Health Plan Likely to Cover Abortions : Benefits: The Administration will include the elective procedure in its basic medical package, knowledgeable sources predict. Strong opposition is expected.

The Clinton Administration plans to include coverage for elective abortions in the basic package of medical benefits guaranteed to all Americans under the health care reform proposal now taking shape, knowledgeable sources said Tuesday.

Although some members of the task force have expressed fears that abortion coverage could jeopardize support for the overall health care plan, the dominant feeling is that “there is no choice” but to cover abortion because President Clinton has clearly staked out his position on the subject, said one source involved in the process.

“The feeling is that this man has committed himself to making abortion available and secure as a legal right, and it’s something that a health care system has to include,” the source said. “My sense politically is that it would cause more problems if it wasn’t in there than if it was.”

Task force members believe that opponents in Congress eventually can be won over by the argument that many private plans already cover abortion, and, for the most part, “we’re not talking about using federal funds to pay for it,” one source said. Most Americans would continue to be covered by privately funded health plans under the proposed reforms with the government subsidizing insurance for the 37 million people who have no coverage and cannot afford to pay.

Providing coverage for abortions would be consistent with a series of actions Clinton has taken in the first months of his presidency that further abortion rights.

During his first week in office, for example, he overturned the “gag rule” that restricted abortion counseling at federally funded family planning clinics, decided to allow abortions at U.S. military hospitals overseas and reversed a 1984 order, known as the Mexico City policy, which prevented the United States from providing foreign aid to overseas organizations that perform or promote abortion.

And last week, in his first budget, Clinton proposed removing abortion restrictions that long have been included in appropriation bills, including bans on abortion coverage in federal employee health insurance plans.

Under the proposed health care system, every American would have health insurance and would be guaranteed access to a nationally mandated package of benefits, probably determined by a national health care board. The benefits package would serve as a model against which all plans in the country would be measured.

Abortion foes Tuesday said that they expect a legislative battle on Capitol Hill if the health reform benefits package includes abortion.

“We would strongly oppose any mandate on the part of the federal government that compelled employers, health care providers and citizens to collaborate in abortion on demand,” said Douglas Johnson, legislative director for the National Right to Life Committee. “We would hope that the pro-abortion movement wouldn’t try to hijack the national health plan.”

David Kush, a spokesman for Rep. Christopher H. Smith (R-N.J.), a leading abortion opponent in the House, said: “Any plan that puts abortion into the national health care system will be opposed. It will force members from the undecided column into the opposed column.”

Bruce Fried, an influential Washington health care lobbyist who advised the Clinton transition team, predicted that the move probably would cause problems but ultimately would not thwart health care reform.

“For those who want to oppose health care reform, this will be another reason to do it,” he said. “So it really will put him (Clinton) in a difficult position. But on balance, it’s not going to make or break the political dynamics of this thing.”

The extent to which elective abortion is currently covered by insurance plans is unclear because the issue is poorly documented, health policy experts said.

“This is an untalked-about area,” said William S. Custer, research director of the Employee Benefit Research Institute.

While medically necessary abortions are covered by the vast majority of employer-based insurance plans, the scope of private insurance coverage for elective abortions “has never been quantified, to my knowledge,” Custer added.

Although no final decisions have been made by the health care reform task force headed by First Lady Hillary Rodham Clinton, some task force members believe that the best way to handle the issue is to include abortion within the general area of “reproductive health services” without being specific, sources said.

“There probably won’t be a line that says ‘abortion rights,’ but ‘full reproductive rights’ will be in there,” said one congressional source.

One source present during White House meetings where the benefits package was discussed agreed, saying: “There are some ways to finesse this issue so that it doesn’t get embroiled in controversy.”

He predicted that “there will be controversy in Congress, but that isn’t the Administration’s problem--or its fault. Clinton has to do this politically or the people who voted for him will raise more of a ruckus than the people who didn’t.”

Numerous health policy analysts said Tuesday that they were not surprised by the decision to cover elective abortion and agreed that it is likely to cause controversy.

“He (Clinton) campaigned as a pro-choice candidate,” noted Drew E. Altman, president of the Henry J. Kaiser Family Foundation, a health care philanthropy organization based in Menlo Park, Calif.

“Because of his commitment to choice and to a full range of services in a basic benefits package, you can’t design a package without it,” Altman said.

“The danger is that this one issue will create enough heat to cause real problems for the overall plan, which is hardly going to be for want of controversy to begin with. But I really think he has no choice.”

Kate Michelman, president of the National Abortion Rights Action League, said that she believes it is time for abortion to be regarded as “a medical issue,” since many women initially enter the health care system when they need reproductive health services.

“Health care reform and this benefits package is going to affect everybody in the country, so if they choose to exclude abortion, this would mean that not only poor women would lose abortions as an option, but all of us who now have it covered under private health insurance plans would lose it,” she said. “We’re no longer talking about poor women and federal funds; we’re talking about all women.”