There’s a famous saying warning that those who do not study history are doomed to repeat it. As the Trump administration and Republicans in Congress begin the process of fulfilling their campaign promise to “repeal and replace” Obamacare, it makes sense to review the legislative history of a key component of that law to ensure that the errors of the past are not repeated.
In 2010, as President Obama’s signature health care program was making its way through Congress, a group of pro-life Democrats led by Congressman Bart Stupak of Michigan joined Republicans in offering an amendment to ensure that long-standing prohibitions against federal funding for abortion applied to the new law. A provision known as the Hyde Amendment bars federal taxpayer funds from being used either to pay directly for elective abortions or to finance insurance programs that allow federal dollars to be used to purchase elective abortion coverage. The Hyde Amendment first passed Congress in 1976 with a majority of votes from Democrats, and it has been substantially applied to federal health care programs ever since.
President Obama, the Democrat-controlled Congress led by Nancy Pelosi, and their allies in the abortion industry strenuously objected to any effort to extend the Hyde Amendment to their new health care scheme. Nevertheless, the pro-life forces in the House, Democrats and Republicans alike, held the balance of power. Without the votes of Congressman Stupak and his coalition of pro-life Democrats in the House, President Obama’s health care plan likely would not have prevailed.
What happened next is a travesty and a cautionary tale. Under intense pressure from the president and party leadership, all but one of the pro-life Democrats in the House abandoned their principles and voted for the Affordable Care Act, even though it authorized taxpayer funding for abortion. In exchange for their crucial votes in favor of the president’s top legislative priority, they accepted a promise from President Obama to issue an executive order that would prevent tax dollars from flowing to such things as risk pools and community health centers — an ephemeral document that could be changed with the stroke of a president’s pen — and accepted that federal tax credits could be used to subsidize insurance plans that finance elective abortion. In response to this stunning betrayal, the pro-life movement responded politically, driving from Congress 15 of the 20 Democrats who chose political expediency over the lives of the unborn. Congressman Stupak, seeing the writing on the wall, ultimately chose not to seek re-election.
Why rehash this ancient history? Because unlikely as it seems, Republicans in Washington seem to be considering making the same mistake. With each passing day and fresh media report, momentum seems to be building for an approach to replacing Obamacare that creates new funding streams that may not be covered by the Hyde Amendment’s limit on using federal tax dollars to subsidize abortion.
One can sympathize with the difficulties involved in repealing and replacing a law as complex and far-reaching as Obamacare. Senate filibuster rules, the byzantine annual process of budget reconciliation, and the conviction that Republicans must simultaneously repeal and replace Obamacare with no expectation of help from Democrats to fix that decaying program are significant hurdles to overcome.
But, in fact, the issue isn’t complicated at all. The votes of pro-life Americans across the country delivered a pro-life GOP majority to the House and the Senate. They elected a pro-life President, who promised in writing during the 2016 campaign that he would support four major initiatives, including the defunding of Planned Parenthood and a measure to make the Hyde Amendment permanent law, government-wide.
That promise is incompatible with the maneuvering and the trial balloons ascending from some policymakers in the Congress right now. To use a reconciliation mechanism, with its 51-vote threshold, to pass a new funding stream, including a general tax credit to purchase health insurance, without explicitly including the Hyde Amendment protections against taxpayer funding of abortion, is a repudiation of the most fundamental plank of the pro-life platform which the GOP majorities were elected to uphold. Unlike the pro-life Democrats who traded their votes to Barack Obama in exchange for a toothless executive order, the pro-life movement will not be bought off by promises of administrative interpretations or future actions. These so-called “protections” could be swept away in a moment by a new administration, gutted by an activist Judiciary, or blocked by a future Congress hostile to pro-life principles.
Despite all the parliamentary and legislative obstacles ahead, the path forward for Republicans is very clear: integrate the Hyde Amendment into any and all health care spending or tax subsidy laws from the beginning. Obamacare was the largest expansion of abortion since Roe v. Wade; it passed without a single Republican vote. What a tragedy it would be if, in trying to “fix” Obamacare, a Republican House, Senate and White House approved a law that could in fact expand Obamacare’s most heinous provision. Pro-lifers drove from office 15 Democrats who put political self-interest ahead of protections for the unborn in 2010, thereby switching control of the House to the GOP. They will feel an even greater sense of betrayal if the allies they have sacrificed so much to elect make the same mistake.
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