Abortion Fight Seems Certain In Debate On Health-care Plan The Clintons Want It Included In The Basic Benefits. And That Means Taxpayers' Money Would Be Involved.

Posted: October 03, 1993

WASHINGTON — Despite President Clinton's hopes, another titanic battle over abortion seems inevitable as his health-care reform plan moves through Congress.

Although a draft copy of the health plan refers only to coverage of ''pregnancy-related services," in recent days, both the President and Hillary Rodham Clinton have made clear that they are determined to make abortion part of the basic package of benefits.

"It will include pregnancy-related services, and that will include abortion as insurance policies currently do," Hillary Clinton firmly told the Senate Finance Committee on Thursday.

At the same time, however, the House and the Senate have vigorously reaffirmed their long-standing refusal to use taxpayers' funds to pay for abortions.

That prohibition - known as the Hyde Amendment - applies to poor women who cannot afford private health insurance and are covered by the federal Medicaid program.

But if Congress holds to its position when Clinton's health plan comes up for a vote, middle-class women whose insurance now covers the cost of abortion would lose that benefit.

"They would be taking away a benefit that millions of women with private health-care plans now enjoy," said Bill Hamilton, vice president of the Planned Parenthood Federation of America, a leading abortion-rights organization.

That is because the Clinton plan would fold Medicaid into the new "health alliance" system, which means federal funds would be mingled with premiums paid by employers and employees.

"If our plan goes through, it will be impossible to separate out the public and the private funds," the President said on ABC's Nightline.

Asked by ABC's Ted Koppel if tax money would be used to support abortions, Clinton acknowledged: "Indirectly they will. . . . The public and the private

funds would all be mixed together."

The White House had hoped it could avoid an abortion battle, which could cost it scores of votes it needs to pass the plan. But it now appears impossible to bypass what the President acknowledged would be "a big political minefield."

"We can't avoid it," Sen. Bob Packwood (R., Ore.), an abortion-rights supporter, told Hillary Clinton on Thursday. "If the President wants funding for abortions, he will have to fight for funding for abortions."

"The issue is going to come up for a vote," said Rep. Lee H. Hamilton (D., Ind.), a Hyde Amendment supporter whom Clinton briefly considered last year as his vice presidential nominee. "Congress is not going to provide federal funds for abortion. . . . That would be a radical change."

Not surprisingly, administration officials predict they can beat back an effort to attach the Hyde Amendment to the health plan.

"The politics of health care is different from the politics of Medicaid," said Bill Galston, deputy assistant to the president for domestic affairs. ''This is not a 'poor people's issue.' This affects the entire middle class. That's why it (the ban) will not pass - we hope."

Nevertheless, anti-abortion forces vowed to do everything they could to write an explicit ban on abortion funding into the health-reform bill.

"We will fight as never before," said Rep. Christopher H. Smith (R., N.J.), a leading congressional foe of abortion. "We will exclude it from the basic package."

Smith and his allies object to paying for abortion with money collected either from taxes or from the mandatory "premiums" to be collected from private employers and employees under the Clinton plan.

"If I ran a business and I was a strong pro-lifer and I didn't want my money to be used for abortion, I would be forced to pay for abortion," Smith said. "That's outrageous."

For now, the opponents appear to have majority opinion on their side.

A New York Times/CBS News poll in July 1992, for example, found that 80 percent of Americans thought abortion should be available, but only 42 percent wanted tax dollars to pay for it. A majority of 52 percent opposed public funding. Other surveys show as many as 70 percent against the use of tax money for abortion.

Recent congressional action on the Hyde Amendment reflected this sentiment. The House voted 255-178 to keep the ban June 30; the Senate agreed 59-40 on Tuesday.

For the first time, however, the ban was relaxed to permit federal funding for abortions in cases of rape or incest. Previously, payment was given only when the mother's life was in danger.

It is not known how many insurance plans cover abortion and how many of the estimated 1.6 million abortions performed each year are paid for by insurance, Planned Parenthood's Hamilton said.

HEALTH-CARE QUESTIONS?

* If you have a question about President Clinton's health-care reform plan that you would like to see answered in future Inquirer articles, call 854-5515.

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