplish it?

Posted by: CJ on March 6, 2010 at 11:27 AM | PERMALINK

The only faith Stupak seems to keep is the faith with the Familly and the rest of his "C" street brothers.

Stupid is wrong about the facts. Perhaps he's also wrong about the commitment of these so-called "yes" votes.

Or, he's bluffing. I notice he never comes out and names the people who suddenly want to switch sides. I say don't give hime shit by way of conceessions and call his bluff.

Posted by: Winkandanod on March 6, 2010 at 11:31 AM | PERMALINK

If this crowd is not going to vote with their party on an issue as fundamental to the party as health care, then the party needs to do everything it can to make sure they are not in a position to vote for anything after November.

Posted by: km on March 6, 2010 at 11:38 AM | PERMALINK

My concern is it's being sold as the abortion bill through his lies. We all know how easy it is to lie and how believable lies like this are and how defending them almost empowers the lie.

And the image of being attached to this (even though it's a lie) is enough to make many in Congress head for the hills.

Obama and others like Gibbs need to really put out all their guns now if they mean business.

Obama said he'll fight for this bill, so let's see what's he got.

I'm talking ads, whatever it takes..attacking his facts and questioning his intentions, which are obviously maliciously driven.

Kudos for Maddow for doing what she can to reveal what she can about Stupak's credibility.

It would be great to hear from some Republicans or even moderates on this and question Stupak's facts in public.

At least ABC actually tried to set the record straight. Good for them.

Posted by: Insanity on March 6, 2010 at 11:40 AM | PERMALINK

By denying any insurer from offering abortion coverage and taking federal funding, Stupak is denying all tax-paying citizen their right to choose the coverage they want.

He is trying to leverage HCR to force his religious agenda on the entire country, which clearly violates the separation of church and state requirement.

Stupak needs to be rhetorically tarred and feathered for this.

Posted by: bdop4 on March 6, 2010 at 11:48 AM | PERMALINK

I saw Rachel Maddow's piece about C Street and Stupak last night, and it really sounds to me as if Stupak has pledged to the Family that he will not vote for HCR (perhaps there was a formal dress ball involved, a la those father-daughter virginity events that creep me out). Stupak seems to be flailing a bit to try to explain his opposition, and won't listen to the actual facts about federal funding of abortion in the HCR plan, so it makes sense to me that he's just staying faithful to some secret Family religious pact.

Posted by: Winslow on March 6, 2010 at 11:53 AM | PERMALINK

Do we have a list of these 11 representatives? Because I am skeptical. Stupak's respect for truth and accuracy aren't such that I am willing to take his word for it.

After watching Rachel Maddow last night, my impression is that what Stupak really wants is to stay in the news. Perhaps we could arrange for him to achieve that in another way?

Posted by: Tazistan Jen on March 6, 2010 at 11:54 AM | PERMALINK

He holds valuable committee memberships and chairs a subcommittee. Perhaps a little bird from the Speakers' office should pass the word along that the price of his "conscience" is his chairmanship and his committees.

Pack him off to another committee where he will immediately become the most junior member, and promise he'll be shuffled from committee to committee on a regular basis for as long he he remains in the House. Oppose the party on health care and become a permanent floating junior member.

And then there's the Nuclear Option. As a long-time incumbent, I'm sure he has a valuable parking spot. Most members seem to care more about their parking space than the commonweal, so perhaps that he could be assigned to a more removed ground. As Skeffington says in "The Last Hurrah," things like that will drive a man to Tolerance. Or in this case, party loyalty.

In short, answer the Grand Petty Objection with the Grand Petty Retaliation.

Posted by: Edward Furey on March 6, 2010 at 11:56 AM | PERMALINK

One has to wonder why 11 others would allow Stupak to lead them around to begin with - he has no power, no serious chance of going to any higher office than he now holds.

I certainly hope the whip operation has talked to every Democrat in the House, and independently knows where they stand, notwithstanding Stupak's claims. At this point, the easiest thing may be to just work everyone but Stupak, and when he goes to show his might and pull his 12 votes, there is no one there but him, all alone, in a losing, embarassing cause, out on a limb for all to see.

Then saw the fucking thing off and let him fall. Its time to put the "whip" in whipping the caucus.

Posted by: zeitgeist on March 6, 2010 at 12:11 PM | PERMALINK

There must be ice in Satan's swimming pool today. I mean, a major news outlet actually reporting the truth of an issue instead of just spewing RNC talking points? Somebody pinch me, I must be dreaming!!

Let's hope that others, having noticed that the world did not shatter, will start to do the same.

Posted by: Curmudgeon on March 6, 2010 at 12:16 PM | PERMALINK

"I certainly hope the whip operation has talked to every Democrat in the House, and independently knows where they stand, notwithstanding Stupak's claims. At this point, the easiest thing may be to just work everyone but Stupak..."

This. Stupak has painted himself into a corner with his public statements and will not likely admit that he was wrong, but the others should be persuadable.

Posted by: sacman701 on March 6, 2010 at 12:20 PM | PERMALINK

Stupak lies about the legislation, and he lies about his "twelve" Dem allies.

Cut the crypto-Republican loose already.

Posted by: 1st Paradox on March 6, 2010 at 12:31 PM | PERMALINK

"Stupak needs to be rhetorically tarred and feathered for this"."
Posted by: bdop4 on March 6, 2010 at 11:48 AM

Why stop at "rhetorically"?
I don't know his voting record w/r/t torture (and am too lazy to look it up) but it wouldn't surprise me if he were with the Thuglicans on that issue as well. If he is, the process could prove... educational for him. Two birds, one waterboard.

Posted by: smartalek on March 6, 2010 at 12:31 PM | PERMALINK

Stupak doesn't have twelve votes. If he had twelve votes, the twelve votes would've announced themselves as being against the bill by now; as they haven't, I can only conclude that he's bluffing.

Posted by: ACS on March 6, 2010 at 12:37 PM | PERMALINK

One thing that's ignored in this, is this may not be about abortion at all.

These Washington religious groups, such as The Family and The Foundation tend to subscribe to a form of belief that I refer to as "neo-calvinism". This belief states that your level of success on this plane of existance is determined by God. So if you're a successful person, then you are a chosen holy person. And if you're not..well..you're a heathen who deserves to be punished for your lack of success.

This idea comes from the DeVos family, a far right wing family, and the originators of the AmWay capitalistic cult. They're big addition to society is the idea of "Fake it until you make it", the idea that keeping up airs is the key to personal success.

This neo-calvinism is the root of everything wrong in our society.

Posted by: Karmakin on March 6, 2010 at 12:47 PM | PERMALINK

fyi, An opposing view on Abortion Funding



It's now becoming clear that Barack Obama is willing to put everything on the table in order to be the president who passes health-care reform. Everything, that is, except a ban on federal funding for abortion.

Last September, the president promised that "no federal dollars will be used to fund abortions, and federal conscience laws will remain in place." Yet the legislation most likely to move forward in Congress would be the single greatest expansion of abortion since the 1973 Roe v. Wade decision.

The White House knows how to turn Mr. Obama's September commitment into legislative action. I met with senior White House officials and told them that only adding a so-called Hyde Amendment to the health-care reform bills would fulfill the president's promise to protect Americans from subsidizing abortion.

