Proposal Calls Fetus a ‘Child’ for Health Care

The Bush administration said Thursday it will define human embryos as children so that states can offer expanded prenatal health-care services to poor women, but women’s advocates sharply criticized the move as a poorly disguised effort to weaken abortion rights.

Health and Human Services Secretary Tommy G. Thompson proposed a regulatory change to the federal-state program that provides health insurance coverage for children from low-income families. By redefining eligible participants as “children from conception to age 19,” he said, the new regulation would allow states to cover low-income pregnant women under the Children’s Health Insurance Program, or CHIP.

The Bush administration first floated the idea of changing the definition last summer and received a strong negative response from abortion rights advocates. Bush officials said Thursday they did not understand the criticism.

“What we are going to do is provide for low-income women to have prenatal care,” Thompson said. “How anybody can try and turn this into a pro-choice, pro-abortion argument, I don’t understand.”

Abortion rights advocates said they support quality prenatal care for all women, but accused the administration of playing politics with the issue.

“It seems much more designed to achieve a political goal than a health goal,” Kim Gandy, president of the National Organization for Women, said of the proposed regulation.

Rep. Henry A. Waxman (D-Los Angeles), an author of the original CHIP legislation, said a definition of child that begins at conception “seeks to pander to the extreme views of anti-abortion constituents who believe that termination of a pregnancy for any reason is murder.”

Thompson’s announcement, made in a news release, focused immediate attention on a central, highly charged sticking point of the abortion debate:

For 30 years, abortion rights advocates have emphasized the rights of women to make their own health-care choices. For just as long, abortion opponents have focused on the rights of unborn children to be protected from harm. And in abortion law, the rights of the woman and her unborn child are in direct conflict.

In recent years, the fetus has been gaining legal rights. Two dozen states, including California, have laws that treat fetuses as separate from the mother as victims of crime. And in April, the House passed the Unborn Victims of Violence Act, which recognized as a separate victim a fetus harmed during the commission of a federal crime.

Abortion rights advocates worry that a federal court might someday rule that the legal rights of a fetus trump a pregnant woman’s rights.

“The whole effort throughout the country to ascribe rights to the fetus, separate and apart from the woman, is an attempt to create a legal patchwork, and over time to roll back Roe vs. Wade,” said Kate Michelman, president of the National Abortion and Reproductive Rights Action League.

“This proposal to cover embryos is another demonstration of the Bush administration’s commitment to have the government make abortion illegal,” she said.

Douglas Johnson, legislative director of the National Right to Life Committee, praised the administration’s proposal, and said “only the most extreme pro-abortion ideologues” could oppose it. The new definition “will have no legal bearing” on abortion law, Johnson said, as Roe vs. Wade--the 1973 Supreme Court decision establishing a woman’s right to abortion--is based on a woman’s right to privacy.

The practical effect of the proposed regulation, which will be published in the Federal Register and subjected to a formal comment period, was unclear Thursday. The regulation would allow states to provide prenatal care to eligible women, but would not require them to do so.

Waxman said many states already provide prenatal care through Medicaid for pregnant women earning as much as 185% of the federal poverty level--about $15,890 for a single person.

Normally, when state officials want to change a federal-state program in some way, they apply to the federal government for a waiver. In the case of CHIP, Rhode Island and New Jersey applied for and received waivers to expand their services to pregnant women.

And last week, the Bush administration granted a waiver to Medi-Cal and California’s version of CHIP, Healthy Families, so that the state could offer health insurance to about 300,000 working poor parents as well as to their children.

Likewise, Waxman and abortion rights advocates said Thursday, the Bush administration could have used the normal waiver process to allow CHIP programs to cover prenatal and delivery care for low-income women. Instead, they charged, by proposing a regulation that redefines “child,” the administration is revealing its anti-abortion agenda.

The change is “so clearly unnecessary,” said NOW’s Gandy, “that it seems fairly transparent to me that this is an effort to undermine women’s reproductive choices.”

The administration and its supporters said regulatory change was the best way to expand CHIP coverage.

“This is just easier,” HHS spokesman Campbell Gardett said. “There is a large pool of money sitting idle, and it could be put to use fairly quickly.”

Congress in 1997 set aside $40 billion in federal CHIP funding over 10 years. The federal government covers about 70% of all CHIP funding by the states. Thompson said that President Bush’s proposed budget for 2003 would give states access to $3.2 billion in unused CHIP funds.

Thursday’s action was not the first time that controversial language about the “unborn child” was a part of federal social welfare policy, Gardett said. Until the 1970s, the program specifically noted the eligibility of unborn children, as did Medicaid regulations until 1981. The language was removed, Gardett said, because of conservatives’ concerns that poor women were having children just to get welfare or Medicaid.

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Times staff writer Megan Garvey contributed to this report.