Abortion heats health debate Churches could opt out of coverage


WASHINGTON -- Barely two days after unveiling his health care reform program, President Clinton appeared to be losing ground yesterday in his bid to avoid a divisive battle over the issue of abortion.

Mr. Clinton, in an effort to appease anti-abortion forces, is proposing that some health plans not be required to pay for abortions, a new wrinkle that was not included in the draft of his reform proposal given to Congress earlier this month.

But opponents of abortion rights said yesterday that doesn't satisfy their objections to the Clinton plan, which they depict as a back-door vehicle for mandating easy access to abortions. The anti-abortion forces are already threatening to hold up passage of any health reform plan that includes abortion coverage.

Meantime, abortion rights supporters say they'd be disturbed if the president's reform program exempts some health plans. "It is a violation of the basic principle of the [president's] plan," said a consultant to the National Abortion Rights Action League, referring to the promise that everyone would receive the same basic package of benefits.

On several occasions this week, the president and Hillary Rodham Clinton -- his chief health policy adviser -- have been saying that not all health plans offered to consumers would have to cover abortions.

In an interview Tuesday on MTV, Mr. Clinton said that "most plans will cover abortions." He said that "there will be religious exemptions" and specified that "Catholic churches or other religious groups that have health plans don't have to cover it."

That remark goes beyond previous presidential statements that the reform program wouldn't require individual doctors and hospitals to perform abortions if they have religious objections -- what is termed a "conscience" exemption.

What Mr. Clinton says now is that a health plan composed of many doctors and hospitals, serving thousands of consumers, could be exempt.

"Most people will get this [abortion] service covered because most private [insurance] plans do it" currently, Mr. Clinton said in nTC a nationally televised "town hall" meeting Thursday night. He added that "some" people won't be covered for abortions "if they choose to join plans that don't cover them."

The president didn't clarify his statements about how a health plan could receive an exemption from the requirement to provide abortion services.

A 239-page draft of the Clinton proposal doesn't specifically mention abortion. But it states that "each health plan must provide coverage" for several categories of services, including "pregnancy-related services," which Mr. Clinton says includes abortion. Proposed legislation spelling out final details isn't expected for a few weeks.

A top official of the Department of Health and Human Services who helped draft Mr. Clinton's reform proposal, Judith Feder, said yesterday that health plans could be exempted under a conscience clause if all their providers and hospitals are opposed to abortion.

"Unless a plan were made up solely of providers who invoked a conscience clause, which would be the exception rather than the rule, plans would cover abortion," she said.

That doesn't mollify abortion foes, who are fighting the Clinton plan partly because they believe it evades the current congressional ban on federal funding of abortions under the Medicaid program.

Mr. Clinton's health proposal would, in effect, mix private and federal funds to pay for abortions for poor women who can't currently get them from Medicaid.

Mr. Clinton, acknowledging that tax funds would be used "indirectly" to support abortions, said, "It would be a terrible price to pay, just over this issue, to keep segregating all the Medicaid patients and deny them the opportunity -- and us the opportunity -- to have the benefits of everybody being in large-group health care."

Republican Rep. Henry J. Hyde of Illinois, the author of the legislation banning federal funding of abortions, says it's "great" that Mr. Clinton would permit some health plans not to cover abortion. But he objects to having federal funds mingled with other plans that perform abortions, "thereby dragooning or coercing tax dollars to pay for abortions contrary to the conscience and moral scruples of millions of people."

Bishop John Ricard, auxiliary bishop of the Baltimore archdiocese and chairman of the National Conference of Catholic Bishops' domestic policy committee, warned Thursday that it would be a "moral tragedy, major policy misjudgment and serious political mistake to burden" health reform legislation "with abortion coverage."

Abortion opponents, including the National Right to Life Committee, say Mr. Clinton can resolve this issue by establishing abortion as an insurance option, or policy "rider," which people could buy if they want coverage for abortions.

But abortion rights supporters say this would be a financial burden on the poor and a denigration of a woman's constitutional right to abortion.

In an interview, Kate Michelman, president of the National Abortion Rights Action League, said she believed Mr. Clinton's proposal makes abortion "part of the basic services." One "can't have one [health] plan deciding it is an option and another not."

That seemed to put her at odds with Mr. Clinton's proposal to permit health plans to be exempted for reasons of conscience. But a consultant to the group said yesterday that it believes the president remains committed to abortion coverage.

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