The Hyde Amendment dates back to the 1970s, when congressional leaders discovered that Medicaid was paying for nearly 300,000 abortions a year. This had not been an intended outcome of the Medicaid program, which was created in 1965 with strong bipartisan support. So in 1976 Rep. Henry Hyde introduced an amendment to the Health and Human Services appropriations bill prohibiting taxpayer funds from paying for abortions.

Similar amendments have been added to health-care bills ever since. Without specific language prohibiting the practice, history has shown that the courts or administrative agencies end up directing government dollars to pay for abortions.

For example, in the 1996 case Planned Parenthood v. Engler, the Sixth Circuit Court of Appeals found that "under Medicaid, certain categories of medical care are mandatory." The court then found that abortion "fits within many of the mandatory care categories, including 'family planning,' 'outpatient services,' 'inpatient services,' and 'physician services.'" In short, the court created a mandate for funded abortions through Medicaid if the Hyde Amendment is ever eliminated.

Over the past year, language similar to the Hyde Amendment was crafted by Reps. Bart Stupak (D., Mich.) and Joe Pitts (R., Pa.) and inserted into the health-care bill that passed the House. When asked about the Stupak-Pitts Amendment in November, Mr. Obama talked around the issue. He said that "there is a balance to be achieved that is consistent with the Hyde Amendment." When asked if Stupak-Pitts struck this "balance," the president replied "not yet."

That's an odd reply. The question of abortion funding doesn't have any Zen to it: The funding is either prohibited or it's not.

In November, presidential adviser David Axelrod, on CNN's "State of the Union," also talked around the Hyde Amendment, saying that the president "doesn't believe this bill should change the status quo as it relates to the issue of abortion." But then Mr. Axelrod claimed that "this shouldn't be a debate about abortion" before concluding that there were discussions in Congress about "how to adjust [the abortion language bill] accordingly."

Apparently, his definition of "adjust" means opening up the spigot for the abortion lobby. The president's latest proposal mirrors legislation that has passed the Senate, which doesn't include a Hyde Amendment, and would inevitably establish abortion as a fundamental health-care service for the following reasons:

• It would change existing law by allowing federally subsidized health-care plans to pay for abortions and could require private health-insurance plans to cover abortion.

• It would impose a first-ever abortion tax—a separate premium payment that will be used to pay for elective abortions—on enrollees in insurance plans that covers abortions through newly created government health-care exchanges.

• And it would fail to protect the rights of health-care providers to refuse to participate in abortions.

The president's plan goes further than the Senate bill on abortion by calling for spending $11 billion over five years on "community health centers," which include Planned Parenthood clinics that provide abortions.

The bottom line is that the president wants to deploy words that sound soothing like "balance" and "adjust." Meanwhile, the courts are rendering precedent with stark words like "mandatory."

When confronted by House Minority Leader John Boehner about abortion funding during the health-care summit last week, the president dropped his head and looked down at the table. How revealing.

Posted by: Martha on March 6, 2010 at 1:00 PM | PERMALINK

It helps to remember that Stupak is a Yooper.

Posted by: nonheroicvet on March 6, 2010 at 1:00 PM | PERMALINK

I don't believe there's anything in the constitution that stipulates a minimum level of intelligence.

Posted by: rbe1 on March 6, 2010 at 1:28 PM | PERMALINK

What ACS said: if Stupak really had those votes, some of them would have stood up and been counted by now. (If not, then they're a bunch of total chickenshits.) I think Stupak's just trying to pretend that he swings a bigger dick than that shriveled little thing he surely has.

Posted by: low-tech cyclist on March 6, 2010 at 1:30 PM | PERMALINK

Just likes the spotlight? Gets a little thrill out of his fleeting hold on power? Is our very own Jim Bunning?

Excuse me. I'm going to ignore Stupak and spend the afternoon rereading Christopher Lasch's book on narcissism.

Posted by: pw on March 6, 2010 at 1:39 PM | PERMALINK

In essence Stupak is seeking to kill Americans. (Campaign finances or twisted cult reasons...it doesn't matter when the result is death)

And this is active killing of PEOPLE now alive...not a potential group of cells.

Posted by: Evergreen2U on March 6, 2010 at 1:47 PM | PERMALINK

When one is tarred and feathered, the tar is traditionally applied hot enough to burn and blister the skin -- perhaps depending on the temperature of the mob.

John Yoo might not think of that as torture, but I certainly do.

Posted by: joel hanes on March 6, 2010 at 2:04 PM | PERMALINK

If this crowd is not going to vote with their party on an issue as fundamental to the party as health care, then the party needs to do everything it can to make sure they are not in a position to vote for anything after November.

I thought this crowd and ALL crowds when we are speaking of US Representatives were supposed to vote with their CONSTITUENTS.

Guess I was wrong ... I guess what we are really voting for are representatives from the PARTIES to US. Not US to the parties.

........ Or maybe THAT is the basic reason why Scot brown won?
Cause, maybe, it wasn't the Democrats seat? It was the people's seat?

Posted by: Chromehawk on March 6, 2010 at 2:06 PM | PERMALINK

Okay, Stupak and however many of his pals are willing to trash HCR presumably because they're "pro-life," and thereby leave us with the current system which: (a) according to one widely circulated estimate, kills 45,000 a year from lack of health care insurance; (b) sticks the U.S in 19th place in mortality amenable to health care (France is 1st at 65 unnecessary deaths per 100K while the U.S. rate is 110); (c) according to the CIA is the U.S. is something like 43rd in the world in infant mortality (the CIA for some odd reason lists the rates from worst, Angola #1 to best Singapore #224--the U.S. is 180).

Posted by: john sherman on March 6, 2010 at 2:07 PM | PERMALINK

KM said "If this crowd is not going to vote with their party on an issue as fundamental to the party as health care, then the party needs to do everything it can to make sure they are not in a position to vote for anything after November."

That's a very tempting viewpoint, but it is very wrong. As frustrating as it is, it is much better to be in power with a broad and annoying coalition, than out of power with a party that is narrow and pure. The solution is multi-prong - you don't give the guy more power than you have to, you entice and reward collaboration where you can, and you try to primary out members who are insufficiently dedicated to the cause (but only when they are from a constituency that will elect a more progressive candidate, rather than simply handing the seat to a republican).

Things are far from ideal under the Democrats, who are likewise far from perfect, and I wish Obama could wave a wand and fix all the republican damage and disasters instantly, but politics doesn't work that way. Keep your focus on all the bad stuff that is not happening because the republicans are out of power, but will happen again if they get back into power.

Posted by: N.Wells on March 6, 2010 at 2:28 PM | PERMALINK

The only faith Stupak seems to keep is the faith with the Family and the rest of his "C" street brothers.

Posted by: Winkandanod on March 6, 2010 at 11:31 AM

Why are these people even allowed to call themselves Democrats? "C Street" is nothing but a cult, and it's time that it, and its members, ought to be referred to with the type of derision usually reserved for child molesters.

Posted by: electrolite on March 6, 2010 at 2:29 PM | PERMALINK

My question is why Stupak gets to be the leader here. He seems to have become the voice of the anti-choice faction simply by being the most unreasonable and extreme in his demands.

