How can health care reporting get worse? Add abortion to the mix

Led by Chris Matthews, much of the media has adopted factually incorrect and logically flawed conservative spin about how health care reform would affect abortion funding, applying an anti-choice frame to both the health care and abortion debates.

If you want an illustration of how conservative framing dominates media coverage of politics and policy, you need only watch Chris Matthews talk about abortion each night on Hardball. Since early summer, the Hardball host has been hyping anti-abortion complaints about proposed health care reform, even though the proposals would have done nothing to expand abortion rights. In doing so, he has trafficked in falsehoods, embraced flawed and illogical conservative talking points, and portrayed pro-choice advocates who have already compromised as rigid, unyielding ideologues.

The controversy stems from conservative claims that proposed health care reforms would undermine or circumvent the Hyde Amendment, which prohibits direct federal payments for abortion services (with exceptions for pregnancies that are the result of rape or incest, and for those that are necessary to save a woman's life). Those claims are incorrect: The proposed legislation would have maintained the status quo.

It is important to keep in mind that the status quo -- the Hyde Amendment -- already constitutes a compromise by supporters of abortion rights. Abortion is a legal medical procedure; a ban on federal funding for it is a substantial concession by abortion-rights advocates. (You might be tempted to think of Hyde as a similarly substantial concession by abortion-rights opponents, as they want the procedure to be illegal. But it isn't really a legislative concession, as the preferred outcome of abortion-rights opponents -- an outright ban on abortion -- is unconstitutional, and thus off the table.)

So, that's the background: Proposed health care reform would maintain the status quo when it comes to federal payments for abortion services -- a status quo that already represents a significant concession by abortion-rights advocates.

But those basic facts haven't been reflected in Chris Matthews' coverage. (Matthews' comments about abortion and health care reform have by no means been unique; I focus on him here because he has addressed the subject regularly over the past several months, and because it serves as yet another reminder that, despite conventional wisdom, neither Matthews nor MSNBC is really “liberal.”)

To begin with, Matthews portrays progressives who oppose a change in the status quo as rigidly insisting upon “a clear statement supporting a woman's right to choose” and describing them as people who “don't want any fudging” and refuse to compromise. This ignores the reality that maintaining the status quo is already a significant concession. It makes the compromise position seem like the far left and a conservative position seem like a middle, compromise position.

(This may remind you of the broader health care debate, in which many in the media have portrayed the public option as the far-left position, when, in fact, it represents a massive concession on the part of liberals who support single-payer and other, more fundamental, reforms.)

Matthews' comments about abortion are premised on the idea that abortion should be treated differently from other medical procedures. He doesn't explain, or even ask, why that should be -- why we should ban federal funding for a perfectly legal medical procedure. He doesn't explain, or even ask, how that is consistent with the concept of insurance. (Answer: It isn't. If we can all veto coverage for procedures we don't want covered, insurance doesn't work.)

There is no great controversy over whether government health care funds should be spent treating lung cancer or broken arms or influenza or sprained ankles or erectile dysfunction. And Matthews doesn't explain why abortion should be treated any differently. Doesn't even ask his guests to explain -- he just assumes, and argues, that it is. That's the very definition of adopting right-wing framing.

Matthews finally acknowledged this problem this week:

MATTHEWS: People say, well, it's just like any other health care procedure. Well, it isn't just like any other health care procedure. [...] [W]e wouldn't be debating it. We don't have national debates over kidney removal or anything else like that. This is unique in our culture, in our value system.

In other words, we should treat abortion differently because it's different, and it's different because some people want it treated differently. Obviously, that is completely circular reasoning and can't be taken seriously. It doesn't even occur to Matthews that the fact that we don't have these debates over other medical procedures doesn't mean there is anything unique about abortion; it means that abortion-rights opponents are demanding -- and receiving -- special treatment for no reason other than that they want it.

Nor do other obvious problems occur to Matthews. For instance: The death penalty is inconsistent with my value system, and with that of millions of others. Yet we pay for it with our tax money. Millions of people find wars of choice morally abhorrent, but are forced to pay for them anyway. Why should abortion be treated differently? You can spend an awfully long time looking for a news report that addresses that question, and you'll come up empty.

Again: The fact that these inconsistencies don't even occur to Matthews is a clear demonstration of how thoroughly he has internalized conservative framing.

Next: Matthews has adopted the phony right-wing spin that it would constitute a departure for health care reform legislation to allow federal subsidies to go to health insurance plans that offer abortion coverage to unsubsidized consumers. Here's Matthews:

MATTHEWS: The problem with that is it looks like an accounting trick. It looks like you're saying, OK, some of the money that goes into an insurance plan will go to abortion, some won't. Everybody knows that money's fungible and that this is basically an accounting trick. And I don't think it'll work with people who have a moral problem with abortion funding by the federal government.

Now, here's why that's baloney: Government funding currently works that way, under the Hyde Amendment. Federal funds go to Medicaid, and in 17 states, Medicaid covers “all or most medically necessary abortions” -- not just abortions in cases of rape and incest, or where the life of the woman is at stake. Under Matthews' “money's fungible ... this is basically an accounting trick” reasoning, such federal funding for Medicaid should not be allowed and shouldn't “work with people who have a moral problem with abortion funding by the federal government.” But that's how current law works.

