Interview: DeGette On Abortion In The Health Reform Debate

Rep. Diana DeGette (D-CO), a co-Chairwoman of the House Pro-Choice Caucus, has been an outspoken critic of the abortion language included in the House health care bill.

In the interview that follows, she makes the case that current language in the House health care bill--proposed by Rep. Bart Stupak (D-MI) and passed on the House floor shortly before the entire package was voted on--amounts to a massive expansion of abortion restrictions. In an interview last week, Stupak said his amendment amounts to no more than current law; in this interview, DeGette responds to his explanation.

The abortion debate in Congress has come down to a battle between two proposals--Stupak's, and one offered by Rep. Lois Capps (D-CA) and supported (or, as they will point out, agreed to as a compromise) by pro-choice Democrats.

The Capps proposal would create an accounting firewall to segregate federal funds from paying for abortions for recipients of federal subsidies who shop for insurance on the regional health insurance exchanges created under the bill. It would also require regional insurance commissioners to try to ensure that each exchange offered one insurance plan that does cover abortions, and one that does not.

Were you satisfied with the abortion language included in the House health care bill--proposed by Rep. Lois Capps--before the Stupak amendment passed? How did that come about? Was it a compromise, and did you think it was the right way to go?

When the abortion issue came up in the Energy and Commerce Committee, the main concern that we had was keeping the bill neutral on the issue of abortion, because as the president said last week, this is a health care bill, not an abortion bill, and so we, some of the pro-choice members, negotiated with some of the pro-life Democrats, and we came up with the Capps amendment, which basically preserves the status quo. What it does is it says that no federal funds in the exchange or in the public option shall be used to pay for abortions, and then it sets up an accounting system to segregate the money so that if somebody has premium assistance or if they are in the public option, no federal funds can go to pay for insurance policies that will cover a full range of reproductive care.

Congressman Stupak says that his amendment is an extension of the Hyde language [the current, annually renewed ban on federal funding for abortions]--that it's just the same as current law. You and other pro-choice members of Congress have said that that's not the case. Can you elaborate on the differences?

This would be the biggest expansion of restrictions on a woman's right to choose, certainly in my career, because it doesn't just preserve Hyde, it goes much, much further. The Hyde amendment says no federal funds shall be used for abortion, except for in the situation of rape, incest, or the life of the mother. What the Stupak amendment said is that in the insurance exchange, or in the public option, people will not be able to buy insurance plans that cover abortion, even with their own private money. So the Capps amendment says you can't use federal dollars to pay for abortions, but people can still use their own private money to buy these policies, and [the Stupak amendment] would effectively eliminate people's ability to get coverage for full reproductive care in the exchange or in the public option.

The way that I understood the Stupak amendment was that you could buy a plan in the exchange with your own private money that covers elective abortions, but you couldn't if you received subsidies [Note: under Stupak, subsidy recipients can buy supplemental abortion-coverage plans with their own money], and that the argument against it is that so many people receive subsidies in the exchange that private health insurers just wouldn't provide them--but this is not what you're saying.

That's correct, because what the Stupak amendment says is that if somebody gets a subsidy, then they cannot buy an insurance plan in the exchange even with the portion of their subsidy that is their own private dollars. Let's say somebody pays a hundred dollars a month for their insurance premium in the exchange. Let's say they have a $10 premium assistance, and $90 of their own private money. What the Stupak amendment would say is that they can't even apply the $90 of premium to buying a health care plan that would cover abortions. And it's also true that because 80 percent of the people in the exchange will be estimated to have some kind of premium assistance, most people feel that it would be unlikely that the exchange would offer these plans that cover abortions to even the 20 percent who are paying purely with their own private dollars. So we think the effect of the Stupak amendment would be to deny everybody in the public option or in the exchange in general from buying insurance with their own private money that would offer full reproductive care.

The pro-life Democrats in the caucus had succeeded in getting different language--that was not Stupak and not Capps--into the manager's amendment. What did you think of that language, and would you be better off if you had just accepted that and avoided a vote on Stupak?

Here's what happened. Congressman Stupak said that he wanted to have an amendment made in order on the floor, and if he didn't get his amendment, he and his people would vote against the rule to bring the bill to the floor. So we went out, and we gathered the votes to pass the rule without Mr. Stupak and his supporters. And so Speaker Pelosi said to him, 'We've got the votes for the rule, so we're not gonna give you your amendment, we're gonna move forward.' So then Bart moved the goalposts, and he said, 'Well, okay, now what we're saying is if you don't include my amendment in this rule, in the manager's amendment, then we're gonna vote against the final passage.' And the Speaker had some other defections on final passage, so she looked at it, and she was worried that she wouldn't be able to pass the bill if she didn't do that.

But the problem was the amendment that Congressman Stupak wanted in this manager's amendment was what he calls 'Stupak lite,' but it's not really Stupak lite. What it is is the Stupak amendment, and then he says it'll be brought up for a vote every year. So not only do you have all the restrictions in the Stupak amendment, but then you have to have the acrimony of having a vote in Congress every year on this. So to the pro-choice caucus, we didn't think that this was a compromise at all. It was far beyond current law. So we told the Speaker, 'We cannot vote for a rule that contains this Stupak language, because then we would have all voted for an unprecedented expansion of restrictions on a woman's right to choose,' and so she said, 'Well, in that case, then, I'll just let him have his amendment on the floor, and we said, 'Well we'd rather vote against on the floor.' But to us, it wouldn't have been a better situation, it would have been a worse situation, because the language was still essentially the same--the same restrictions--and we would've all had to vote for it, so that was unacceptable to us.

Have you gotten any indications on how the Senate is going to handle this, and do you see any kind of compromise or middle ground happening down the road?

Well, we've been working with our Senate allies, and I think what's happening over there, and it's also happening here in the House, is that over the last week people have really realized how restrictive the Stupak amendment is--that it's not simply a reiteration of the Hyde amendment, and that it would pretty much stop people from buying reproductive care in the exchange, but it could also have farther reaching implications than that. So our Senate allies are really working to make sure that the Senate language is more reflective of what we tried to do in the Energy and Commerce Committee. They have language similar to the Capps amendment in the Senate Finance bill, and I think they're looking at trying to do that. The thing to realize is it's not like we consider the Capps amendment to be a victory. We're opposed to the Hyde amendment to begin with. The Capps amendment was really a compromise to keep the status quo.

We're still willing to talk about language...the Senate's looking at language. If there's language that can augment or supplant or replace the Capps amendment, that can have the effect of preserving the status quo, then we would accept that.

Stupak's amendment would prevent recipients of federal subsidies from using any of those funds to help pay the premium of an exchange plan that covers elective abortions (not in the case of rape, incest, or a threat to the life of the mother. It also specifies that subsidy recipients can purchase supplemental coverage--separate from their main plan--to cover elective abortions.