At one point Brad Ellsworth-- someone who is totally indistinguishable in terms of how he votes from a Republican, yet who the Democrats are about to inexplicably reward with a shot at a Senate seat-- was willing to go forward with the HCR bill with language reportedly like that of the Nelson amendment. Doesn't he have any pull with the other blue dogs, isn't there any faction of Ellsworth-like Democrats? And why are we so worried about a bloc of 10 blue dogs when the Democrats have like a 40-seat lead in the Congress to begin with? Do we pick up NO blue dog seats with a fairly stringent set of funding rules like the Nelson amendment PLUS a missing public option?

Posted by: mcc on March 6, 2010 at 2:35 PM | PERMALINK

Per Martha's post at 1:00 PM, frankly, I'd like independent confirmation of the article's claims. Because, a lot of those assertations appear to be complete anti-abortion propaganda. And, even if they weren't, how can anti-abortionists justify hijacking life-saving legislation that will help *everyone*, and save lives, especially in these hard economic times where many people are losing, or have lost necesary health insurance?

Posted by: knightphoenix2 on March 6, 2010 at 2:36 PM | PERMALINK

Stupak has the votes to kill this thing, and thank God for it too. Don't believe me? Then answer this question. Why would Nancy Pelosi, one of the most pro choice members of the House and Speaker at that, allow Stupak's amendment in the first place? I think its because she didn't have the votes otherwise. There are also other Blue dogs who are threatening to flip/ would love to flip, such as Ellsworth. Call me a conservative troll, I am a conservative and proud of it. You don't realize what this bill will do. Lots of doctors are threatening to quit the practice if this bill goes through because they see what will happen. What good is universal access to NO medical care, as opposed to having 30 million uninsured, many of whom voluntarily choose to do so and/or are illegal. Just my two cents. Call me a troll but I mean honestly whatever happened to open debate? We are segregating via ideology way too much in America and it is not healthy. By the way, my solution for reform is to give everyone a tax credit to purchase health insurance and allow insurers to sell across state lines. I know, I know, Republican talking points. Have a nice day.

Posted by: smallguy on March 6, 2010 at 2:55 PM | PERMALINK

I really don't think this is just about abortion, I think the C Street gang have some kind of cult ideas that women should be subservient to men and do what they are told, from what I have heard about this group they also think that men should be able to have affairs and women should just keep quiet.Also, they idolize people like Hitler and Stalin, which makes them a pretty scary group. I think he has been told by the cult not to let HCR pass.

Posted by: JS on March 6, 2010 at 3:06 PM | PERMALINK

Lots of doctors are threatening to quit the practice if this bill goes through because they see what will happen. What good is universal access to NO medical care, as opposed to having 30 million uninsured, many of whom voluntarily choose to do so and/or are illegal. Just my two cents.

Care to provide a link that discusses doctors quitting? Or is that something you read in the comments of Powerline? Or the claim of the uninsured are uninsured because they want to be? How many is many, anyway? Cite, please.

Here's one for you: the AMA supports healthcare reform. Sounds like a lot of doctors. It's clear to those who provide medical services believe that something should be done. Something significant.


Posted by: jcricket on March 6, 2010 at 3:16 PM | PERMALINK

Stupak is working hard to get his dead ass into heaven. That is all it is about. His dead ass.

Posted by: Silver Owl on March 6, 2010 at 3:19 PM | PERMALINK
By the way, my solution for reform is to give everyone a tax credit to purchase health insurance and allow insurers to sell across state lines. I know, I know, Republican talking points.

No, just stupid "talking points" that will do nothing to actually address the real issues of access to health care and spiraling health costs. Come back when you've done your homework.

Posted by: PaulB on March 6, 2010 at 3:21 PM | PERMALINK

Just my two cents.

No, just your self-serving bullshit backed up by absolutely nothing at all.

Posted by: Truth on March 6, 2010 at 3:22 PM | PERMALINK

Lots of doctors are threatening to quit the practice if this bill goes through because they see what will happen.

How many? Put up or shut up. Or did you drop by just to take a shit on this thread and then go running away? Typical.

Posted by: Truth on March 6, 2010 at 3:24 PM | PERMALINK

It's kind of weird how Stupak keeps talking about his 12 disciples. Who does he think he is, Jesus? And, like others here, I'd like to see those 12 names listed. Paint them all together, maybe, for posterity.

Posted by: exlibra on March 6, 2010 at 3:32 PM | PERMALINK

smallguy (unfortunate that):

Your concern that doctors will quit if HCR passes is totally off-base.

Why is HCR endorsed by the AMA?

Why does the USA with our current system only have 2.3 doctors per 1000 people, while countries that have universal health govt-backed health care like Spain, Sweden, France and Germany have more than 3 doctors per 1000 people.

As a medical specialist, why would I quit a job that pays me $500,000 per year if health care reform passes?

There are plenty of things in this bill that are good for doctors.

What you are saying makes no sense.

Now, if I were a blood-sucking insurance company executive, I would hate this bill.

Posted by: DK on March 6, 2010 at 3:39 PM | PERMALINK

DK: And maybe more to the point, why would doctors oppose a bill that basically just reforms *health insurance*?

I could imagine doctors being angry if the medicare-linked public option had got in, because doctors don't like being paid medicare rates. But the bill more or less leaves providers alone. That's in fact one of the biggest criticisms of it, that it doesn't substantially fix any problems in the medical system that stem from providers!

Posted by: mcc on March 6, 2010 at 3:44 PM | PERMALINK

So, query for you geniuses about "reconciliation":

Technically what cannot then be passed via reconciliation? A hypothetical: in 2013, the House passes Budget X; the Senate with 60+ votes passes budget Y; neither mention healthcare. They reconcile legislation Z including a provision that renders anything passed this year as null and void.

Solve for a contradiction or difficulty? Given the delay in implementing anything signed into law this year, what would the Democrats or, if you prefer, the people, gain?


Posted by: The Very Democratic USA Citzen on March 6, 2010 at 3:46 PM | PERMALINK

So much hatred, why? I don't work for a health insurance company and am not connected with the insurance companies in any way. I happen to be a 23 year old college student with no insurance. It is a voluntary choice I have made. That is how it should be. Insurance is a gamble on both sides. I most likely will not need anything but a catastrophic plan, which I hope to purchase once I get a job. However, I cannot purchase anything without money, which only a job can provide. If anything there should be an individual mandate for jobs before a mandate to purchase something. My argument about doctors comes from the fact that this reform bill cuts Medicare funding ( which is government run) and doctors are taking even fewer patients now. http://www.boston.com/news/nation/washington/articles/2009/09/24/democrats_seek_cuts_in_medicare_advantage/

Sorry the link does not highlight, a fault of my computer. I am dismayed by both sides. I have read both sides blogs and followed this issue fairly closely. It is unfortunate that there is so much vitriol and hatred. There is such a need to score political points that neither side can think clearly.

Posted by: smallguy on March 6, 2010 at 3:59 PM | PERMALINK

vduc, i'm not sure I understand your point, but the idea is reconciliation has limited rules such that it can be used for some things and not others. So you cannot pass the health care bill using reconciliation. But as has been pointed out, the democrats will not pass the health care bill using reconciliation. They will be passing the health care bill normally. They will *also* pass a series of fixes adjusting things like taxation structures and medicare payouts to states, and maybe (probably not) adding a public option. The fixes will be passed through reconciliation. The bill will not.

