Howard Dean's Democracy for America is SO Wrong

I've been a member of the Howard Dean founded group Democracy for America for several years, and I've been consistently impressed with the force, vision and vigour that they add to the political discussion in America. I like their approach of prominently backing strong progressives around the country with a chance to take the fight to Republicans in tough districts, and I'm glad they sometimes challenge the Party establishment to stay honest by raising strategic primary challenges against Democrats who disappoint them. (See Specter, Arlen for an example of how a primary challenge can sometimes go to far - Pat Toomey - but on other occassions just bring the person more comfortably in line with the party mainstream - Joe Sestak.) This is, after all, more or less how Democracy is supposed to work.

But they are spectactularly wrong about health care reform.

I've supported DFA for years - and I've met Governor Dean several times and I think he's an outstanding leader and was exactly the right DNC Chair for the moment. No one is more fervently pro-healthcare reform than I am.


As background, DFA has been lobbying extremely hard for the public option to be included in Health Insurance reform. And well done, too.

But their fundamental position seems to me more based on macho posturing of the "we've given up enough, we want candy now" thinking rather than an honest assessment of what's good and bad in the current bill,. They are currently urging their supporters to call their Senators and demand that they not compromise any further on the public option.

This is a TERRIBLE, TERRIBLE idea.

Firstly, they seem to take for granted that the bill will pass one way or another. That's just flat out not true. We're still several votes away from the majority we need to get past the filibuster.

Furthermore, an apparently pretty constructive conversation is currently happening in the Senate that isn't just focussing on "Public Option, in or out" but is actually looking at what the public option was designed to achieve and asking whether there are any other approches that could do the same thing. Some of the ideas that are being batted around strike me as not just pointless compromises, but actually substantive policy approaches in their own right. Dare I say, some of them could even be BETTER than the public option.

Consider, for example, the idea of not-for profit insurance plans administered under tight controls from the Office of Personnel and Management. This is one idea that has been floated, and it would closely replicate the way that health care is currently delivered for Federal Government employees. Although not strictly "public" in that it would not be run by the government directly, it would have all the same cost controlling power of the government run public option. Plus, and this is the bit that interests me, it's lower risk in many ways because it replicates an existing program that we know already works.

Or, what about allowing people to buy in to Medicare? What about imposing much tighter cost controls on the private sector? What about expanding the amount of subsidies available to poorer patients? All of these things are being considered - each of them might be at least as effective as the public option. 

Or, they may not. To be sure, the public option - even in its current weakened form - may be the best option we currently have for controlling costs. But the one thing that we know for certain would NOT work is the status quo. And senators who reject a compromise out of some misguided notion of "Public Option or Else" will most likely condemn Americans to decades more of a flat out failed health system, and the Democratic Party to years in the wilderness. Deservedly so, by the way. If we screw this up we don't deserve to lead.

So I'm extremely unimpressed with DFA's current strategy.

They've e-mailed me today to ask me to call my Senator, with the following call to action:

Call your Senators today and tell them where you stand:

America stands with Healthcare Heroes who fight for a public option, not Insurance Industry Senators who care more about the insurance interests who fund their campaigns than providing every American real healthcare reform.

We're done negotiating. Enough is enough. The public option in the current Senate bill is our final compromise.

I sent them this note in their contact form.

You are wrong about this. The public option, while a good idea, is not even close to the most important part of this bill. In fact, in its weakened form, it may actually be a less powerful force for health cover expansion and cost controls than many other options that are now being talked about as "alternatives" to the public option - notably Medicare Expansion, increased subsidies and stronger market regulation. You are doing our joint cause great harm here, and a "victory" for your approach could actually make life worse for many Americans, while failure that results in non-passage of the bill could literally lead to the death of thousands and set our cause and our Party back for a generation.

Please reconsider. I'm begging you.

Weekend wrap up

Just a quick post to point to the stuff I wrote about over the weekend. My stats suggst that you guys don't do a lot of reading over the weekends, but this is often when I have most time to blog. (Translation: My readers have real lives, whereas I...) So I thought I'd experiment with pointing out some of my Saturday and Sunday efforts.

• Here's an encouraging press report on Stimulus jobs.
• Here's a report on Obama's decision to attend the final day of the Copenhagen conference, after all.
• Here's a reminder why health care reform would be a massive achievement for our party.
• And finally, here's my report on the moment Barack Obama seemed ready to quit the campaign.

Happy reading!

