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Missouri Right to Life reaffirms belief that health-care changes could expand abortion coverage

This article first appeared in the St. Louis Beacon, Aug. 12, 2009 - Pam Fichter, president of Missouri Right to Life, today took issue with Sen. Claire McCaskill's comments at Tuesday's town-hall forum in which she said that none of the Senate health-care bills would allow federal money to be used for abortions.

"In response, (McCaskill) said that she has read the entire Senate bill, and there's no mention of abortion in the bill,'' Fichter said in a statement emailed today to anti-abortion allies and others. "While she is technically correct, her answer is disingenuous in that she ignores the language in the bill that has been and will be interpreted to mandate coverage of abortion."

Later, a statement sent out by Right to Life, the state's largest anti-abortion group added, "Sen. McCaskill is either woefully uninformed or is being intentionally disingenuous in her comments. If, as she says, she will not support legislation that mandates coverage for abortion, then we urge her to vote against any health-care bill that does not explicitly exclude abortion."

Fichter's concerns reflect, in part, the heightened emphasis over reproductive health services as both sides seek to lobby Congress as the Senate and House continue to work on various bills that would revamp the nation's health care system.

So far, as McCaskill pointed out, there is no one main health care bill. At the moment, there are three major health care bills in the House and two in the Senate.

Some advocates of reproductive rights have accused abortion opponents of seeking stronger anti-abortion language in the bills than what exists now in federal law.

In any case, McCaskill said she would not vote for a health-care bill that called for federal money to be spent on abortions.

Fichter explained her thinking in an earlier e-mail interview today: "For instance, there is no doubt that coverage of abortion will be mandated as an 'essential benefit' " under the bill proposed by Sen. Ted Kennedy, D-Mass., "unless Congress explicitly excludes abortion from the scope of federal authority to define 'essential benefit[s].'  Past administrative and legal interpretations of federal law bear this out."

"If the Senate didn't want abortion covered, they could have passed the proposed amendment in the committee that would specifically exclude abortion from such coverage. The amendment was defeated along party line votes," Fichter added.

"For example, when the federal Medicaid statute was passed, the law did not mention abortion, but it was interpreted to require coverage of abortion," Fichter said, citing various court opinions that led to Congress' passage in 1976 of the so-called "Hyde Amendment" that bars federal spending on abortion, except in cases of rape, incest and to save the life of the mother.

"Once abortion is mandated as an 'essential benefit,' the result will be federally mandated coverage of abortion on demand in virtually all of America’s health plans. The Senate Kennedy bill will also require plans participating in the new marketplace (“Gateway”) to ensure a 'wide choice of providers,' which will require many issuers to establish abortion-providing sites. Moreover, state laws that impede 'access' to the essential benefit of abortion (such as waiting periods and parental notification requirements) may be nullified as conflicting with the purposes of the federal law."

"Preventative" (or 'preventive') care is just one of the many broad mandatory categories that can and will be construed to cover elective abortion (except when Congress explicitly says otherwise)," Fichter said.

Fichter also cited a recent letter from Sen. Dianne Feinstein, D-Calif. and a member of the Senate Finance Committee, in which the senator responded to a similar query about abortion coverage.

Feinstein's response said, in part:

"I understand your opinion that private coverage of abortion services should be restricted in health reform. However, I believe that reproductive health services should be treated no differently than any other health-care service or benefit. I understand that many individuals may not want to purchase health insurance that covers reproductive services, but I believe that everyone should have the opportunity to select health insurance without those services restricted."

Jo Mannies is a freelance journalist and former political reporter at St. Louis Public Radio.