A reconciliation bill from a Republican-controlled government could of course undo anything this reconciliation bill did. But because this reconciliation bill does very few things there would be very little point. The major parts of the legislation in the main bill, like the regulations on insurance companies, could not be undone through reconciliation.

Of course you could technically probably kill almost any government program you wanted, whether it was instituted by reconciliation or not, whether it has anything to do with health care or not, through reconciliation, because budget is a good blunt tool for killing things and the reconciliation procedure gives a free pass to anything that reduces the deficit. You could defund the exchanges or the insurance subsidies (although the states could probably continue funding them, I don't know?), maybe you could defund whatever part of HHS enforces insurance regulations. But that would be kind of silly and in the latter case at least surely unpopular.

What exactly is your point, incidentally?

Posted by: mcc on March 6, 2010 at 3:59 PM | PERMALINK

smallguy, your article is from September 2009 discussing what might end up in the bill, whereas the finished bill did not make it out of the Senate until late December 2009. Not only that, but you conflate Medicare with Medicare Advantage, which is a give-away to private insurance companies for services not covered by basic Medicare.

Stay in school, son. Take some reading comprehension courses while you are there.

Posted by: jcricket on March 6, 2010 at 4:16 PM | PERMALINK

My argument about doctors comes from the fact that this reform bill cuts Medicare funding ( which is government run) and doctors are taking even fewer patients now.

That doctors are taking fewer patients now (and the article doesn't seem to talk about this) does not mean we shouldn't reform medicare, it means we should reform the health care system so citizens with average incomes can afford to pay for it. If we can cut the waste out of the system--starting with the salaries of health insurance execs--we can bring all of these costs back towards something our economy can actually reform. Without selectively turning old people and the poor out to die because they can't afford care or medicine.

As to your making "the choice" to not have health insurance, do you also have a card forbiding the EMTs or anyone else from taking you to an emergency room? Are you willing to refuse help from a doctor or hospital if you are injured or sick and have no cash to pay it? This is what the Christian Scientists do, and they are one of the few groups that can claim to exist independently of public health services.

Consider your current net worth and that even a simple medical procedure, like an appendectomy or treatment for a broken leg, will cost you $15,000 dollars minimum out of pocket, and costs for more complex problems can easily run into hundreds of thousands of dollars and sometimes into the millions.

If you have only, say $30,000 per year in earning power, which will likely disappear if you are severely injured, your ability to pay off major medical bills like this in your working lifetime is virtually nil. This means that medical practitioners have to either turn you away or get someone else to cover the cost of caring for you. Invariably, that is going to be people with private or public insurance.

That is where the need to refuse care comes in. If you opt out of the health care system, you need to opt all the way out. If you are going to change your mind the instant you need medical care, or if you've made no provision to prevent others from caring for you if you are incapacitated, then you are a parasite, whether you know it or not.

Living independently of the insurance system was still possible sixty years ago, when basic care was reasonably cheap relative to average income, when exotic care was less high tech, and when only a few people had insurance and the market kept costs down. Once a sizable fraction of the middle and working classes got insurance, the medical system tapped into that enormous store of reserved wealth and has been sucking more and more wealth out of the economy every decade since.

Something similar happened to farming over the last two centuries. High tech, capital intensive farming became the market norm. Money followed money, the agri-business system became priced to market farming, and subsistance farming became impossible.

When subsistence farming was priced out of the system by market farming, millions upon millions of Americans moved from farms into cities. When subsistence medical care gets priced out of the system, the only thing millions upon millions of Americans will be able to do is stay lucky, or get sick and die.

Posted by: Midland on March 6, 2010 at 4:44 PM | PERMALINK
Technically what cannot then be passed via reconciliation?

Anything that doesn't directly affect the budget, the key word being "directly."

They reconcile legislation Z including a provision that renders anything passed this year as null and void.

Can't be done.

Posted by: PaulB on March 6, 2010 at 4:54 PM | PERMALINK

To smallguy,
I used to be a 23 year old student who thought having no health insurance was a smart move. Then, I got hit by a car while crossing in a marked crosswalk with the light.

Posted by: Bonnie on March 6, 2010 at 4:58 PM | PERMALINK
So much hatred, why?

I'm looking in vain for any "hatred" in this thread. Perhaps you can point me to some? We do have a low tolerance for ignorance and wholly unsupported assertions, both of which you are guilty of. Deal with it.

It is a voluntary choice I have made. That is how it should be.

Bullshit. It "should" only be that way if we are prepared to let you die and/or heal entirely on your own should you suffer an accident. As a society, we have decided we will not do that.

However, I cannot purchase anything without money, which only a job can provide.

Which is why every bill under discussion includes more or less generous subsidies precisely for your scenario.

My argument about doctors comes from the fact that this reform bill cuts Medicare funding

No, it doesn't. It cuts money for private insurance plans that are add-ons to Medicare; that's an entirely different matter. Nor do you have any evidence at all to suggest that such a cut would cause *any* doctor to not take patients.

I have read both sides blogs and followed this issue fairly closely.

Then why is your proposed "solution" idiotic and demonstrably unable to solve *anything*, including your own situation?!

It is unfortunate that there is so much vitriol and hatred. There is such a need to score political points that neither side can think clearly.

Bullshit. We are thinking quite clearly, thank you. That you are unable to comprehend the arguments being made is not our fault and not our problem. As I said, come back when you've done your homework. Right now, you're just embarrassing yourself.

Posted by: PaulB on March 6, 2010 at 5:03 PM | PERMALINK

For those of you who were wondering about my claim that doctors would be nervous about this, Thomas Sowell, who has a PHD from the University of Chicago, wrote an article about it. If the link does not work, the article can be found under today's Real Clear Politics site. http://www.realclearpolitics.com/articles/2010/03/06/alice_in_medical_care_part_iv_104664.html

Midland, you brought up the point of my going completely without protection. I would take the risk if I could but The Supreme Court said that is not possible. In all honesty this is about fear of an inability to pay leading to a prison term. If the legislation does not provide for a prison term, I would be greatly relieved to hear it, but that would require seeing a final bill. As is, the senate legislation is 2,700 pages long. Do you really think Congress will let me simply buy catastrophic health insurance as opposed to buying a bunch of add on coverage as well ( e.g. cosmetic surgery, mental health, vision/dental) which I may not wish to buy? I am open to persuasion, and being of a libertarian persuasion, I believe in self reliance. The very idea of being a government parasite is abhorrent to me. I understand and sympathize with the idea that we must block free loaders from gumming up the system, but I do not trust a 2,700 page bill full of bribes ( Nelson, Landrieu) to do that. Sure the Senate says they will fix that through reconciliation, but they honestly don't have to. Once Obama signs the Senate bill he doesn't have to do anything else and may not want to given HCR has taken so much time already.If Landrieu and Nelson's bribe are in there, what other pay offs are in there? In fact, since this legislation does not offer a public option, it is nothing but a give a way to insurance companies who will then influence legislators to " require" the additional coverage I mentioned. This issue comes down to a simple matter of trust for me. I do not trust the government to do this right. I do not mean to disparage anyone here, just looking for more information and an honest debate without reference to emotion. I thank you for your patience. This is my final post.

