As Democrats in the House of Representatives exchanged high-fives and flicked each others' butts with metaphorical wet towels after passing the health insurance reform bill this weekend on a narrow 220-215 vote, millions of pro-choice women learned that this "victory" came at the cost of their rights.

Rep. Nancy Pelosi and the Democratic leadership caved to a coalition of pro-life Democrats led by Rep. Bart Stupak (D-MI), who threatened to torpedo the passage of HR 3962 unless the House agreed that would bar insurance companies participating in the health insurance "exchange" and any insurance company receiving Federal funds of any kind from covering abortions, except in the most extreme cases.

Under an earlier compromise at least one insurance plan in the exchange would have to provide abortion as part of its service, but at the last moment the pro-life coalition reneged and refused to throw their support behind the bill unless the Rep. Stupak's amendment was brought to the floor for a vote. It sailed through with a vote of 240-194.

To be clear, the Stupek Amendment does not outlaw abortion. It just adds yet another barrier, yet another hurtle, that women have to jump in order to obtain a perfectly legal, Constitutionally-protected medical procedure. Like may bills and amendments and rules passed by the Federal and state governments since 1973, it seeks to impose public morality on what the Supreme Court has definitively and consistently ruled a private matter.

Practically, one could argue that the amendment makes little difference. According to the Guttmacher Institute, a 2001 survey found that about 75% of women pay out-of-pocket for abortion services, with only 13% submitting to insurance. Not all insurance policies cover abortions now, and of course, Federal funds cannot be used to pay for abortions.

Philosophically, it's a kick to the head.

Democracy is an ongoing debate over the relation of the individual to the State. The Stupak Amendment reinforces the idea that it's entirely OK for the Federal government to insert itself in between an individual and her medical care (inasmuch as medical care has become tied to health insurance) on moral grounds, Constitutional right to privacy be damned.

And, by singling abortion out from thousands upon thousands of other medical procedures, it follows the pattern set by similar laws of trying to slap that big old scarlet "A" on the uteri all women who might need to seek the procedure.      

If an insurance plan covers other gynecological and obstetric services, why not abortion? There's no medical reason to exclude it. Not only is it one of the most common surgeries performed today, it's one of the safest, with only 0.3% of surgical abortions resulting in hospitalization due to complications. First-trimester abortions pose no significant risk of problems in future pregnancies, and exhaustive studies in the U.S. and Europe have shown no link between abortion and breast or other cancers later in life.
   
There are plenty of people who will say: "I don't want my tax dollars to fund someone else's abortion."

To which I reply: "Fine. Don't pay your taxes."

We don't get to pick and choose. Taxes go to pay for all sorts of things one group or another finds morally repugnant. Taxes fund wars. Taxes fund medical research. Taxes fund "faith-based initiatives." Taxes fund "abstinence-only" education and traditional contraception. Taxes fund provocative art.

But war and science and faith and stupidity and contraception and art are all legal. So is abortion.

If you feel that strongly about the issue, refuse to pay into that system, and face the consequences.

But do not support laws that fly in the face of something we all should cherish: the right to make difficult and personal medical decisions without the interference of outsiders.

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1. 100 Days In Tehran 
2. The Obamas, the Date Night & the Public Purse