Abortion Rights: What Next After Health Reform?

Back in December, senators who support abortion rights were faced with a decision: derail health-care reform or settle for restrictive abortion language. To win the crucial 60th vote of Sen. Ben Nelson, they chose the latter. The language that came out of that negotiation, which will almost certainly persist in the final package, requires insurers covering abortion to collect two payments from their enrollees: one for abortion coverage, one for everything else. While abortion-rights senators acquiesced to the deal, activists have adamantly opposed it, arguing that the stringent accounting requirements of a two-check system will push insurers to drop abortion coverage altogether.

Is there a silver lining for abortion-rights supporters? Katha Pollitt over at The Nation thinks so: she argues that they deserve "payback" from the Democrats—serious action on another women's rights issue in return for playing nice. Potential peace offerings include full funding of Title X and swift movement on the Paycheck Fairness Act. But the charge that Democrats have accrued a women's rights debt is pretty weak in light of the many pro-women parts of the health bill. The bill largely eliminates gender rating, a widespread insurance practice of charging women higher premiums. It increases access to ob-gyn care and guarantees free preventive care, which includes breast- and cervical-cancer screenings. These provisions have received overwhelming praise from the same groups that deride the abortion language.

Jos Truitt at the blog Feministing offers a more sobering, and realistic, analysis of the situation: after throwing in the towel, abortion-rights supporters are nowhere near a "thank you" from the Democrats. Instead, by caving, they're just more marginalized. "The pro-choice community in Washington has shown that it did not have the power to live up to its commitment," she writes. Simply put, "you don't get payback in politics for rolling over."

Truitt's argument suggests that abortion-rights supporters would be in a better bargaining position had they not rolled over. But in truth, abortion-rights supporters were set to lose power in health-care reform no matter what they did; the Democrats put them in a lose-lose situation. They could stand firm, like anti-abortion Democratic Rep. Bart Stupak, and take the blame for bringing down health-care reform. Or they could back down, disappoint their core supporters and reveal their stark lack of bargaining power. They were forced to chalk up a loss and choose the latter, arguably less damaging, option. They come out of the health-care battle much more cognizant of their vulnerabilities, even within the Democratic Party, and aware that Obama, generally an abortion-rights supporter, may not always be on their side.