Posted by: smallguy on March 6, 2010 at 5:13 PM | PERMALINK

I think he may be thinking of running for Governor of Michigan. What better way to get yourself publicity? Although Michigan WILL NOT vote in another Democrat.

Posted by: ziggrl on March 6, 2010 at 5:30 PM | PERMALINK

If the legislation does not provide for a prison term, I would be greatly relieved to hear it, but that would require seeing a final bill. As is, the senate legislation is 2,700 pages long.

Then learn to read. Alternately, learn to use your web browser's "find" function. Looking at the bill, if I search for the word "responsibility" (the buzzword legislators use for mandates) I immediately find subtitle F, part 1, "Individual responsibility". Searching within this section for "tax" I quickly find the information on how the mandate penalty works: There is a penalty of $750/yr, starting in 2016 and thereafter adjusted for inflation. The penalty does not apply to those under the poverty line, those for whom insurance would be more than 8 percent of your yearly income, or anyone with a religious exemption. And the bill specifically says:

"`(A) WAIVER OF CRIMINAL PENALTIES- In the case of any failure by a taxpayer to timely pay any penalty imposed by this section, such taxpayer shall not be subject to any criminal prosecution or penalty with respect to such failure.
`(B) LIMITATIONS ON LIENS AND LEVIES- The Secretary shall not--
`(i) file notice of lien with respect to any property of a taxpayer by reason of any failure to pay the penalty imposed by this section, or
`(ii) levy on any such property with respect to such failure.'."

This isn't hard!

Do you really think Congress will let me simply buy catastrophic health insurance as opposed to buying a bunch of add on coverage as well ( e.g. cosmetic surgery, mental health, vision/dental) which I may not wish to buy?

This is just plain silly. Why "do you think?" READ THE BILL! IT'S RIGHT THERE. IT'S WRITTEN IN ENGLISH. It's not mysterious and none of that gibberish is in there. They say you can buy any plan on the health insurance exchange, and specifically list government health plans such as medicare (which doesn't include dental) as acceptable. If you can read Thomas Sowell's conservative propaganda you can read the bill, and then you won't have to make stuff up about it complain about on web forums. Go to thomas.gov, click the link on the front page that says "H.R. 3590", click "Text of legislation". This is the Senate bill and it will not be amended any further except through reconciliation.

Posted by: mcc on March 6, 2010 at 5:37 PM | PERMALINK

The biggest news story of this decade would be if someone can expose "The Family!"

Posted by: antiquelt on March 6, 2010 at 6:24 PM | PERMALINK

The Masked Defender, pick a handle and stay with it -- knock off the sockpuppeting. And if you're not going to bother educating yourself about this issue before spouting the same nonsense under various handles, at least try a little study of other subjects so your parents don't have to pay for another year. That school of yours isn't cheap.

Posted by: on March 6, 2010 at 6:35 PM | PERMALINK

Stupak is a nobody without this issue. He has never been heard from before now. Rachel had a good piece on this a couple of days ago. This is Stupak trying to get into the spotlight. That is all.

He makes me vomit.

Posted by: ecthompson, md on March 6, 2010 at 6:50 PM | PERMALINK
For those of you who were wondering about my claim that doctors would be nervous about this

Sigh... Did you actually *read* that article you pointed us to? There is nothing supporting his claims, or yours, in that column. No real data, no studies, no polls, nothing. He spends the entire first half of his column talking about a single doctor (and doesn't give a name, so we have no idea if he's making shit up or not).

Sowell's basic claim is that there will be a lot more paperwork and that the extra paperwork will drive doctors away, along with, potentially, reduced payments. Nowhere does he support his assertions that there will be more paperwork or reduced payments to doctors. Nowhere does he point us to any study that supports his assertions that doctors are being driven away. Not one shred of evidence or single verifiable fact in the article. And you found this persuasive? No wonder you're so confused.

Posted by: PaulB on March 6, 2010 at 6:57 PM | PERMALINK

Where is Joe Wilson when we really need him?

Posted by: Bonnie on March 6, 2010 at 7:15 PM | PERMALINK

Let's be a little chairitable folks. Stupak is devoutly Catholic, and has a decent record on some things. Many of you are right though - NO ONE would pay any attention to ANY congressman from this district in normal times. Normally, they get to be the chair of the sub committee on inland waterways and coast guard affairs.

So, there is probably a bit of wanting to get time in the sun [ there sure as hell is none where he is from]. Maybe a sit down with Joe Biden, fellow Catholic, over a coffee and they can read the damn bill?

NFW he runs for gov. in MI. No yooper would ever get elected to a statewide post. The western MI conservative repubs {hookstra et al] would eat him form pre breakfast.

Posted by: bigwisc on March 6, 2010 at 7:35 PM | PERMALINK

It's quite shocking the number of people here, including Steve Benen, who continue to claim Stupak is wrong when Stupak has cited the page, section and wording of the legislation that in does explicitly levy a fee to pay for abortion. Anyone can go read it but the loon-left would rather keep repeating the talking points rather the read it themselves.

Those supporting this monstrosity of bill are as uninformed, and I suspect intentionally so, group as I've ever seen on any issue.

Ignorance is bliss seems to be the operational standard for Obamacare.

Posted by: Paul In Pittsburgh on March 6, 2010 at 7:39 PM | PERMALINK

Tip of the hat to ABC News...

The clip is an oasis in a media desert.

Posted by: Ohioan on March 6, 2010 at 7:56 PM | PERMALINK

I happen to be pro-choice (with some limitations), but I also think the Health Care Reform bills being proposed by the Democrats are terrible. Hence I am rooting for the "Stupak dozen" (see http://snipr.com/uo7ev for the list) to remain an insurmountable stumbling block to passage in the House.

As to the question about the accuracy of Stupak's abortion-funding claims, I think there's an easy response: Why didn't the Senate just include Stupak's language in its bill? Nelson was originally holding out for that, but settled for some compromise language which was meant to appease other Democrats with strong pro-choice views. But if present law and/or the Senate bill does indeed block federal abortion funding, then what would have been the harm in adopting Stupak's language which he believed would block abortion funding but was more air tight? Why risk losing a dozen house votes for HCR over a minor and insubstantial difference in language?

So either Democrats were incredibly stupid for failing to include the Stupak language in the Senate bill, or there really is a significant difference which justifies Stupak's opposition. Either answer is okay with me, if it helps to defeat HCR.

Posted by: dpwiener on March 6, 2010 at 8:15 PM | PERMALINK

Gee, I did read it and Stupak is still wrong. Please select #6, and then refer to pages 2069-2078.

Full Text of HR3590

Paul in Pittsburgh, be careful what you ask for. You just might get it.

Stupak is wrong.

Posted by: jcricket on March 6, 2010 at 8:18 PM | PERMALINK

dpweiner, whether Stupak likes it or not, abortion is legal and he cannot outlaw it by proxy by prohibiting private insurance policies to forbid coverage. There is no federal funding provision for abortion. But where state laws do not interfere with insurance coverage, the bill allows private insurance to continue coverage.

Stupak doesn't like that, but tough shit. Abortion is a legal procedure, and private coverage is still legal under HR 3590.

