    [House Hearing, 113 Congress]
    [From the U.S. Government Publishing Office]

                      NO TAXPAYER FUNDING FOR ABORTION ACT

    =======================================================================

                                    HEARING

                                   BEFORE THE

                       SUBCOMMITTEE ON THE CONSTITUTION
                               AND CIVIL JUSTICE

                                     OF THE

                           COMMITTEE ON THE JUDICIARY
                            HOUSE OF REPRESENTATIVES

                        ONE HUNDRED THIRTEENTH CONGRESS

                                 SECOND SESSION

                                       ON

                                     H.R. 7

                                   __________

                                JANUARY 9, 2014

                                   __________

                               Serial No. 113-57

                                   __________

             Printed for the use of the Committee on the Judiciary

          Available via the World Wide Web: http://judiciary.house.gov

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                           COMMITTEE ON THE JUDICIARY

                       BOB GOODLATTE, Virginia, Chairman
    F. JAMES SENSENBRENNER, Jr.,         JOHN CONYERS, Jr., Michigan
        Wisconsin                        JERROLD NADLER, New York
    HOWARD COBLE, North Carolina         ROBERT C. ``BOBBY'' SCOTT,
    LAMAR SMITH, Texas                       Virginia
    STEVE CHABOT, Ohio                   ZOE LOFGREN, California
    SPENCER BACHUS, Alabama              SHEILA JACKSON LEE, Texas
    DARRELL E. ISSA, California          STEVE COHEN, Tennessee
    J. RANDY FORBES, Virginia            HENRY C. ``HANK'' JOHNSON, Jr.,
    STEVE KING, Iowa                       Georgia
    TRENT FRANKS, Arizona                PEDRO R. PIERLUISI, Puerto Rico
    LOUIE GOHMERT, Texas                 JUDY CHU, California
    JIM JORDAN, Ohio                     TED DEUTCH, Florida
    TED POE, Texas                       LUIS V. GUTIERREZ, Illinois
    JASON CHAFFETZ, Utah                 KAREN BASS, California
    TOM MARINO, Pennsylvania             CEDRIC RICHMOND, Louisiana
    TREY GOWDY, South Carolina           SUZAN DelBENE, Washington
    MARK AMODEI, Nevada                  JOE GARCIA, Florida
    RAUL LABRADOR, Idaho                 HAKEEM JEFFRIES, New York
    BLAKE FARENTHOLD, Texas              [Vacant]
    GEORGE HOLDING, North Carolina
    DOUG COLLINS, Georgia
    RON DeSANTIS, Florida
    JASON T. SMITH, Missouri
    [Vacant]

               Shelley Husband, Chief of Staff & General Counsel
            Perry Apelbaum, Minority Staff Director & Chief Counsel
                                     ------

               Subcommittee on the Constitution and Civil Justice

                        TRENT FRANKS, Arizona, Chairman

                        JIM JORDAN, Ohio, Vice-Chairman

    STEVE CHABOT, Ohio                   JERROLD NADLER, New York
    J. RANDY FORBES, Virginia            JOHN CONYERS, Jr., Michigan
    STEVE KING, Iowa                     ROBERT C. ``BOBBY'' SCOTT,
    LOUIE GOHMERT, Texas                 Virginia
    RON DeSANTIS, Florida                STEVE COHEN, Tennessee
    JASON T. SMITH, Missouri             TED DEUTCH, Florida

                         Paul B. Taylor, Chief Counsel

                    David Lachmann, Minority Staff Director

                                C O N T E N T S

                                  ----------

                                JANUARY 9, 2014

                                                                       Page

                                    THE BILL

    H.R. 7, the ``No Taxpayer Funding for Abortion Act''.............     3

                               OPENING STATEMENTS

    The Honorable Trent Franks, a Representative in Congress from the
      State of Arizona, and Chairman, Subcommittee on the
      Constitution and Civil Justice.................................     1
    The Honorable Jerrold Nadler, a Representative in Congress from
      the State of New York, and Ranking Member, Subcommittee on the
      Constitution and Civil Justice.................................    15
    The Honorable Bob Goodlatte, a Representative in Congress from
      the State of Virginia, and Chairman, Committee on the Judiciry.    19
    The Honorable Steve Chabot, a Representative in Congress from the
      State of Ohio, and Member, Subcommittee on the Constitution and
      Civil Justice..................................................    20

