Five centrist Democrats --Reps. Tim Ryan, (OH), Dale Kildee (Mich.), James Langevin (R.I.), Artur Davis (Ala.) and Kendrick Meek (Fla.) -- have written a letter to Nancy Pelosi urging that health reform maintain the "status quo" on federal abortion funding. Here is their proposal:

...we believe that a common ground solution is to include language in the final legislation that makes clear that no insurance company will be required to pay for an abortion except in extraordinary circumstances -- nor will they be prohibited from paying for an abortion, so long as health insurance plans offered in the exchange that choose to provide abortion coverage pay for those services with funds that are separate and distinct from any federal subsidies.

This solution maintains the current status quo in the private market – where insurance companies can choose whether to include this coverage in their plans and individuals can choose which plan (and what sort of coverage) fits their individual needs and values while ensuring that no federal funds are used to pay for abortions.

Lastly, we believe that health reform legislation should not preempt constitutionally permissible state laws that establish pre-requisites that a patient must satisfy before obtaining an abortion, such as parental consent and waiting period laws.

The letter contains no mention of the public plan. But by opposing "federal subsidies" for abortion, these Democrats align themselves with Republican abortion opponents, whose goal is to prevent abortion coverage under any new public insurance options, just as the Hyde Amendment currently prevents Medicaid from funding abortion for poor women.

None of the health reform bills in Congress would repeal Hyde, meaning that as Medicaid is expanded to cover all Americans within 133 percent of the poverty line, the poorest women will still need to pay out-of-pocket for abortion. (A first-trimester abortion costs between $300 and $400.) What reproductive rights advocates are hoping for from health reform is that the new public insurance option will offer some abortion coverage, just as most private insurance plans currently do. But with increasing numbers of Democrats allowing abortion opponents to frame the health reform debate, little short of an intervention from the White House can slow the roll of the abortion grandstanding. So far the administration has shied away from the issue. Here's hoping that in his televised speech tonight, President Obama indicates that he won't allow anti-family planning ideologues to delay reform.

--Dana Goldstein

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