No One is Better than Ezra

The achievement of this bill is $900 billion to help people purchase health-care coverage, a new market that begins to equalize the conditions of the unemployed and the employed, and a regulatory structure in which this country can build, for the first time, a universal health-care system. Thousands and thousands of lives will be saved by this bill. Bankruptcies will be averted. Rescission letters won't be sent. Parents won't have to fret because they can't take their child, or themselves, to the emergency room. This bill will, without doubt, do more good than any single piece of legislation passed during my (admittedly brief) lifetime. If it passes, the party that fought for it for decades deserves to feel a sense of accomplishment.

Sorry for turning this blog into an Ezra Klein appreciation society, but when someone is that good they should get their props.

I entirely share Ezra's concern that this bill, potentially the greatest victory for Progressive Americans since Roosevelt passed Social Security (and in one stroke solved the problem of drastic poverty amongst seniors), may wind up with liberals achieving a victory and declaring defeat.

And in any case, although I want a public option, but I'm just not convinced it's anywhere NEAR as important as other features of the bill that seem to get much less attention.

Consider, for example, the case of the Medicare Commission - which was quietly killed in the House and is threatened in the Senate. By taking control over Medicare costs away from the politicised congressional process and putting it in the hands of actual, ya know, health care types this feature could do more to cut the cost of health care in a stroke than the fairly weak-tea public option currently proposed ever could.

But I bet you'd never heard of the Medicare Commission proposals until now, right?

My point, exactly.

Copenhagen Summit - Promising Signs!

I have to admit to being a Copenhagen Summit pessimist. Although I've always thought that it was vitally important to achieve international agreement on some agressive target to curb global warming soonest, it has seemed increasingly likely lately that no such bold agreeement is on the cards. I thought Obama had a moral obligation to attend the summit, and for his administration to commit to the strongest deal they could get, but I was fairly unsurprised when I head that Obama would make a fairly low-key stop in Copenhagen in the first week of the Conference.

So imagine my pleasant surprise to learn that Obama has now rescheduled his Copenhagen trip to attend the end of the Summit, when 80 other world leaders will be present. Rumours are that this change of plans is a reaction to the better-than expected deals being struck with critical but hard to persuade big polluters such as China and India.

If he’s willing to stick his neck out like this, Obama must be pretty confident that he can get a deal. There have been signs of momentum for weeks now. The much-discussed deal with China was just one in a raft of commitments from the developing countries, including India and Brazil. Movement from the developing world has undercut one of U.S. conservatives’ principal arguments for inaction. Over 65 world leaders have pledged to attend.

Do we have a global consensus after all? Now THAT'S change I could believe in...

Jobs Jobs Jobs Jobs Jobs Jobs Jobs

And did I mention jobs?

Do make sure to watch this video - trust me, two minutes nineteen seconds well spent.



This is good stuff. As I reported before, it's not quite enough or as much as we'd like. But it's a damn sight better than nothing, or the less than nothing that the Republicans' "let's freeze federal spending" economic plan would have led to.

"The Audacity to Win": When Obama Almost Dropped Out

After what felt like a ver frustrating delay (why could Amazon get the last Harry Potter to me by 8AM on release day, but I had to wait two days for this? Isn't David Plouffe at least as culturally significant as the Boy Wizard?) I finally received the book and have been combing through it with great interest.

I'm not going to do a formal book review or anything - but in general The Audacity to Win is clearly written and inciteful. There are some surprises and a lot more detail about campaign moments that many of us followed obsessively but never knew the whole story. But then, I'm a bona fide Plouffe groupie, so perhaps my review is about as unbiased as a 14 year old girls thoughts on Twilight.

To the extent that the book has a weakness so far, I have to say I'm slightly irritated by the extremely long perfectly constructed paragraphs of clean text that are quotes verbatim - surely no one really sounds like this in actual conversations, and even if they did I doubt that Plouffe would have been recording or note-taking in enough detail to capture the wording years later.

But still, I'm sure what he's reporting is a fairly accurate rendering of the content of conversations even where I have doubts about the word choice.

And there is an especially striking conversation that Plouffe reports between himself and Barack in Spring of 2007.

At this point, Barack has launched his campaign successfully and has made a very strong showing in the early fundraising. But the pressures of a national campaign are wearing on him, and he is, frankly, not campaigning well. He's bored, tired and grouchy. In April, Spokesman Robert Gibbs decides to have a heart to heart with Obama on the campaign plane.