Matthews, however, is apparently unaware of this:

In our health care system, poor women get Medicaid. Medicaid has never allowed women to get abortion paid for by the government. This is current law and has been law for 30-some years now, 32 years.

That simply isn't true. Not under Matthews' own definitions of what constitutes funding and of the fungibility of money. You'd have to play what Matthews derides as an “accounting trick” to defend his claims about Medicaid.

Even after a Hardball guest, Politico reporter Jonathan Allen, explained the “intellectually dishonest” nature of claims like those Matthews is making about the government subsidizing abortion, Matthews misses the point. Here's Allen:

ALLEN: You know, when you talk about subsidies, what's interesting -- and I haven't heard anybody bring this up -- is, we already subsidize insurance companies that have abortion plans -- have plans that cover abortions. [...] We do it through the Medicare prescription drug law, through tax breaks. Insurance companies are subsidized by the American taxpayer in all forms of way. And, so, it's a little intellectually dishonest for some of these Republicans and Democrats who are against abortion rights to say now, we don't want to subsidize.

Matthews steadfastly refused to understand, telling Allen he's “missing the point” that some people don't want the government to pay for abortion and continuing to suggest that health care reform would move away from current law by allowing federal subsidies for insurance companies that cover abortion, leading Allen to try again: "[W]hat I'm saying is that you already have insurance companies that have plans that cover abortions ... that are subsidized by the American taxpayer in a lot of ways." Matthews still didn't get it, though, apparently not understanding that if money is fungible under health care reform, money is fungible already, and so we already -- by his definition -- subsidize abortion with federal funds.

Matthews also gets the concept of government intervention in abortion decisions wrong. He says that if government funds can be used to pay for abortion, that constitutes the government meddling in individual decisions about reproductive health:

MATTHEWS: [I]sn't there some way to separate out, so that people who are taxpayers can support a health care plan without getting involved in the individual decision which is a guaranteed right under this Constitution to choose an abortion? You don't get involved in that decision.

It's totally that woman's choice, that you're not subsidizing it or taxing it or anything -- it's a neutral choice as far as you're concerned, which is what most Americans, I believe, are comfortable with, if they support abortion rights. Even those people say, let the person pay for it.

This is completely backward. If the government refuses to cover a medical procedure, that is precisely a case of the government “get[ting] involved in that decision.” Banning federal funding is inserting the government into the “individual decision”; allowing it is keeping the government out of the decision. Unless, of course, you think the fact that Medicaid covers treatment for your broken leg to be an example of the government getting involved in your medical decisions.

But because Matthews has adopted the conservatives' illogical premise that the government refusing to fund a medical procedure constitutes the government staying out of private medical decisions, he never asks conservatives to explain the tension between their oft-stated warnings of a government bureaucrat getting between you and your doctor and their opposition to federal funds being used for abortion.

Matthews not only adopts factually inaccurate and conceptually flawed right-wing framing on the substance of the debate, he does so when it comes to the politics, too. He repeatedly claims that there are 40 House Democrats who will oppose health care reform if it does not contain the Stupak amendment's broad restrictions on abortion coverage:

  • CECILE RICHARDS (president of Planned Parenthood): [T]here were a handful of folks who were holding the health care reform bill hostage Friday night who said they would keep the bill from actually passing out of the House unless they got this amendment in.

    [...]

    MATTHEWS: You called them a handful of, but it was 40 Democrats. [Hardball, 11/9/09]

  • MATTHEWS: Anyway, how do you solve the problem of 40 people saying this bill's going down if it's not pro-choice, and 40 people saying it's going down if it's not pro-life, and you're Nancy Pelosi, you've got to solve the problem? How do you do it? [Hardball, 11/9/09]
  • MATTHEWS: Forty people have said they will -- they will not vote for this bill if it's not pro-choice. Forty people have said they will not vote for the bill if it funds -- or uses taxpayer money to subsidize abortion coverage. It sounds like a real no -- no -- no deal to me. [Hardball, 11/10/09]

So, are there actually 40 House Democrats who won't vote for health care reform if it does not include the Stupak language, but will if the Stupak language remains? House Democratic whip James Clyburn suggests it's more like 10, not 40. But Matthews keeps using the higher number.

Finally, Matthews doesn't question the sincerity of abortion-rights opponents, though there are ample reasons to do so. A spokesman for House Republican whip Eric Cantor admitted this week that his party sees the inclusion of the Stupak amendment as the best way to derail health care reform:

“If defeating Stupak wouldn't [have changed] the outcome on Saturday,” said Brad Dayspring, a spokesman for Minority Whip Eric Cantor (R-Va.), “then it is clearly evident that having it in and sparking a civil war amongst the Democrats is the best way to stop the overall bill.”

And, according to The Washington Independent's David Weigel, groups like the National Right to Life Committee reportedly will oppose health care reform even if it contains the Stupak amendment, which they lobbied for, and which would constitute a significant limitation on the ability of women to exercise their freedom of choice. Yet Matthews portrays anti-abortion rights activists as principled fighters for their moral values, even as they admit to cynically using the issue to torpedo reform, and even as they refuse to support health care reform even if it contains the anti-choice provisions they say are so important.

Jamison Foser is a Senior Fellow at Media Matters for America, a progressive media watchdog and research and information center based in Washington, D.C. Foser also contributes to County Fair, a media blog featuring links to progressive media criticism from around the Web, as well as original commentary. You can follow him on Twitter and Facebook or sign up to receive his columns by email.