Posted by: jcricket on March 6, 2010 at 8:23 PM | PERMALINK

To 'forbid coverage' s/b 'to allow coverage'.

Sorry...preview was used and still did not catch it! :(

Posted by: jcricket on March 6, 2010 at 8:25 PM | PERMALINK

Repeating error does not achieve truth. Benen repeats Noah's erroneous statements that the Hyde policy, the government may not fund abortions, is not law because the Congress can change law. This is absurd. Stupack simply added the Hyde policy to the House bill in order to garner enough votes to pass it, recognizing the different funding streams that are included in the bill. The current impasse is that if different social policy, ie. the Senate version, which gutted the Hyde policy, is in the bill, the Senate may not use reconciliation, a simple accounting tool. The Senate bill is new policy, subject to filibuster rules. Stupack has stated that he is not counting votes, but many conclude this issue, whether US money can fund an abortion, will kill the legislation. The issue is clear, Stupack made no mistake.

Posted by: R. L. Hails Sr. P. E. on March 6, 2010 at 8:25 PM | PERMALINK

Deep apologies for the OT (and multiples thereof, since I'm putting this into every thread), but:
If you're seeing the same ad that I am on the WaMo splash page (top center-right (how inappropriate -- should clearly be on the FAR right), for FreedomWorks.org, "Stop Reconciliation"), you might take a moment to remember that WaMo, and possibly Mr B his-own-self, get a few ducats for every click...
Plus, you can take this opportunity to help the nice people at FreedomWorks to recognize their inaccuracies, so that they might rectify them. I'm sure they'd be most grateful to be informed in some detail just how their info is inaccurate, and (in the wrong hands) could be highly misleading. Yes, I'm quite confident they'll quickly move to correct what must clearly be innocent errors, once they've been pointed out...
Cheers, all.

Posted by: smartalek on March 6, 2010 at 8:31 PM | PERMALINK

Thank you, Martha, for your post.
You are quite right.

If you listen carefully to the ABC piece you see that it doesn't contradict Stupak's main point at all: namely, that there are insufficient protections to prevent indirect federal funding of abortion in the Senate bill. Since many of the details about how the exchanges will function, will have to be worked out by bureaucrats later, the possibility, even probability of federal funds eventually covering abortions is a major loophole.

There is no power of the Congress to mandate anyone to buy insurance, but that doesn't stop "progressives" from forcing their way on people who don't want it. If the Constitution itself whose language is pretty clear is a "living document" which can be twisted to mean whatever the left wants it to mean, then there are bound to be a thousand surprise abuses hiding in the 2000 pages of legal tangle the Congress has produced, and it can mean anything a bureaucrat says it does.

Stupak is right.

As usual, when the left doesn't like your position they take a minor side point to quibble with, say you're wrong about that on the "facts", then call you a "liar" and finally threathen to bloody your nose if you don't get in line.

Posted by: EJM on March 6, 2010 at 8:48 PM | PERMALINK

jcricket, I don't disagree with you about abortion. But you don't have to worry about me, since I'm not a Congressman and Stupak is. Stupak obviously does disagree with you, and he (and his "dozen") are the ones standing in the way of the House passing the Senate bill.

From my perspective, I don't particularly care about Stupak's motives or the accuracy of his claims, as long as he succeeds in blocking the bill. Sure, I'd prefer that people vote my way for the right reasons, but if they vote my way for the wrong reasons I'll still take it.

If the government were to keep its nose out of health care altogether, there wouldn't be any abortion funding issue to argue about. Some insurance policies would offer abortion coverage, and others wouldn't. Customers could choose the policies which met their personal requirements as well as their religious beliefs. Pro-life people still wouldn't be happy that abortion was legal, but at least they couldn't complain that their their tax dollars were being used to subsidize murder.

Posted by: dpwiener on March 6, 2010 at 8:56 PM | PERMALINK

Unfortunately, dpweiner, Government has already had its nose in healthcare for decades by exempting it from anti-trust laws. A predatory industry has been allowed to run amok without competition for decades.

There is no clean, easy answer to fix the expensive mess decades of exemption has caused for a middle and working class that could easily be bankrupt by even a temporary health issue. At this point, just removing the exemption will not change the predation of the industry. If there were an easy answer, it would have been enacted by now.

In my view, this bill is flawed in that it does not wipe the slate clean of the predatory industry altogether and set up a single payer system. If the progressive House members stand on the principle of demanding single payer, i can't fault them.

What I can fault is deception, and what you call "voting your way for the wrong reasons". It is the condoning of the propagation of lies, distortion, obfuscation and the abject stupidity coming out of the mouths of the rightwing and those who have such a flawed moral compass that this is okay with them that make me speak up, as I have today to re-iterate that Stupak is wrong in his assertions.

I feel sorry for you that your moral compass is such that gaining votes through deception is okay. It is even not surprising that you seem to be proud of this. We have discussed on this blog many times that the shame threshhold of many on the right seems to be non-existent.

Posted by: jcricket on March 6, 2010 at 9:26 PM | PERMALINK

I guess I have a more cynical view of Congress than you do, jcricket. I do not expect most members of either the House or Senate to vote based on principles, but rather to vote based on what the polls say and where their campaign contributions come from and (in some cases) where their bribes come from.

Under these circumstances, my main concern is how to minimize the damage that Congress can inflict. If competing interests and opposing ideologies succeed in clogging up the process and preventing a really bad piece of legislation from passing, then I prefer that over the alternative of logrolling and bribes (e.g., the Louisiana Purchase and the Cornhusker Kickback) which squeeze such legislation through.

I'd much prefer to elect moral, principled representatives who would vote the right way for the right reasons. I keep trying to promote that in my own small way, and work with others to accomplish the same. But in the meantime we have to deal with the Congress we have, not the Congress we'd like to have.

Posted by: dpwiener on March 6, 2010 at 9:42 PM | PERMALINK

As someone who supports women's rights to an abortion (more strongly than most), I find the original cave-in to Stupak appalling; but if you follow his reasoning then he has a point: if you subsidize insurance with government funding, then, yes, you are providing federal funds that, in theory, subsidize abortion, if its included in the coverage. The problem here isn't so much Stupak as the stupidity of Hyde; once you start down the road of saying the Hyde amendment is acceptable... then the rest is matters of interpretation. Benen and others have an interpretation that Nelson's language in the Senate bill is sufficient, and the Bishops and Stupak think only Stupak's is acceptable. I agree Stupak can be, at best, deliberately naive about what his amendment does: its net effect, really, will be to end private insurance coverage of abortion services for all women, no matter how he tries to say otherwise... but then, that's the point, really. Stupak and the Church just don't like saying it quite so clearly.

"Stupak's wrong" is really neither a good argument nor an actual position that supports women's abortion rights. The real pro- abortion rights position would be to, as Stupak fears - and Democrats can't have the nerve to do - repeal Hyde altogether. That would end the atrocious policy that essentially bars poorer women from abortions (i.e. Medicaid, which is the real issue here, can't fund abortions), for the sake of everyone else. That's what's really offensive here: that, in reality, we're making a class-based distinction on who should and shouldn't have access to abortions. The net effect of Nelson, after all, will be to limit abortion coverage to only those who can pay the additional fee; that seems "innocuous" and "nominal" but in the hundreds of dollars it will have practical effects on the poorest women (never mind the still problematic quality of insisting women decide, absent a pregnancy, on whether they might ever, in the future, want an abortion).