"Are you having any fun at all?" he asked him.
"None," Obama flatly replied.
"Do you see any way we can make it more fun?" Gibbs replied.
"No."
Reggie Love, who was listening in on the conversation piped up, "Well if it's any consolation, I'm having the time of my life."

Realising that they had a seriously grouchy candidate on their hands, and one who was underperforming on the stump, Plouffe and David Axelrod decided to sit him down for a serious talk. Plouffe tells him,

"Maybe you shouldn't have run... But you did, and the one thing that won't happen is that you'll quit. So let's at least give it a go, try to enjoy ourselves. Worse case, in eight or nine months we'll be out and have nothing but time on our hands. This is hard enough firing on all cylinders -- it's unbearable if your heart is not one hundred percent in it."

He thought about it for a moment. "I guess it's like being in the middle of the ocean. It's the same distance to swim back as to keep heading across. Just tell me this is going to get more fun."

Well, I think it did get more fun. But it's chilling to hear him talk about things in those terms - what if he'd been a few yards closer to the near shore?

If in Doubt Assume I'm Wrong & Ezra Klein is Right

Ezra says (and thanks to KathyF for pointing it out to me) that the article I quoted in my last post was not an accurate reflection of the CBO report. In truth, says the Prophet Ezra, the 10-15% increase in the predicted average premium is based entirely on an assumption that people will chose to buy more expensive plans. The idea is, as I understand it, that because many people will be able to offset their health insurance with government subsidies, some people will chose to purchase better coverage than they could otherwise afford.

First, the bottom line of the report is simple: The CBO says premiums will go down for the vast majority of Americans, and that the same insurance policy will cost less under reform.

The confusion comes in the CBO's analysis of the individual market, which serves about a tenth of the population. CBO expects prices in the individual market to rise by 10 or 12 percent, an expectation driven entirely by predictions that individuals will purchase policies that are much more comprehensive, and thus somewhat more expensive, then the insurance they can afford now. Then the CBO turns to look at the impact of the subsidies, which will cut premium costs by a bit over 50 percent for a bit over 50 percent of the market.

But as the CBO explains on page five, part of the increase in the type of insurance being purchased is the result of "people’s decisions to purchase more extensive coverage in response to the structure of subsidies." In other words, the change is driven by the subsidies, not offset by them.

Meanwhile, as I understand it, the tax on "Cadillac" plans - health insurance that offers little to no additional health outcomes, but a more lusurious service will tend to discourage people from buying these plans (though of course anyone is still free to do so if they wish). On average, then, under the new legislation most people will wind up with a plan somewhere in the middle of the cost charts - robust enough to cover all chronic conditions and to prevent health bankrupcy, but using the power of the market to discourage people from wasting medical resources where they could be better used.

This stuff is complicated, and I'm no expert. But I trust Ezra on this issue more than me, so go read him.

Premiums Will Go Up. But You'll Probably Pay Less

As we edge (creep, crawl, inch, take baby steps - insert your own word for mollases like progress) closer and closer to passing comprehensive health insurance reform, those of us who support the bills have been hoping that one effect they would have would be to lower the out of pocket costs of buying healthcare.

Well it turns out that most people's day to day costs WILL in fact be lower (phew), but that premiums themselves are likely to go up slightly. How can this be so?

According to CBO, average premiums in the individual market would increase 10 to 13 percent because of provisions in the Senate health care bill, but, crucially, most people (about 57 percent) would actually find themselves paying significantly less money for insurance, thanks to federal subsidies for low- and middle-class consumers, than they would under current law.

Furthermore:

Separately, for those who have high-end employer-provided insurance, CBO finds that a new excise tax on high-end policies will have disparate effects on premiums. Those who keep their "cadillac" insurance would end up paying higher premiums than they do today, and those who choose instead to choose less luxurious policies would pay lower premiums.

"[P]eople who remained in high-premium plans would pay higher premiums under the excise tax than under current law, and people who shifted to lower-premium plans would pay lower premiums under the excise tax than under current law," the report reads.

But CBO also finds that on average, people who have plans susceptible to the 40-percent tax will ultimately be paying less in premiums than they would without health care reform: "On net, CBO and JCT estimate that the excise tax and the resulting behavioral changes...would reduce average premiums among the 19 percent of policies affected by the tax by about 9 percent to 12 percent in 2016."

Senator Evan Bayh, who had requested the CBO report in the first place out of concern that healthcare costs might go up under the proposed Senate legislation, was encouraged by the findings:

This report alleviates a major concern that has been raised--that insurance costs will go up across the board as a result of this legislation.

