Thoughts on the Stupak Amendment

I've posted a bit about the Stupak amendment on facebook, and Daniel recently offered the following comments concerning it. I thought I'd respond here were I can more easily do so at length. I haven't bothered to link any articles that we've been discussing, because I don't think they're particularly necessary for understanding this comment, but Daniel can always add them later if he feels that such context is necessary. Anyway, here's what Daniel said concerning the amendment:

"So I've been thinking about this Walden Pond School of Public Finance some today. I still agree with you that if the Stupak amendment gets the votes and represents the center of gravity of American public opinion it's great. Insofar as this is what the people want, fine. But I don't know about this tendancy to opt-out of things that some people find morally reprehensible. We have pacifists in this country - that doesn't mean they can subtract the portion of funding that goes to offensive weaponry from their taxes. If we as a country decide to go to war, we accept all that that entails. We have environmentalists in this country, but that doesn't mean they can subtract the tax revenue that goes to highways. Likewise, we have pro-lifers in this country - should that mean that we whittle down what "health care" is when we decide as a country that we want to subsidize "health care"?

Or put it this way - why hasn't there been a comparbale "Stupak amendment" for the decades of tax subsidies that we've given to employer health benefits, which cover abortions? Kind of funny isn't it? When employees lucky enough to have a job that offers health benefits get a subsidy from the government, nobody says "you can't buy an abortion with that subsidy money", but as soon as low income families get subsidies people come down hard on the restrictions. When you think of it that way, the parallel with Walden seems even more relevant - the amendment itself starts to look more symbolic than substantive."

I don't know exactly where to begin with Daniel's comment. There's a lot that I would just flat out say is inapplicable to the current situation, or simply not the case, or simply confusing. I don't see how the current amendment is an "opt-out" in any relevant sense of the term. It's a restriction on federal funding, whether or not any particular person wants to use federal money for abortive procedures. No pro-life advocates are "opting-out" of paying taxes that pay for abortions. The amendment is restricting federal funds from going to abortive procedures. To carry on the pacifist analogy, this would be like a nonproliferation decision, or a troop withdrawal... not a decision to restrict funding of weapon manufacturing in wartime on the say-so of some pacifist lawmakers.

It's also quite a controversial statement in the first place that abortion constitutes a health care procedure at all- that is indeed what the fight over this amendment is largely about, isn't it? Actually, not even- in the few cases where abortion might be less controversially considered an acceptable part of healthcare (situations of endangerment to the mother), the amendment allows for it (Sec. 265 a). This is only "whittling down what health care is" given a certain stance about what abortion is. But simply assuming the conclusion about abortion doesn't seem to get us anywhere.

All that being said, I think Daniel's general point concerns the idea (and here I know I'm oversimplifying) of "legislating one's morality". Even given the importance of one's conscientious moral objection to certain things (warmaking, environmental destruction, abortion), a baseline recognition of give-and-take seems to be necessary. A liberal and morally pluralist society cannot simply constrain certain societal actions because they offend the conscience of some in the society.

But where, exactly, does that put us in the case of abortion? Is this really an argument against something like the Stupak amendment? Or rather, is it any more an argument against the Stupak amendment than it is against a healthcare bill that would fund abortion from the federal level? The choice on abortion seems to be between a public fund for a procedure deemed unjust and barbaric by millions, and a refusal of public assistance which constitutes unjust and barbaric negligence in the eyes of millions of other people. For neither alternative does the possibility of consensus appear very hopeful. Why, then, would the former (the amendment) constitute undue deference to some people's moral sensibilities in a way that the latter wouldn't? How would the argument here not be just as reasonably made against HR3962 sans Stupak?

Daniel's second paragraph is truly bizarre, and I don't know exactly what to do with it. As I understand it, there are such restrictions. The Hyde Amendment restricts HHS money from going to abortions except in situations of rape, incest, and endangerment to the mother, and there are restrictions on plans for government employees as well. So there does seem to be precedent for this. I'd agree that ESI subsidies need reform and are problematic, but that's an issue even apart from the question of subsidizing abortion, so I don't see what the problem is. Low-income families were screwed by these arrangements long before any federal subsidies for abortion were made unavailable. And in any case, the question presents itself again: who says that not providing people with abortions is "coming down hard" on them? This assumes a good deal about abortion, and a good deal that those in favor of restrictions would not grant. In the same way that pro-choice advocates have argued that these sort of restrictions disproportionately hurt low-income people, pro-life advocates have consistently argued that abortion disproportionately hurts low-income people rather than those with more resources at their disposal. Simply pointing out that our country has a problem with providing adequate health or other care to low-income groups isn't an argument against abortion restrictions- it's an argument against failing to provide proper care. But working towards a situation where abortions are no longer performed goes hand in hand with true care for people's health, and don't work against it. The restriction on funding for abortion saves lives, or at least works towards preventing federal provisions from ending them.

I might be willing to agree that the Stupak amendment is more symbolic than substantive, but I'd say that it's symbolic in a rather substantive sense of the term. It is not a compromise of real healthcare reform, but rather a good (though rather small) start to reforming our system of medical care in response to various barbaric practices that are currently in place. Substantive progressive reforms would involve making these restrictions on government funding into outright restrictions of abortive procedures. But for now, given the importance of symbolic progress for the state of the conversation on abortion, I'd be willing to say that the Stupak amendment's most important contribution is symbolic.

In the end, many advances in progressive politics come through fits and starts. Various contradictions of legislative decision making (we pay for it there, why not here?) thus seem perfectly explainable by the fact that our system is imperfect, and that not all legislative assemblies will gather up similar voting blocs given different occasions. But presumably a lack of precedent for certain reforms isn't an argument against reform itself, is it? I mean, I agree that people shouldn't think of the amendment as some wonderful pro-life work of art. It is what it is. It's small reform, but it's something.