The realities of HR 3200

by Michelle Maynard

PAC Assistant Director

As we go to print, there are three major health reform bills being considered by Congress – two in the U.S. Senate and one in the U.S. House. The bills and debates have become messy, confusing, and overwhelming. However, the need for all of us to be engaged and educated is very real. While this article examines the realities of HR 3200, all health care bills should be carefully examined to see how the proposed “reforms” impact life issues. It is our responsibility as pro-life Americans to stand up for the lives of our fellow citizens, whether unborn, disabled, or elderly.

Reality #1: Federally mandated coverage of, and access to, abortion.

Despite claims that abortion is not part of the health care bill, a massive expansion of funding, access, and deregulation of abortion is the undeniable reality of HR 3200. Until recently, abortion was not specifically mentioned on a specific line or page of the bill. However, several Court decisions – including Planned Parenthood Affiliates of Michigan v. Engler (Sixth Circuit Court, 1996) – have set a precedent that abortion is mandatory care unless it is specifically excluded by Congress.

Various forms of the Hyde Amendment have been in place for three decades. But the Hyde Amendment does not apply to funds outside of the Health and Human Services appropriations bill. HR 3200 directly funds a public plan, and funds subsidies for private plans. These funds will not be limited by the Hyde Amendment.

Unless Congress adopts a Hyde-like amendment that specifically bans the use of taxpayer dollars for abortions through both the public option and through subsidies to private insurers, HR3200 will cover taxpayer funded abortions.

Reality #2: Attempts to include an amendment to ban taxpayer-funded abortions have been blocked.

Pro-life members of Congress have diligently tried to place a ban on taxpayer-funded abortions into HR 3200. Unfortunately, these amendments have been rejected.

On July 30, Representatives Joe Pitts (R-Penn.) and Bart Stupak (D-Mich.) offered an amendment that would exclude abortion from any basic benefits list. The amendment was ultimately defeated 30-29, allowing taxpayer-funded abortion to stay in HR 3200.

Reality #3: Abortion services has been specifically added to HR 3200 coverage.

After rejecting the bipartisan and pro-life Pitts/Stupak amendment, the House Energy and Commerce Committee adopted an amendment from Rep. Lois Capps (D-CA). The Capps Amendment explicitly authorizes the public option plan to cover all elective abortions. “HR 3200 would drastically change longstanding federal policy,” said Douglas Johnson, Legislative Director for the National Right to Life Committee. Johnson continued:

“The Capps Amendment explicitly authorizes this plan to cover all elective abortions. This means that any citizen who wants to take advantage of the public plan will be compelled to purchase coverage for abortion on demand. The federal agency will collect the premium money, receive bills from abortionists, and send the abortionists payment checks from the federal Treasury account. It is a sham to pretend that this does not constitute funding of abortion. If this passes, the federal government will be running a nationwide abortion-on-demand insurance plan.”

Reality #4: Some Freedom of Choice Act (FOCA) language is in the bill.

HR 3200 (page 49) says the mandates in HR 3200 will “not supercede any ... State law ... except insofar as such requirements prevent the application of a requirement of this division, as determined by the Commissioner.” If abortion continues to be covered as part of HR 3200’s mandatory coverage, any state law that prevents abortion on demand will be overturned. This means that any state law that restricts abortion – parental involvement laws, waiting periods, etc. – will be overturned.

Reality #5: Concerns about end-of-life consultations are legitimate.

One of the most publicized portions of HR 3200 is Section 1233. Authored by Portland, Oregon’s Representative Earl Blumenauer, this section established “Advance Care Planning Consultations” for Medicare patients. Contrary to some reports, these consultations are not currently mandatory, but they still merit caution. These Advance Care Planning Consultations between patient and practitioner can take place every five years – or sooner, if a patient’s health situation changes dramatically. The stated goal of the consultation is to establish advance care planning on, “advance directives, including living wills and durable powers of attorney, and their uses ... palliative care and hospice.” The practitioner is also directed to provide “a list of nation- and state-specific resources to assist consumers and their families with advance care planning ...”

The inclusion of “State-specific resources” is especially disconcerting in Oregon, where assisted suicide is legal and currently treated as palliative care by the Oregon Health Plan. Section 1233 also establishes training on “the goals and use of orders for life-sustaining treatments” to all health care workers.

Wesley J. Smith, Senior Fellow in Human Rights and Bioethics at the Discovery Institute, Associate Director of the International Task Force on Euthanasia and Assisted Suicide, and a special consultant for the Center for Bioethics and Culture, says:

“End of life counseling could easily be subtly or overtly outcome directed, as studies have shown often happens with genetic counseling of pregnant women testing positive for a Down [syndrome] fetus. Thus, there is much about which to be concerned when Medicare pays practitioners to engage in counseling about end of life, and indeed, authorizes part of the counseling to consist of referrals to outside organizations that might have ideological agendas such as Compassion and Choices” [formerly known as the Hemlock Society]. [In fact, Compassion and Choices has publicly admitted to writing the controversial portions of the legislation that deal with rationing.]

The adoption of HR 3200 – or any bill containing similar language to HR 3200 – will have significant ramifications on both abortion and end-of-life care in America. Until these concerns are remedied, pro-life Americans cannot support the bill.

In a letter to Congress, Cardinal Rigali, Chairman of the United States Conference of Catholic Bishops’ Committee on Pro-Life Activities, clearly summed up the pro-life concern with the proposed health care reforms. He stated, “Much-needed reform must not become a vehicle for promoting an ‘abortion rights’ agenda or reversing longstanding policies against federal funding and mandated coverage of abortion.” He continued, “In this sense, we urge [Congress] to make this legislation ‘abortion neutral,’ by preserving longstanding federal policies that prevent government promotion of abortion and respect conscience rights.”

Reality #6: Rationing of Health Care.

Unless there is sustainable, adequate financing, health insurance for the uninsured will almost surely lead to rationing when, down the road, government has to face the shortfall.

All versions of the health care restructuring bill provide for premium subsidies to help the uninsured obtain health insurance. The problem is that the proposal to date fails to ensure a sustainable method of financing these subsidies.

A substantial part of the subsidies would be paid for by reducing Medicare funding for older people in order to cover the uninsured. The dangerous consequence is that, in a few years, having over-promised and under-funded HR 3200, the government will be faced with the choice of adding other means of revenue or, more likely, in some way imposing rationing.