Jeff Fecke links to Karoli explaining why there's a strong chance that compromise between the House and Senate bills will involve a trade-off between the public option and Stupak-Pitts. I've heard something similar from a few people in the know on these things, basically that it's going to be no public option or funding ban on abortion---those are the chips that liberals have to play with. So the question is, which one would you prefer to see lost in order to get the other?
As anyone who knows that just because I excel at feminism doesn't mean that I think that it's always the number one most important issue at all times would probably guess, I think a bill with Stupak-Pitts but also with a public option is better than one without a public option or a ban on funding abortion. This is a pragmatic preference borne from looking at the numbers, and also using a reproductive justice frame that puts the interests of the most vulnerable first in order to arrive at its conclusions. Here's my reasoning:
1) Stupak-Pitts hurts lower income women the most, for sure, but repealing it wouldn't do anything for the most vulnerable women out there, the ones who have the most trouble pulling together $500 for an abortion. Those are the women on Medicaid. So already, we aren't maximizing the protection for the most vulnerable in our society.
2) Without a public option, there is a strong possibility that a lot of people are going to be financially ruined by this bill. We know that insurance companies will do everything they can to exploit the mandate, while still looking for reasons to kick people off or charge them outrageous amounts of money for insurance. If someone has a "pre-existing condition" and has to pay thousands of dollars a month for insurance, then the subsidies won't matter. If the subsidies come as tax credits, they really won't matter. Thousands of dollars in insurance costs for individuals versus hundreds of dollars for (most) abortions? Thousands is a more pressing concern.
3) Even with an abortion funding ban, true affordable universal health care will do more than not to improve women's reproductive health, and it will still improve their freedom. We know a lot of women get abortions because they were inconsistent with contraception use. We know that lower income women are more likely to suffer this fate. The only reasonable conclusion is that being uninsured or under-insured is a contributing factor. That makes perfect sense---hormonal methods like the pill are still the most effective, but if you can't see a doctor every year or you have to pay full price for drugs, that might mean you don't use them. Condoms aren't exactly cheap, either. But the pill would be covered, and that alone would be a huge help to women. While I'm allergic to the "common ground" stuff---mostly because I feel that the vast majority of people who are super hostile to abortion are disinterested in improving contraception access---I think pro-choicers should (and do) consider those things that lower abortion rates by preventing unintended pregnancy to be a priority and part of the struggle.
4) A bill that requires you to give insurance companies money is not going to go over well with the public, especially if those companies start looking for every loophole possible to screw the consumer. Which they will. Giving people a public option will go a long way to smoothing that over, because now people have a choice.
5) The government should get out of the business of capitalist protectionism. If capitalists want to use "free market" as their battle cry, then they should be forced to compete on a truly free market. By refusing to create competition for insurance companies on the grounds that they shouldn't have to compete, more groundwork is laid for the idea that the government should be there to consolidate corporate power over the people instead of check it. Refusing to create a public option is, like the bank bailout, a step towards even larger abuses of corporate power, such as allowing unchecked monopolies, buying bureaucrats outright, etc.
6) It's probably easier to overturn Stupak-Pitts---and to do it right, by addressing the Hyde Amendment, instead of telling poor women and our fighting forces they can just fuck off---than it is to get a public option created down the road. I also think that feminist groups like NARAL that took the "status quo" strategy should reconsider, and start to think of abortion in a big picture sense. Protecting the rights of women who can afford insurance to have abortion covered is important, but making sure that every woman who wants an abortion can get one as early as possible to protect her health and her rights should be our starting point. Fixing either problem will be an uphill battle, but at least with abortion, we have a strategy, and that's called "organizing to repeal Hyde and Stupak-Pitts all at once".
I'm grateful to have been exposed to so many cool feminists who take the reproductive justice strategy, or else I don't think this would all be as clear to me. Abortion rights can't be considered outside of the larger framework of health care, economic issues, and women's overall needs. And women need affordable health care, not just affordable abortions. We need both, of course. But your average woman has a lot more and more expensive health care needs than abortion, and we can't forget that moving forward.