Reply to Ryan Anderson re. SCHIP

Thanks to Ryan Anderson for his thoughtful response on SCHIP and pro-life positions.

Let me reiterate from my previous post that the SCHIP debate involved matters of judgment not litmus tests for Christian faithfulness.  My objections to Ryan were, first, that people should not misstate the facts about what the vetoed bill would have done.  SCHIP would not become (as Ryan claimed in his Weekly Standard article) a "welfare program for the middle class"; it would still largely benefit families with very modest incomes (with 70 percent of the recipients still in families below the line of $41,300 for a family of four, according to the Urban Institute, and a good portion of the others not far above that -- which is not much income given the costs of health care and health-insurance premiums).  The bill would not "do nothing" (as Ryan suggested) to get currently eligible but uninsured children covered; by increasing funding and incentives for states to enroll families, it would (according to Congressional Budget Office estimates) mean that 84 percent of the newly enrolled children would be previously eligible for SCHIP or Medicaid (and about 70 percent of the new SCHIP enrollees would be those already eligible for SCHIP -- about 1.5 million versus 600,000 newly eligible). The bill would not involve "nationalized care" as Ryan (like other opponents) claimed; the large majority of its beneficiaries receive and would continue to receive their health care through private managed-care plans (see, e.g., this Kaiser Foundation report, pp. 2-3).  A helpful post on these and other SCHIP "myths" is at Vox Nova.

Second, I objected to President Bush criticizing the SCHIP proposal for not focusing on covering the poor when the administration's own proposal for increasing coverage, which relies on tax deductions, would unquestionably deliver a much higher proportion of its benefits to those who are better off.  I asked, "Where is the administration proposal that focuses on expanded [insurance] coverage for the modest-income family?," and I still don't see an answer -- from Ryan or others.  (The President's other proposal, for health savings accounts, also plainly would not focus on the poor, for reasons that Susan Stabile, among others, has detailed in her article "Poor Coverage," posted to the right.)  In that context, I asked whether in this debate, the administration can really be said to have focused on helping those in the most need. 

I mean that as a question about what the administration has/hasn't done on this issue, not as a question about people's intentions overall.  I agree with Ryan's point that questioning people's hearts is often unhelpful and unfair.  For the record, I certainly believe that people across the political spectrum have a concern for those in need, for essentially the reasons he gives.  As someone who has written and litigated frequently in support of school vouchers and the faith-based initiative -- and typically worked for and with "conservative" groups in doing so -- I also give a lot of weight to solving problems through assisting subsidiary organizations.  Finally, I accept the judgment of those who credit the President personally with concern for the poor.  But that doesn't mean the administration has actually done a good job on this front.  For example, with respect to the faith-based initiative, the testimony of John diIulio (to whom Ryan refers) -- as well as of David Kuo, Republican congressional supporters of the initiative, and others -- shows that there's been a huge gap between the administration's professed commitment and its actual commitment.  As with covering modest-income children's health, the administration's "focus" should be judged by what it's done.

The important question here, it seems to me, is whether it's within the bounds of fair argument to present something like the SCHIP expansion as a "pro-life" policy and therefore to criticize an otherwise pro-life legislator for voting against it.  Yes, the Catholics United ad that Ryan lambasted in his Weekly Standard piece was quite simplistic.  But if a group believes (as that one does) that expansion of SCHIP responded to a pressing need to get more modest-income but non-Medicaid children covered, and that the alternative proposals wouldn't produce anywhere near the same coverage increase, then the mere fact that others come to a different judgment shouldn't stop the group from arguing that it's correct and the others are wrong.  I agree, however, that empirical evidence of that would be better than condemnatory rhetoric: it would be better to explain the arguments that expansion was needed and the alternative proposals were worse.  (That's true of many other political ads besides this one, no?)

But Ryan's objection in the Weekly Standard article is broader.  Even if there were no reasonable debate about whether SCHIP expansion was necessary to children's health, it appears he would still object to calling children's health a "pro-life" issue.  He said that the term should be limited to "opposition to legalized abortion coupled with support for mothers facing crisis pregnancies." (I assume he'd include euthanasia, embryonic stems cells, and other familiar issues.)  He said that those who try to expand "pro-life" to encompass "poverty-fighting" goals are "charg[ing] to eviscerate the term."  He accused the sponsors of this ad of "gross moral equivocation" and the "intentional hijacking of language" (which itself seems an attack on their motivations); I don't know that he would apply that charge to every case where someone argued for increased government funding of children's health as a "pro-life" policy, but the rhetoric seems plainly aimed at dissuading people from ever making such arguments. 

That's the issue I raised in my original post.  It seems to me that there is a quite reasonable position that the term "pro-life" should expand to encompass other policy priorities, such as children's health, which have a direct effect on whether vulnerable people live or die (even if the death is not from killing as in abortion, euthanasia, or more controversially the death penalty).  Such an expanded set of goals, it's true, runs the risk of diluting the focus on abortion and euthanasia by adding other issues on which people disagree.  But the expanded set also has potential advantages too that could be significant.  These other issues involve conditions that can affect women's decisions whether to abort (since some fear they cannot afford to raise a child); the conditions also affect whether some children will die, even if the death is not from killing; and expanding the focus to include these issues can, as I said before, "increase the credibility of the pro-life position among those not already committed to it."  The pro-life movement needs to do something to win more people in the middle toward greater legal protection for the unborn.  And the example of Western Europe suggests that a stronger safety net can help not only to reduce the number of abortions directly, but to make people -- even far less religious people like the Western Europeans -- comfortable with greater restrictions on abortion than we have here (or would have, even if Roe is overturned, in many states).

That debate over the best scope of a "pro-life" agenda should not be ruled out, as it seems to me Ryan's Weekly Standard article tries to do.  There should be tolerance for differing positions in that debate, just as Ryan argues there should be tolerance for differing positions on something like SCHIP.   

Tom B.