Taxpayers Already Subsidize Abortion Coverage. Maybe Even Yours!

by Jonathan Cohn | September 29, 2009

For those who haven't followed the intersection between abortion rights and health care reform, today's New York Times sums up the situation:

Abortion opponents in both the House and the Senate are seeking to block the millions of middle- and lower-income people who might receive federal insurance subsidies to help them buy health coverage from using the money on plans that cover abortion. And the abortion opponents are getting enough support from moderate Democrats that both sides say the outcome is too close to call. Opponents of abortion cite as precedent a 30-year-old ban on the use of taxpayer money to pay for elective abortions.

As the article goes on to note, Obama and the Democrats have tried to accommodate this concern by specifying that insurers divide their revenue streams, with subsidies in one pile and contributions from individuals in the other. Under the planned reforms, insurers couldn't use the subsidy revenues to finance abortion services. But that may not matter:

opponents say that is not good enough, because only a line on an insurers’ accounting ledger would divide the federal money from the payments for abortions. The subsidies would still help people afford health coverage that included abortion.

The opponents have a point here. The distinction wouldn't be terribly meaningful. But, by that logic, every American taxpayer is already subsidizing abortion services.

Remember, the single largest tax subsidy in health care today is the tax break for employer-sponsored insurance. If you have insurance through your job, then you're getting government assistance just as surely as if Washington wrote you a check. And if your policy happens to cover abortion services--which about half of you do, according to the Kaiser Family Foundation's annual benefits survey--then the taxpayers are helping to subsidize it.

I'm not trying to accuse abortion rights opponents of hypocrisy or inconsistency. I'm sure they'd eliminate everybody's subsidy if they could. By trying to keep funding out of the exchanges, they're trying to hold the line--to keep more abortions from happening. I don't agree with their position, but there's nothing illogical about it.

But I suspect a lot of voters think the distinction makes sense for a different reason. They have mixed feelings about abortion, so they like the idea of supporting choice in principle while opposing taxpayer funding. The trouble is, it's not a meaningful distinction because of the employer tax subsidy, which (much to my regret, for unrelated policy reasons) is here to stay.

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