A bill about life: The larger moral picture

In the end, the issue of abortion did not derail health-care reform. But that’s what would have happened had the U.S. Catholic bishops and some hard-line antiabortion Protestant groups had their way.

The legislation that passed stipulates that individuals who receive insurance subsidies have to pay for abortion—or abortion coverage—out of their own pocket. This accounting system wasn’t enough to satisfy the bishops, though it was enough to meet the concerns of 60 leaders of religious orders, representing 59,000 Catholic nuns, as well as officials at the Catholic Health Association. “We believe [the bill] meets the test of no federal funding for abortion,” said CHA president Sister Carol Keehan shortly before Congress passed the bill on March 21.

The bishops and their policy advisers read the bill with a relentless hermeneutic of suspicion. In getting deep into the weeds of legislative language, seizing on any possible scenario by which federal money could end up supporting abortion, the bishops lost sight of the larger moral picture: expanding access to health care is one of the most significant ways to lower abortion rates.

“Expanding health-care coverage reduces the number of abortions,” reports T. R. Reid, author of an influential comparative study of health-care systems around the world. “All the other industrialized democracies figured that out years ago.” The U.S. abortion rate—20.8 per 1,000 women—is the highest in the developed world. In Canada and Western Europe, women have legal access to abortion, but they also have access to health care—the key reason why abortion rates there are lower than in the U.S. (The abortion rate is 7.8 per 1,000 women in Germany, 14.3 in Denmark, 15.2 in Canada.)

Reid recounts a conversation he had with Cardinal Basil Hume when Hume was the senior Roman Catholic prelate of England and Wales. Reid asked why British women had fewer abortions than American women. Hume pointed to the crucial role of Britain’s universal health-care system: “If that frightened 19-year-old knows that she and her child will have access to medical care whenever it’s needed, she is more likely to carry the baby to term. Isn’t it obvious?”

Early reports from Massachussetts, which implemented near-universal health-care coverage two years ago, already show a drop in abortion rates there, according to a study published in the New England Journal of Medicine.

Representative Marcy Kaptur, a Catholic and an antiabortion Democrat from Ohio, got it right when she announced her support for health-care reform. “The health bill . . . is actually a bill about life,” she said. “No longer will any woman have to wonder whether she can bring a child to term because she can’t afford it.”