The larger issue here is that all of this reveals the schisms within the left when it comes to abortion... and why "pro-choice" is often as squishy as "pro-life" when it comes to being a catch-all for positions on abortion that include, in reality, opposing abortion access for women on class and other moral judgments. If we really believed all women have a right to abortion, then we wouldn't play these games with coverage that's needed to pay for them. As long as we're playing on the slippery slope of Hyde's language... there's no real way to win. Not for the women who will, in any case, be profoundly affected, yet again, by limitations on their ability to get necessary family planning services. That's the really appalling thing here. Stupak is a detail.

Posted by: weboy on March 6, 2010 at 10:01 PM | PERMALINK

More lies from the crazy left. Rep Stupak is absolutely right and everybody knows it. The Senate could have used exactly the language in the House bill that Stupak supported, but it didn't. It didn't because it wanted to fool the American people long enough to get the bill passed so that taxpayer money would go for abortion. Obama, Pelosi, and Reid and the rest of the crazy left have been to dishonest and tricky for their own good. This corrupt monstrous healthcare bill should die before it ruins healthcare and bankrupts the nation. It would be just if the tricks and lies regarding abortion are what kills it!!!!!

Posted by: valwayne on March 6, 2010 at 10:08 PM | PERMALINK

[...] being of a libertarian persuasion, I believe in self reliance. The very idea of being a government parasite is abhorrent to me.
Posted by: smallguy on March 6, 2010 at 5:13 PM

Just don't let me see you in "my" Free Clinic, please. I'm still suffering from dry, sour heaves, induced by having to be polite and respectful to an equally "libertarian" (we believe in self reliance) family. 12 home-schooled (naturally!) kids, 8 of whom managed to qualify for our program (for all I know, you're one of the remaining 4). Apparently, being a *charity* "parasite" is A-OK, but contributing to the government so it can take care of everyone is a "principled" no-no.

At the moment, we have 180 volunteers (I'm one of them) and 10 paid staff. Our paid staff is likely to be cut (thanks, Gov McDonnell!), while our "customer base" is growing, exponentially, due to sucky economy. So, if you show up at "my" clinic with your self-reliant BS, don't be surprised if I throw up all over your libertarian sneakers.

Posted by: exlibra on March 6, 2010 at 10:28 PM | PERMALINK

Stupak is as Stupak does.

Posted by: Mxyzptlk on March 6, 2010 at 11:41 PM | PERMALINK

This is so disturbing. This is NOT about pro-choice or pro-life. If it WAS then the vote would be to protect 45 million LIVES. Obama did NOT hang his head (MARTHA) because he was shamed, he hung it because he was depressed that there were so many greedy, crappy politicians that would use ANY excuse to help people pay for health care. They are not 'religious' or 'small government' or anything else. They are bigoted, racist aholes that will go to church tomorrow and sing in the choir and preach their hateful rhetoric. They are NOT Americans. Maybe they should spend just a little bit of time reading the HISTORY of what makes America American.

Posted by: SYSPROG on March 7, 2010 at 12:53 AM | PERMALINK

I was curious as to how Stupak was wrong. Amazingly, your post fails to explain. Stupak is right and I support his efforts to keep tax payers money from funding abortions.

Posted by: tjking62 on March 7, 2010 at 6:58 AM | PERMALINK

After reading most of these posts, I wonder how many of the so-called "Pro Life" crowd are also members of the Tea Party, Birthers, and Flat Earth Society. . .

Posted by: DAY on March 7, 2010 at 7:19 AM | PERMALINK

Re antiquelt's suggestion that someone should expose 'the family'
1000% right - we should have an in depth investigation on just who is telling Stupak what to do, I also have a feeling that the family gets any little bit of info as a hold on it's followers and could blackmail them into doing anything the family wants. I wonder how much rent over the years they have subsidized for him and if he has declared it for tax purposes.

Posted by: JS on March 7, 2010 at 9:29 AM | PERMALINK

Hello hello??? Have you EVER heard of the HYDE AMENDMENT??? That restricts abortion being paid by the federal government. What Stupak does is stop funding of ANY abortion by ANY means...unless of course, you want to be on a LIST that says 'you nasty woman, you chose to abort a LIFE.' Don't play the rotten morally corrupt compass with ME. READ THE BILL...READ HISTORY. Honest to GOD.

Posted by: SYSPROG on March 7, 2010 at 10:09 AM | PERMALINK

Ok, then this should be easy. If what you say is true,even though you chose not to explain your conclusions in this article then just give Stupak a written promise signed by Obama. The promise should simply state that the Senate will enact through reconciliation the following language to be part of the Healthcare bill. There will absolutley be no Taxpayer money whether Federal, State,excise, property, sales tax,or whatever used to pay for an aborion regardless of the circumstances. Including the everpresent ruse "in the case of the Mother's life" which means everyone one of these drug & alcohol addicted sluts cannot say "hey I'm going to kill myself if you don't abort my illegitmate baby". Also, this promise will need to eliminate the right of a doctor to make any such determination,as they have no moral standing left either. simply put you spread your legs, you live with the consequences. pretty simple.

Posted by: JRay on March 7, 2010 at 1:32 PM | PERMALINK

If Stupak is making a big deal about nothing then why not just adopt the language of the Stupak amendment. Something is at issue here and I am afraid the author is hiding the pea. The Senate bill subsidizes the purchase of insurance by certain people. The question is will the subsidized policies cover abortions.

Abortion is almost always an elective procedure. Conception is completely avoidable absent rape. Women rarely choose to have a large number of abortions. Abortion is not expensive. Why must abortion be covered if most Americans are opposed to funding it with government money?

An expanded government role in health care inevitably makes the government funding of abortion a bigger issue. This is not a phony issue.

Posted by: Charles R. Williams on March 7, 2010 at 2:58 PM | PERMALINK

If Stupak's wrong and there isn't a chance any tax payer dollars will fund abortion, what's wrong with a separate bill saying just that? Unless there is funny stuff going on by the libs and their media allies? Nah!!!!!!!

Posted by: susan boyer on March 7, 2010 at 3:47 PM | PERMALINK

Actually, it's a bit subtle, but Stupak is indeed correct -- the Senate bill does not explicitly guarantee that the government will not subsidize abortion. The senate bill does require health plan participants to pay a separate premium for the abortion coverage within the plan. At first blush, that sounds like the government is not subsidizing abortion (because abortion is being paid for separately). But that's not the right way to think about it.

Here's the correct reasoning. According to the Senate bill, EVERYONE in the plan has to pay for the extra abortion coverage -- it is mandatory, not optional. The only way someone can avoid paying for abortion is to enter an equivalent plan that excludes abortion. However, the Senate bill does not guarantee that for every plan with abortion coverage there will be an equivalent plan (or at least an equally desirable plan) without abortion coverage. Indeed, in most cases that is highly unlikely (note, it's not sufficient that there merely be SOME plan that excludes abortion -- for every plan with abortion coverage, there has to be one without abortion coverage that is otherwise equally or more desirable for each potential customer).