"This study indicates that for most Americans, the bill will have a modestly positive impact on their premium costs. For the remainder, more will see their costs go down than up. Hopefully, we can continue to focus the Senate debate on additional ways to make health insurance even more affordable for all Americans."

Yet another non-failure... Asia trip success

While we're on the subject of things that are working better than people say, it's worth pointing out that apparently Barack Obama's trip to Asia- though a miserable failure in the "not generating stories critical of Presidential bowing" competition - seems to have been rather successful in the lesser known "winning important concessions and agreement with major world powers" stakes.

James Fallows points out that following Obama's trip, China has now agreed to:

• Reduce greenhouse gases
• Criticising the Iranian weapons program
• Considering removal of weapons that threaten Taiwan
• Preparing to end the rigid currency control that has been harmful to the US

Fallows has lots more fascinating details of the trip on his blog. He concludes:

To sum it up: the Administration may or may not end up getting what it hoped for from this trip to Asia, especially China. But its members had a clearer idea of what they were after, how they could get it, and how to represent American interests and values than most coverage gave them credit for. The words that stick with me through this whole episode are those in the subtitle of Tish Durkin's piece last week: "Even through a veil of censorship and propaganda, the Chinese people managed a clearer view of Obama's visit than the US media did."

Experts Agree: "Without the Stimulus It Would Have Been Worse"

One of the really hard things about governing during a time of economic downturn is that people are understandably uninterested in being told taht things are bad, but they could have been so much worse.

Heck, it's an argument I hate making. People that I love are hurting, badly, in this economy - people that I love are worse off financially than they have ever been in their lives. So it's not very comforting to know that, while bad, things were very nearly much, much worse.

Uncomforting though this truth may be, however... it is true.

Mark Zandi, chief economist of Moody's Economy.com and an occasional adviser to lawmakers from both parties, said, "[T]he stimulus is doing what it was supposed to do -- it is contributing to ending the recession." Zandi added that without the recovery bill, the "G.D.P. would still be negative and unemployment would be firmly over 11 percent. And there are a little over 1.1 million more jobs out there as of October than would have been out there without the stimulus."

For example, remember that a great deal of the stimulus money went directly to states to fund programs that they would have otherwise had to cut because of the downturn in their tax revenues.

"Programs" sound clinical, though - the types of things states were need to cut back on were teachers, firefighters and police. Let's say your small town loses one firefighter, one teacher, and one police officer. OK, now you've got three peopele out of work - that's three people who won't be buying much stuff in your town now. Direct effect = bad.

But the loss of that teacher means slightly larger class sizes for all the other kids. There's a proven correlation between class sizes and student performance - that means an entire school's worth of kids are slightly worse off in ways that will harm their future.

One fewer police officer on the street means the PD needs to reorganise their shifts - slightly more of each officer's time is now focussed on emergency callouts, for instance, and slightly less on patroling. Areas that aren't patrolled can become more welcoming for a small number of criminal elements.

Let's not even talk about what happens if the fire department is down one many (possible consequences = detroyed property and lost lives).

Long term indirect effects = even worse.

A LOT of money was spent by the government trying to forestall the worst effects of the recession. But in the long run, in my view, this was all DEFICIT busting expenditure. It costs a lot more to fix a community once it's broken than it does to keep it from breaking in the first place. The President wasn't free to spend as much money as he would have liked in the stimulus package. But there simply is NOT ARGUMENT whatsoever based on fact that says the stimulus didn't save jobs - it paid salaries of people who would otherwise have been fired.

Unfortunately, an awful lot of people who deserve a hell of a lot better got badly burned anyway. It's heartbreaking.

Things I'm Thankful For...

In no particular order.

