Conservative Principles Now

The President promised that under health reform taxpayers would not be forced to fund abortion. Not true.

The new health care outline posted by the White House this morning appears to aggravate concerns about a new abortion funding scheme that is not covered by any limitation, including the traditional Hyde amendment governing annual appropriations to the Department of Health and Human Services and the Stupak-Pitts amendment adopted by the House of Representative last November in its version of health reform. Instead, the White House plan would invest $11 billion in an expansion of Community Health Centers, others known as Federally Qualified Health Centers (FQHCs), with no limitation at all.

This $11 billion price tag is $2.5 billion higher than called for by the Senate bill approved on Christmas Eve. That legislation provided for $7 billion in fresh appropriations for operating funds and another $1.5 billion in spending for construction of FQHCs (both sums over five years). Because this money would be directly appropriated if the Senate bill is adopted and signed into law, it does not need to be included in the annual Labor-Health and Human Services spending bill. As a result, the Hyde Amendment abortion funding limit would not apply to these FQHC funds. Nor would the comprehensive Stupak-Pitts funding limit, unless the House-passed language of that amendment is specifically included in the Senate bill updated by today’s White House proposal.

The 11-page White House summary of President Obama’s proposal does not mention inclusion of the Stupak-Pitts amendment in any final bill. Given the opposition of Democratic leaders to the amendment, it is reasonable to assume that the dramatic expansion of FQHC’s, which already number 1,250, could go hand in hand with the expansion of abortion at these centers. The FQHCs are being lobbied to include abortion among their “prevention” services, and the underlying federal authorizing statute does not bar them from doing so. Therefore, the impact of this new and independent funding stream on expanding taxpayer-funded abortion could be immense.

Today’s Washington Post editorial page takes a critical look at Majority Leader Harry Reid’s (D-NV) latest “compromise” health care bill, which it describes as 11th-hour “legislative sausage” that was “made on the fly” and includes ideas dating “at least to the Clinton administration.”

Most significantly, though, the Washington Post sees Sen. Reid’s bill as a “dramatic step” toward a single-payer health care system, even if the public option is not on the table:

[T]he last-minute introduction of this idea within the broader context of health reform raises numerous questions — not least of which is whether this proposal is a far more dramatic step toward a single-payer system than lawmakers on either side realize.

In a nutshell, Sen. Reid’s latest compromise allows uninsured individuals over 55 to buy into Medicare. As we wrote on The Foundry today, that policy brings with it numerous problems, the core of which are higher costs to taxpayers, squeezing individuals out of their private coverage (including retiree coverage from a former employer), and adding costs to an already-unsustainable Medicare system.

Why would costs skyrocket? As The Washington Post notes, sicker seniors “might flock to Medicare,” thinking that the government will be more likely to approve their treatments, which “would raise premium costs and, correspondingly, the pressure to dip into federal funds for extra help.” In other words, sicker seniors would move into the public pool, costs would go up, and so too would taxpayers’ bills.

There are more questions than answers, as The Washington Post points out, regarding reduced reimbursements to health care providers and further expansions of Medicare:

Presumably, the expanded Medicare program would pay Medicare rates to providers, raising the question of the spillover effects on a health-care system already stressed by a dramatic expansion of Medicaid. Will providers cut costs — or will they shift them to private insurers, driving up premiums? Will they stop taking Medicare patients or go to Congress demanding higher rates? Once 55-year-olds are in, they are not likely to be kicked out, and the pressure will be on to expand the program to make more people eligible.

There are other serious concerns, too, as detailed elsewhere on The Foundry, including even more unintended consequences of Sen. Reid’s bill. The Washington’s Post final analysis is on point:

The irony of this late-breaking Medicare proposal is that it could be a bigger step toward a single-payer system than the milquetoast public option plans rejected by Senate moderates as too disruptive of the private market.

This marks not the end of the public option, but the beginning of single-payer health care.