Federal health program will cover fetuses

WASHINGTON -- The Bush administration said Friday it will consider developing fetuses as "unborn children" under a government-funded health program, brushing aside complaints that the move is an effort to undercut abortion rights.

The administration said it is making the change to enable more low-income pregnant women to obtain prenatal care. Under the new rule, states could extend health insurance to fetuses -- or even embryos -- from the moment of conception by enrolling them in the State Children's Health Insurance Program.

The debate will now shift to states, which must decide whether to add fetuses to their programs. Both sides of the debate predicted battles ahead.

Because CHIP, as the program is known, is aimed at children, it does not typically cover parents or pregnant women, although states can get permission to include adults if they request it. Under these new rules, it will be a routine matter for states to add unborn children to their CHIP programs.

"It represents a speedy new option for states that want to do more to ensure that women get critical prenatal care that will increase the chances that their children are born healthy," Health and Human Services Secretary Tommy Thompson said in a statement Friday.

He called the change a "commonsense, compassionate measure."

The final regulation, first proposed in January, will be published Wednesday in the Federal Register. It will take effect 30 days later.

A lot of public comment

HHS received a whopping 7,783 comments on the proposal, including many that argued the administration was trying to lay legal groundwork establishing independent rights of the fetus as a step toward abolishing abortion.

Some accused the administration of trying to circumvent congressional debate; others called the regulation an "anti-choice proposal disguised as a health care proposal." Critics also argued that, given the divisive debate over when life begins, HHS should not adopt a policy that takes one side.

The department responded that CHIP is voluntary and no woman -- and no state -- is required to participate. It said, "Prenatal care benefits both mother and child and therefore does not create tension between them."

"This rule, rather than limiting an uninsured woman's choices in fact expands them by offering important health care that may not otherwise be available to her," said the 111-page regulation.

Douglas Johnson, legislative director for the National Right to Life Committee, praised the Bush administration action but feared it will be stymied at the state level.

"The next question is, will pro-abortion politicians in some states cave in to pressure from pro-abortion groups who insist there is no such thing as an unborn child, and so deny this aid to mothers and their babies?" he asked.

In fact, abortion rights groups said they will urge states to reject this option. They noted that states can accomplish the same thing by asking for permission to include pregnant women in CHIP -- something two states, New Jersey and Rhode Island, have already done.

Or, they said, if the administration really wants to get prenatal care to more women, it could simply support legislation pending in the Senate to add pregnant women to CHIP.

"They could support it and it would pass in a nanosecond," said Gloria Feldt, president of Planned Parenthood.

Thompson has said he supports the Senate bill.

Clarifying one aspect of the policy, the regulation explained that all fetuses are eligible for coverage even if their mothers are immigrants who are not. CHIP bars all illegal immigrants and only covers legal immigrants who have been in the country for five years. But babies born in the United States are citizens and therefore eligible for assistance.

That angered some who were already bothered by the policy.

"It's so offensive to immigrant women to say we don't care about you, but if you're pregnant, we'll give your fetus coverage -- but never you," said Laurie Rubiner of the National Partnership for Women and Families.

HHS said this was not the first time a fetus has been eligible for government benefits. In the past, developing fetuses were eligible for both welfare benefits and for Medicaid, which allowed for prenatal care.

The regulation addressed some other questions: Does this mean that a fetus will be counted in the Census? On tax forms? No, for both. HHS explained that nothing changes current law.

It also clarified that a pregnant woman would not be eligible for care for mental health, broken bones or other ailments that are not related to the health of the fetus.

HHS spokesman Bill Pierce said HHS would count fetuses in its statistics about number of children covered by CHIP. He said it wasn't clear if the department would break out the number of born vs. unborn children.

The plan does not include any new money for the coverage. Rather, states that want to participate would simply add to their existing programs in which they share the cost of coverage with the federal government.