If liberals in the House are to be taken at their word, then health care reform has never been in greater danger. There is now a clear path to destroying the legislation. The 41 Democrats pledging to vote against reform if Stupak's abortion amendment remains have very little, if any, leverage. They're negotiating against an opposition that would just assume the bill doesn't pass or, at best, is looking to exact a pound of flesh on a high-profile issue. That doesn't make for great odds at success. And those odds are even worse in the Senate should liberals stage an uprising, where due to arcane rules, Harry Reid must convince 60 colleagues to vote for cloture and bring the bill to the floor. Nancy Pelosi succeeded in passing the House's legislation with 50.5 percent of the vote.
There's been debate over just how much of an impact the Stupak amendment will have, with some mealy-mouthed white men pointing to the fact that only 13 percent of women who have an abortion bill their insurance companies directly. But that ignores the far larger, less defined percentage of women who pay for the procedure out of pocket and are later reimbursed. The amendment will also punish women whose unexpected health conditions require hospitalization in order for a safe abortion to be performed. But this isn't merely an abortion issue, it's also a class issue. The Stupak amendment prevents any insurance plan that is purchased with government subsidies from covering abortions. More importantly, it doesn't touch the $250 billion the government spends each year making employer-sponsored health-care insurance tax-free:
That money, however, subsidizes the insurance of 157 million Americans,
many of them quite affluent. Imagine if Stupak had attempted to expand
his amendment to their coverage. It would, after all, have
been the same principle: Federal policy should not subsidize insurance
that offers abortion coverage. But it would have failed in an instant.
That group is too large, and too affluent, and too politically powerful
for Congress to dare to touch their access to reproductive services.
But the poorer women who will be using subsidies on the exchange proved
a much easier target. In substance, this amendment was as much about
class as it was about choice.
The inverse is also true. Pelosi caved and made the deal for the same reason: Poor people are politically expendable. The result is an ugly horse-trade: if liberals want their precious health care reform then moderate Dems are going to try and extract a high-profile concession they can flog on the campaign trail next year. And nothing is of a higher-profile than an abortion defeat.