Critical Condition

NRO’s health-care blog.

Abortion Politics and Health-Care Reform


In a recent piece in The American Prospect, Dana Goldstein, one of that magazine’s associate editors, inadvertently makes some persuasive arguments against the current health-care reform proposals. In her article, she discusses how health-care reform presents both opportunities and risks for supporters of legal abortion. On one hand, health-care reform might result in greater numbers of women whose insurance coverage includes abortion services. However, Goldstein worries that if some form of national health insurance passes, future administrations might prevent insurance companies from covering abortion or contraceptives.

Goldstein’s solution is for an independent council of medical experts to determine which services will be covered by insurance plans. This is unsurprising, since supporters of legal abortion typically try to achieve their policy objectives via administrative or judicial fiat — instead of the democratic process.

However, the politicization of health care is actually a strong argument against many of the current health-care reform proposals. One proposal that has been receiving serious consideration is that of federally-regulated health-care exchanges that will house both public and private insurance plans. Once these exchanges are put in place, it will be far easier for the federal government to regulate health insurance. Different groups of health-care providers will all have a strong incentive to see to it that their services are mandated in any federal insurance policy. These additional mandates will drive up health-care costs through either higher premiums or more taxes.

In her article, Goldstein also misjudges the politics of abortion. In order to receive the political support of women, Goldstein encourages Congress to pursue a plan that includes reproductive health services. However, President Obama and congressional Democrats need to tread carefully on this issue, for two reasons: First, taxpayer subsidies for abortion will receive a considerable amount of attention and most Americans oppose federal funding for abortion. Second, if abortion coverage is required as part of whatever health-care reform passes, President Obama’s rhetoric about reducing the number of abortions will appear very disingenuous — especially considering that a number of studies show that subsidizing abortion increases abortion rates.

Indeed, the potential inclusion of abortion coverage in health-care reform is already acting as a wedge dividing moderates from the liberal base of President Obama and the Democratic party. Pro-lifers and other opponents of health-care reform have rightly raised the salience of this issue. They would do well to continue their efforts in the coming weeks.

– Michael J. New is an assistant professor at the University of Alabama and a visiting fellow at the Witherspoon Institute in Princeton, N.J.


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