I’ve talked many times now about the different standards applied to the proximity of taxpayer funds to abortion and the proximity of private premiums to abortion. Of course, from a moral perspective, there is really no difference, and yet the widespread funding of abortion by private health insurance seems a matter of small concern. Guttmacher claims that 87 percent of employer-based plans covered abortion, while 13 percent of abortions are billed directly to insurers (this excludes people who seek later reimbursement from insurance companies). Until a few weeks ago, abortion was covered by the Republican National Committee’s plan, but nobody cared until the current healthcare reform bill pushed this issue into the limelight.
Nobody cared. But they should care. Because the dirty little secret is that insurance companies love covering abortion, because it saves them a lot of money on childbirth costs. In fact, as Tim Noah notes, “For health insurers, the true cost of abortion coverage is less than zero, because hospitals and doctors charge less to perform abortions than they do to tend pregnant women before, during, and after childbirth”. To put this in stark terms, a profit-making insurance company striving to appease shareholders by minimizing “medical loss” has every incentive to encourage abortion and discourage childbirth.
And yet, this is not on the radar of the pro-life movement. It was never on their radar. They didn’t care when Medicare Advantage allowed private insurance companies to cover abortion. Despite the hullaballoo over the healthcare reform bill and abortion, this bill represents the first attempt at the federal level to regulate what insurance companies can and cannot do when it comes to abortion. States can prohibit them from coming to the exchanges with abortion plans. Every person must have an option that excludes abortion – an option, I must point out, that is not available to people on employer-based plans. And those that choose an abortion plan must remit a separate payment that covers the gross cost of abortion (not the saved money from childcare costs) into a segregated abortion fund. (Realistically, how many will choose this option? How many companies will ever bother offering?).While imperfect, this is the first step towards getting the insurance industry out of the abortion business.
Why does nobody seem to care about this? Why has the pro-life movement been asleep at the wheel for decades? One reason is that it remains aligned with that variant of liberalism which emphasizes individual rights and is distrustful of using the government to enforce collective decision-making. In this view, the market is good, and government is bad. Individual responsibility embodies virtue, dependence on others embodies vice.
Applied to health care, Jonathan Chait puts it this way: “Democrats propose to shift resources from the rich and the healthy to the poor and the sick. Republicans want to do just the opposite. Republican health care plans reflect the party’s increasingly widespread belief that good health, like other forms of prosperity, is a matter of personal responsibility.” Of course, he misses the religious dimension – this is Calvinism in action. It is not the Catholicism that sees a clear role for the state in collective decision-making and views healthcare as a basic human right.
And so, the pro-life movement was been in bed with big business, including the abortion-loving insurance companies. After all, one must not disturb one’s allies on the right! Here’s the bottom line: If a private insurance company covers abortion in normal times, no big deal. But if a private insurance company covers abortion during a government-sponsored attempt to insure 30 million more people, then it must be opposed at all costs.
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