Because everyone in the plan is forced to pay the extra abortion premium, whether they want the coverage or not, the government subsidy of the plan is rightly construed as applying to the whole plan, including the abortion coverage. This is due to the fungibility of money (i.e., there isn't a special kind of money that can or must be used to pay for abortions -- all money is equivalent). If the government provides some fixed subsidy, and some group of people receiving that subsidy can only use it to buy a plan that covers abortion (with no equivalent no-abortion alternatives), then the subsidy is a subsidy of the whole plan. This wouldn't be true if people could always choose whether or not they want to pay for the extra abortion coverage (which is what the House bill says), but that's not the case with the Senate bill.

In practice, it could turn out that in every single market, for every plan with abortion coverage there will be an equivalent plan without such coverage whose premium is reduced exactly by the actuarial value of the covered abortion services. That scenario would be functionally equivalent to the House bill, which requires abortion coverage to be offered as a separate rider. However, the Senate bill does not guarantee such an outcome (nor is it likely to occur naturally). Thus, the Senate bill would most likely result in at least some government subsidy of abortion, and it certainly would not guarantee no government subsidy.

The accounting is not intuitive or obvious, but if you think it through, you'll see that Stupak is correct.

Indeed, it's quite bizarre to argue that the restrictions in the Senate bill are functionally equivalent to those in the House bill. If that were the case, then why wouldn't the Senate simply have adopted the exact House language (the Senate bill came later than the House bill)? The reason is that the authors of the Senate bill knew they were drafting a different policy -- one that wouldn't strictly limit subsidies for abortion.

Finally, let's say you're still not quite convinced. At the very least, you have to agree that the Senate language will make it easier and more affordable for women to get abortion coverage (because the cost will be shared across everyone within a plan, whether or not they want the coverage -- not just among a more limited set of people who would explicitly choose an abortion rider). If Stupak's goal is to reduce the number of abortions, then he should certainly have a strong preference for the House language over the Senate language. From that perspective, his opposition to the Senate bill is quite rational and principled, even if there are some quibbles over the exact definition of "subsidy".

If you disagree with Stupak's position on abortion, say so -- but don't continue to pretend he's somehow delusional or mistaken about the differences between the House and Senate bills vis a vis the impact they would have on increasing abortions in the US.

Posted by: atan on March 7, 2010 at 3:56 PM | PERMALINK

To Atan's comments:

Okay, I'll say it. I expressly disagree with Stupak's anti-Democratic Party stance of being anti-choice.

Further, I looked up the Senate language and to Atan's claim that "the Senate bill does not explicitly guarantee that the government will not subsidize abortion," and that "everyone is forced to share in the cost of the abortion premium" -- those two statements appear to be absolutely incorrect:

(A) IN GENERAL.—If a qualified health plan provides coverage of services described in paragraph (1)(B)(i), the issuer of the plan shall not use any amount attributable to any of the following for purposes of paying for such services:
(i) The credit under section 36B of the Internal Revenue Code of 1986 (and the amount (if any) of the advance payment of the credit under section 1412 of the Patient Protection and Affordable Care Act).
(ii) Any cost-sharing reduction under section 1402 of the Patient Protection and Affordable Care Act (and the amount (if
any) of the advance payment of the reduction under section 412 of the Patient Protection and Affordable Care Act).
(B) SEGREGATION OF FUNDS.—In the case of a plan to which subparagraph (A) applies, the issuer of the plan shall, out of amounts not described in subparagraph (A), segregate an
amount equal to the actuarial amounts determined under subparagraph (C) for all enrollees from the amounts described in subparagraph (A).

The bill goes on to expressly instruct community exchanges that the cost of abortions cannot be defrayed in any way with federal funds.

If the costs of abortion coverage goes down because all medical costs are going down across the board, due to the larger national pool of recipients, that is not an abortion-coverage-fueled issue.

And yes, the Senate language does provide that in the exchanges, there be offered at least one plan that does offer abortion coverage and at least one that doesn't. It doesn't give either plan preference over the other. In other words, there is nothing to say that there can't be 10 plans that don't offer abortion coverage and only one that does. There isn't an unfair advantage either way. If you want to make sure you're in a non-choice plan, you can certainly do so, although it's also worth noting that even the RNC wasn't in one of those plans until it came to their attention that being in it gave them one less weapon to use against HCR.

Lastly, it is a leap to a conclusion, not a fact, that abortions will increase because women have access to abortion coverage.

Posted by: JUNE on March 7, 2010 at 5:57 PM | PERMALINK

No Steve, you're a stupid SOB. Are you telling me that what I read in the Senate Bill is wrong? Are my eyes wrong when it tells me that they will take $1 from me to put in a family planning and related health care cost bank? Are you kidding me? Stupak is very much right and I pray every day that more and more people aren't taken in by the likes of CBS, MSNBC, Obama and other liberals/communists that can't be honest about one single solitary thing when it comes to this health care bill monstrosity and this includes the cost. Hey Steve why not tell your readers about Massachusetts and what a lovely system they have (Obama/Romney Care) and they are going broke and everyone's premiums shot through the roof.

Posted by: Sharonann Tomal on March 7, 2010 at 6:44 PM | PERMALINK

To Sharonann's comments:

It would have been great if somewhere in that rant the actual bill page number that was causing all the agita would have been shared. I tried several electronic search attempts of the bill (HR 3590, as passed) using "$1" and variations of "family planning and related health care cost bank," which returned no results to support the outrage. The only thing that came close was a section on *optional coverage* for abortion (page 123) that instructed the Secretary on estimating costs for optional coverage, with the estimate to be based on not less than one dollar. That's a parameter to estimate what it would cost to offer it to those who choose to have it, not a plot to extract a dollar from Sharonann.

As for Mitt Romney, Massachusetts has shown us what HCR would look like if indeed Pres. Obama were to "start over" as the GOP vociferously demanded. As is to be expected, "fiscal conservative" Romney signed legislation without a way to pay for it, or to control its costs. The words "incremental" and "piecemeal" come to mind. Those are the lessons well learned from MA, and according to CBO, not repeated in this HCR initiative.

Posted by: June on March 8, 2010 at 12:11 AM | PERMALINK

Amended to reference pages 124-125 (not page 123), for the Senate bill language regarding $1/optional coverage.

Posted by: June on March 8, 2010 at 12:18 AM | PERMALINK

ABC News did a nice job fact-checking Stupak's argument this week, and Slate's Tim Noah (a Monthly alum) published the definitive takedown a couple of days ago, explaining that some areas of the debate are open to interpretation and debate, but this isn't one of them: "Stupak happens to be wrong."
Q. And what leads you to believe that either of these sources is definitive or unbiased?
A. Your own biases.
Q. Why are we now at this impasse?
A. The Senate had the opportunity to utilize Stupak's clear and unequivocal language. It did not do so.
Q. Why did the Senate not adopt the Stupak language?
A. Because it was unacceptable to them.
Q. If there is no difference in the intent and impact between the Senate language and the Stupak language, why would the Stupak language be rejected by the Senate?
A. Only a dishonest and deceptive commentator would insult our intelligence to argue that there is no difference. And only those with an intellectual poverty driven by their own bias would accept that argument. In both cases, if the shoe fits, wear it.

Posted by: Cincinnati RIck on March 8, 2010 at 1:05 PM | PERMALINK



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