1) My health.
2) Speaking of which, the NHS. Not only do they keep me healthy, they have transformed my life.
3) My family. Most of whom are across an ocean. Miss you!
4) Feeling proud to be an American.
5)Pret a Manger lattes. One of life's daily pleasures.
6) My husband. Another of life's daily pleasures
7) You Know Who.
8) You Know Who's sense of humor. On turkey pardoning: "There are days when I remember why I ran for this office. And then there are days like today, when I pardon a turkey and send it to Disneyland."
9) Michelle. Just because. You've gotta love Michelle.
10) Democrats Abroad. Registering overseas voters, lobbying for American's abroad, getting out the vote, allowing us to be politically active though far from home. They are a lifesaver. Speaking of which...
11) Being Vice Chair of Democrats Abroad, UK. Although some folks felt more inclined to offer me sympathy than congratulations when I was elected, I still consider it a great honor to represent the wonderful people in our membership.
12) Matthew Yglesias.
13) Andrew Sullivan.
14) Josh Marshall. Without these three men, my life would be so much duller and less informed!
15) New Media. I blog, I tweet, I Facebook. And I never thought I would love it... but I do. Thanks for reading.
16) Moving Past 9/11. It felt like the world would end that day. It didn't.
17) Discovering New Places. This year, Asturias in Northern Spain was a revelation.
18) Work. Difficult, interesting, challenging, inspiring projects - that they pay me for! My first year of self employment is turning out to be profitable in all sorts of ways. (Knock on wood.)
19) The London 2012 Olympic Games. Providing much of the afformentioned interesting work. And transforming my neighborhood - hurray for East London!
20) The New Yorker. Still the best magazine in the world, and the only one that can make me read about subject I am otherwise not at all interested in.
21) London.
22) Lovefilm. A constant supply of fresh DVDs has saved us from the rubbish TV options.
23) Comprehensive Healthcare Reform being passed out of all 3 House Committees.
24) Comprehensive Healthcare Reform being passed out of both Senate Committees.
25) Comprehensive Healthcare Reform being passed by the full House.
26) Comprehensive Healthcare Reform arriving on the floor of the Senate.
27) The possibility that comprehensive Healthcare Reform might pass the Senate by Christmas.
28) The most progressive Presidential budget in generations.
29) The Stimulus.
30) The stimulus starting to work.
31) Live chat on Facebook. And how it let's me keep in touch with folks.
32) Hope. I've still got it.

Don't Ask Don't Tell to be repealled next year?

Congressman Barney Frank has stated that the repeal (at long last) of the military's Don't Ask Don't Tell policy will be included in next year's Military Authorization Act.

This is excellent news. Frank is not known for beating around the bush, so when he says something he believes it.

But the bit that made me really believe this would happen was these lovely words:

Anecdotally, Frank recalled an incident earlier this year when Defense secretary Robert Gates made a statement to reporters suggesting that repeal was still an open question.

“There was a point where Gates said, ‘If we repeal don’t ask, don’t tell,’ and the next day he said, 'When we repeal don’t ask, don’t tell,’” said Frank. “That’s because Rahm called him up. The White House has been consistently committed.”

Every soldier who serves with honor deserve the right to live his or her life with honor - asking our men and women in uniform to sneak around and hide the most basic facts about themselves is just... tawdry. It's not worthy of the dignity that should come with service.

My First Blog Post EVER! Those were the days...

Wow. On a whim, I thought I would check to see if my short-lived first blog - the one I started way back in 2003 and used for a combination of political and personal perspectives for a very short period of time until... like most blogs... I trailed off.

Well it IS still up there, and reading it again it's funny to see how much my perspective has remained pretty consistent across time.

My very first blog post ever was inspired by W's visit to Britain at the time, when he was give the Royal treatment (literally) but kept far away from the many thousands of protestors.

So here's how I got started, on day one of My Life as Blogger:

So I live here in London, and I have a lot of friends back home in Washington who have been asking me whether I was at the demonstrations against Bush's state visit. I wasn't. But here's what I think of the visit itself and the protest.

The visit was a stupid idea - no American President has ever before been honoured with a state visit, hosted by the queen, and the time to do this would be when there was a genuine spirit of togetherness and pride in the "special relationship" that these two countries have. From what I have seen back home, Americans are feeling especially warm towards Britain at the moment and Tony Blair is becoming a sort of national hero. That's great - I'm glad that Americans are warming up to a leader who is anti-death penalty, staunchly pro-national health care, willing to invest huge amount of money in education (and not just create an unfunded mandate) and public services. I'm a little surprised, but I'm glad...

Deep thought

These guys don't seem real respectful of the members of the Women's Caucus.

Weird.



On a totally unrelated point, they had a lot of fun on the same day denying abortion rigths to an awful lot of women.

Coincidence, I'm sure, and not at all reflective of any innate misogyny. These guys are famous for their sensitivity to women, after all.

The Abortion Compromise

When I was at college in Washington, DC one of the biggest moments there happened in late January each year. That was the annual anniversary of the Supreme Court’s Roe Versus Wade decision, and for a few days my city would be overtaken by tens of thousands of Right to Life protestors.

My friends and I would always avoid the National Mall during these days – the posters of aborted foetuses were annoying, but even more so the confused mobs of Midwesterners in their matching t-shirts who would block the escalators with their out-of-towner refusals to “stand right, walk left.”

