Ishinoy’s Stuff

There is no question that reproductive health care has become a hot button issue in health care reform. This is very unfortunate. But despite the emotions and sensitivity surrounding the topic of abortion, lawmakers must not lose sight of the facts. Here are a few:

The Stupak-Pitts amendment goes well beyond the status quo and is in no way the simple extension of the Hyde amendment its proponents claim. It will result in a major step backwards for women's access to abortion, a legal medical procedure.

Proponents of Stupak-Pitts say that individuals purchasing health insurance plans in the Exchange without affordability credits can buy plans with abortion coverage. In reality, no insurance plan is going to go through the painstaking process of setting up two separate plans--one with abortion services offered and one without--to cater to less than 20% of the Exchange participants who are allowed to buy plans that include abortion services. As noted by Robert Laszewski, consultant to the insurance industry, in a recent interview with NPR, it wouldn't make any business sense to offer a plan that would only be available to such a small number of potential customers. The argument that this amendment won't restrict access for women who are paying for insurance entirely out of their own pockets is false.

The Hyde amendment prohibits federal funding for abortion in Medicaid programs except in cases of rape, incest and to protect the life of the women, but it allows states to use their own funds to pay for abortions in other cases. Applying this same principle, the Capps Amendment, would have prohibited federal funding to pay directly for abortions in insurance plans in the Exchange, but would allow plans to pay for these services using private funding from patient premiums. Just as churches and military contractors are able to segregate federal funds from other sources of funding, insurance companies can do the same.

My amendment is also consistent with federal tax policy which provides subsidies in the form of tax breaks to businesses to provide health insurance for their employees. It should be noted most Americans receive their health insurance from the traditional employer based system and most of those health insurance plans include coverage for abortions. It is my amendment, not the Stupak-Pitts amendment, which preserves the status quo of preventing federal funds from directly paying for abortion services without restricting access to this legal medical procedure.

There were Members of Congress and representatives of organizations opposed to abortion who were given a chance to review my amendment and offer their input before it was introduced. And because my amendment represented a true compromise on this challenging issue, both pro-choice and pro-life Members of the Energy & Commerce Committee joined me in support, rejecting the more extreme Stupak-Pitts Amendment.

I should also note that most of the Members of Congress and the groups who endorsed the Stupak-Pitts language continue to oppose health care reform. As Mr. Stupak has correctly pointed out, most anti-abortion groups opposed the Capps amendment, but what he left out was the fact that they also opposed passage of our health care reform legislation, even after the Stupak-Pitts amendment was added. In fact, the vast majority of Members who voted for the Stupak amendment opposed passage of H.R. 3962 even after this amendment was added.

At the end of the day, our goal is to pass meaningful health care reform legislation. We must not allow abortion opponents to use our health care reform process to drastically restrict a woman's access to a legal medical procedure and that's exactly what the Stupak-Pitts amendment does.

Congresswoman Lois Capps (CA-23) serves as a Member of the Energy and Commerce Committee. Prior to serving in Congress she worked for 20 years as a public school nurse and health advocate.

All right -- this is my favorite graph in quite some time. Let's show the picture first and ask questions later.

What we have is a comparison of Barack Obama's approval ratings on the economy to his approval ratings overall. It includes all polls in the Pollster.com database that asked about both approval of Obama on the economy and his overall job performance -- a total of 109 polls dating back to the start of his term. I've then drawn in some LOESS curves to illustrate the trend.

The two lines track each other uncannily well. From the very start of Obama's term, there's been about a 5-6 point gap between approval of his performance on the economy and his performance overall, with the latter figure consistently being somewhat higher. Although Obama's approval has declined in both departments (particularly during period between about April 1 and August 1; it may not be declining any further now), the magnitude of the gap has been exceptionally steady over time.

The economy, I suppose, is sort of boring to talk about: it's a slow-moving sort of thing, and one over which the President has only a certain modicum of control. And so you'll have pundits attributing Obama's slide to all various and sundry sorts of things --

Health Care! Henry Louis Gates! Torture Trials!

-- when really it's just been very much about the number of people who have come to blame Obama about the economy has tended to accelerate faster than perceptions of the economy itself.

Let's now add a third variable, which is Obama's approval on health care. We'll look only at those polls that asked about health care in addition to the economy and job performance, in order to create a truly apples-to-apples comparison:

For the most part, the health care numbers are following the same trend, although you can perceive a bit of a secular drop during August, the Month of a Million Town Halls (followed by partial recovery in September, after Obama's address to a joint session of Congress). Although this is not easily provable -- and certainly not proven by this data -- I suspect that much of the anxiety over health care reform also stems from anxiety about the economy, in ways that are both general and specific.

Indeed, the most troubling problem for the Democrats may be that government interventions into the economy -- meaning the bailout and the stimulus -- are increasingly perceived as having failed, which in turn increases skepticism about government intervention overall, in health care and other areas. I'm just not sure where this is headed: perhaps when the jobs picture recovers, so too will perception of these other programs, which will rob Republicans of much of their ammunition (although since employment is unlikely to recover significantly before 2010, they'll have plenty of fun in the shooting gallery in the meantime). But perhaps instead, the damage will be medium or even long-term: if the economy takes too long to recover, it may be perceived as being in spite of, not because of, programs like the stimulus. If that's the case, the 2010s could be a lost decade for liberalism.

To channel my Inner Krugman: it's a political imperative for the Democrats of the highest order to get some sort of jobs bill to Obama's desk -- the sooner and the bigger the better. Suppose you could create jobs at a price of about $40,000 per, which is higher than the figure suggested by empirical research on highly targeted jobs programs. A $200 billion bill would then create 5 million new jobs, which would reduce unemployment by about 3.3 percent (e.g. from 10.2 percent to 6.9 percent).

It's not that easy, I'm sure. But the Republicans -- who have been clamoring for such a bill for months -- are liable to find themselves on the wrong side of the politics of the issue. And even if the jobs bill isn't especially efficient at reducing unemployment on its own, it would have a bit of a wind at its back between the existing stimulus efforts and the organic recovery in the economy.

Might it even be worth tabling health care to get the jobs bill passed? Probably not when health care is so close to the finish line, and when the House can start working on a jobs program while the Senate deliberates health care. But if it looks like health care doesn't have the votes, this would be the exit strategy for the Dems -- for Obama to intervene and say: "we need a jobs bill first." Either way, a couple million more jobs would make everything

much smoother for the Democrats; the economy remains the primary way that the public evaluates their success.