Hitting the Great Divide

The leaders of the Roman Catholic Church in the U.S. were supporting Bill Clinton’s health plan years before he was born. Universal coverage? In 1919 they wrote, “The state should make comprehensive provision for insurance against illness, invalidity . . . and old age.” Employer mandate? They stated that the “insurance fund should be raised by a levy on industry.” Sometimes dubbed socialists for their troubles, the bishops defended these radical notions for the next 75 years.

Yet last week, as variations on the Clinton plan started heading toward compromise in Congress, the church dealt the process a sharp blow. Noting that three of the health-care plans emerging from committees listed abortion as part of a standard-benefits package, the National Conference of Catholic Bishops sadly but unanimously vowed to mount a grass-roots campaign against the final product if it followed suit. That announcement bred others: 72 members of Congress said they would have difficulty voting for any bill that doesn’t include abortion as a benefit. Thirty-five others responded by making public a threat to oppose any bill that does. An awful possibility hovered before the Democratic congressional leadership: however they chose, the abortion issue might cost them the razor-thin margin by which any health plan would be expected to pass Congress. Politically at least, they would be damned if they did and damned if they didn’t.

It was in the hope of delaying such a showdown that Senate Finance Committee chairman Daniel Patrick Moynihan had cut a deal with his colleague John Danforth in late May. In return for the Missourian’s attempt at compromise, the pro-choice New Yorker signed on to the result: two pro-life amendments to the committee’s health-care bill. Like many other senior Democrats, Moynihan hoped to put the issue off for another day.

Inevitably, that day dawned. In the trenches of abortion warfare, nobody has ever given anything up for free; yet until the bishops spoke, it looked as if the pro-choice forces might steal a march. Currently pro-lifers can avoid funding other peoples’ abortions through their tax dollars or insurance premiums: Congress has prohibited the use of federal funds to pay for most Medicaid abortions, and many insurance companies do not underwrite the procedure. Under a universal employer-mandate system with an abortion benefit, however, all insurance companies would have to offer it. And employers would have to pay for it, passing on the costs to their employees. Thus, while the Clinton-inspired proposals emerging from the three congressional committees may seem to maintain the status quo, says National Conference spokeswoman Helen Alvare, “that’s not the effect.”

Yet the bishops’ counterproposal — that abortion should be made a “supplemental” benefit for which women could pay extra — would be a step backward for pro-choicers, most of whose insurance companies routinely finance the services. Says Colorado Congresswoman Patricia Schroeder: “We are totally opposed to women getting private insurance for their private parts.”

Only a minority of Americans, however, believes the health-care system should guarantee payment for abortion. In a TIME/CNN poll last week, 52% of those surveyed said they would oppose a universal health plan that paid for abortions, up from 44% opposition last year. Such disputes take on more importance in the face of a general erosion of health-reform support. In the TIME/CNN poll, only 37% of those surveyed support the Clinton plan, down from 48% in April.

So far, no compromise on abortion has been hashed out. The Danforth amendments to the Finance Committee bill explicitly state that it does not require the creation and maintenance of abortion clinics and allows individuals and companies to refuse to pay for a benefits package that includes abortion. But such a system would ultimately give employers the power to make the decision for all workers. Another route may be to try to pass a health plan in which the standard benefits would be named later by an independent commission. In that case, pity the commissioners who must decide. Claims Schroeder: “There is no compromise on this issue.” Louisiana Senator John Breaux, a conservative Catholic Democrat, maintains that “it can be worked out.” At the moment, most people on the Hill seem to agree with Breaux. But if passions flame higher, America’s most contentious issue could become a health-care deal breaker.

CHART: NOT AVAILABLE

CREDIT: From a telephone poll of 600 adult Americans taken for TIME/CNN on Jul 13-14 by Yankelovich Partners Inc. Sampling error is plus or minus 4% Not Sures omitted

CAPTION: IF THE GOVERNMENT WERE TO GUARANTEE HEALTH INSURANCE FOR ALL AMERICANS, SHOULD THE PLAN PAY FOR ABORTIONS?

IS IT IMPORTANT TO REFORM THE U.S. HEALTH-CARE SYSTEM SOMETIME THIS YEAR OR CAN IT WAIT UNTIL NEXT YEAR?