But I DID go every year to the local Women’s Health Clinic on the day before the march, to link arms with fellow students from our local Students for Choice chapter and form a human barrier as pro-lifers made a concerted effort to enter and shut down the building.

It was ritualistic rather than violent, and fortunately our organisers were experienced and professional – they knew how to keep temperatures cool even in a pretty heated environment, and they made sure all stayed focussed on our core mission: keep the clinic open.

The Women’s Health Clinic was not an abortion factory – the vast majority of their services were related to birth control, STD testing and prenatal care. In reality, the clinic would routinely encourage patients not to make appointments on the protest days – it was traumatic enough for women who were dealing with a pregnancy (wanted or unwanted) without having to wade past an angry army calling them murderers. So the very few patients who did come in on the day were typically drop-ins – women who had not phoned ahead, but made a spur of the moment decision to get tested or seek family planning. But keeping the clinic open was a point of principle and pride for us.

The pro-life people I faced off with, even when they were doing their best to push through our linked arms, didn’t strike me as bad people. They were Christians mostly, and when not shouting names at me, they seemed pleasant enough to each other. I watched them serving each other coffee from thermoses, sharing a joke. Once an older woman fell ill and her friend politely chastised her for not taking her pills. Then the both lay down on the pavement until the police arrested them and carried them away.

But there were one or two unpleasant incidents. One time, a middle aged woman who had been face to face with me on the line for some time, started shouting, “Are you Jewish? Are you Jewish?” right in my face. We’d been instructed not to engage with the protesters, but in this case I was shocked into a response. “No, actually. I’m Episcopalian.”
“Because the Jewish faith permits the murder of babies!” she shouted, apparently unwilling to let go of her script. Or perhaps she just felt strongly that the situation could be improved with some arbitrary, out of context anti-Semitism.

Whatever.

Why Am I Telling You All of This?

This is all by way of somewhat proving my pro-choice bona fides. Because the pro-choice movement just faced in some its biggest setback for decades. And it’s something I’m going to reluctantly support.

I am referring, of course, to the compromise that was agreed in the House’s Health Insurance Reform bill. Faced with a rebellion from pro-life Democrats in her own caucus, Nancy Pelosi agreed to allow an amendment to the bill that would ban abortion provision under the publicly managed health care plan. So far this was pretty much what I was expecting, and an agreement that for political expediency (the ugliest but most unavoidable of excuses) I was prepared to live with.

What came as a shock to me – and apparently also to a large number people in the pro-choice part of Pelosi’s caucus – was the additional provision that would also forbid those who receive health care subsidies from purchasing any plan that also covers abortion.

This is worse than it sounds. Of course, the intention here is to avoid using government money in any way to directly pay for abortion services. I fundamentally disagree with this judgement (if a woman needs a medical service, she needs it regardless of who pays) but I CAN understand the logic of it, and on a subject where so many people so passionately disagree – where they not only disagree but think those who think otherwise are condoning murder – it’s not insane to say that there’s something inappropriate about asking those folks to spend their tax dollars on a service the consider morally abhorrent.

(As an aside, I can’t help but wish these people had been equally respectful of my pretty similar beliefs about the Iraq war – but... well...)

However, the compromise agreed doesn’t just affect the specific use of federal tax dollars – the ban on use of Abortion-inclusive services for all plans made available to women who receive subsidies is likely to have the obvious consequence that most private sector plans will stop including the service altogether. After all, the insurance companies – for all their kicking and screaming – are perfectly aware that this bill represents a significant new customer base for them. If the government says they need to cut abortion from their plans to get these new customers, I’m sure they’ll be happy to oblige – and it’s easiest just to trim it from all the basic packages.

So why am I still supporting the bill even after choking down this bitter pill?

Simple – women’s health includes more than the rare and declining cases where she might need an abortion.

I am lucky enough never to have had an unwanted pregnancy. But I sure do need a regular cervical exam, I’ll be needing breast cancer screenings pretty soon, I’ve got chronic trouble with my lower back (much better at the moment, thanks for asking) and if I break a leg tomorrow I sure don’t want to worry whether my insurance will cover me. Fortunately, I live in England. But somehow I don’t think that’s going to be a workable solution for the 40 odd million uninsured right now.
Most women will never need an abortion in their lifetimes. With good family planning services we can bring down this number even further – and we should. But every woman needs, and deserves quality, affordable health care.

If necessary I will stand with linked arms one more time to stop the right from shutting us down.