                                   WITNESSES

    Helen M. Alvare, Professor of Law, George Mason University School
      of Law
      Oral Testimony.................................................    27
      Prepared Statement.............................................    30
    Susan Franklin Wood, Associate Professor of Health Policy,
      Director, Jacobs Institute of Women's Health, School of Public
      Health and Health Services, George Washington University
      Oral Testimony.................................................    35
      Prepared Statement.............................................    38
    Richard M. Doerflinger, Associate Director, Secretariat of Pro-
      Life Activities, United States Conference of Catholic Bishops
      Oral Testimony.................................................    42
      Prepared Statement.............................................    44

              LETTERS, STATEMENTS, ETC., SUBMITTED FOR THE HEARING

    Material submitted by the Honorable Jerrold Nadler, a
      Representative in Congress from the State of New York, and
      Ranking Member, Subcommittee on the Constitution and Civil
      Justice
        Memo from the National Women's Law Center....................    17
        Prepared Statement of the Honorable Eleanor Holmes Norton, a
          Representative in Congress from the District Columbia......    25

                                    APPENDIX
                   Material Submitted for the Hearing Record

    Prepared Statement of the Honorable John Conyers, Jr., a
      Representative in Congress from the State of Michigan, Ranking
      Member, Committee on the Judiciary, and Member, Subcommittee on
      the Constitution and Civil Justice.............................    72
    Material submitted by the Honorable Jerrold Nadler, a
      Representative in Congress from the State of New York, and
      Ranking Member, Subcommittee on the Constitution and Civil
      Justice
        Prepared Statement of the Honorable Jerrold Nadler, a
          Representative in Congress from the State of New York, and
          Ranking Member, Subcommittee on the Constitution and Civil
          Justice....................................................    74
        Response to Question for the Record from Susan Franklin Wood,
          Associate Professor of Health Policy, Director, Jacobs
          Institute of Women's Health, School of Public Health and
          Health Services, George Washington University..............    85
        Prepared Statement of Sara Rosenbaum, Lara Cartwright-Smith,
          Ross Margulies, Susan Wood, and D. Richard Mauery, School
          of Public Health & Health Services, Department of Health
          Policy, the George Washington University Medical Center....    86
        Coalition Letter.............................................   100
        Letter from Jon O'Brien, President, Catholics for Choice.....   103
        Letter from Vincent C. Gray, Mayor, Washington, D.C..........   106
        Prepared Statement of Laura W. Murphy, Director, and Sarah
          Lipton-Lubet, Policy Counsel, ACLU Washington Legislative
          Office, the American Civil Liberties Union (ACLU)..........   107
        Prepared Statement of the American Congress of Obstetricians
          and Gynecologists (ACOG)...................................   113
        Prepared Statement of the Center for Reproductive Rights.....   114
        Prepared Statement of Vicki Saporta, President and CEO,
          National Abortion Federal (NAF)............................   120
        Letter from Susan A. Cohen, Acting Vice President for Public
          Policy, the Guttmacher Institute...........................   124
        Prepared Statement of NARAL Pro-Choice American Foundation...   133
        Prepared Statement of Nancy Kaufman, Chief Executive Officer,
          the National Council of Jewish Women (NCJW)................   142
        Letter from Emily Spitzer, Executive Director, the National
          Health Law Program (NHeLP).................................   145
        Prepared Statement of the National Asian Pacific American
          Women's Forum (NAPAWF).....................................   148
        Prepared Statement of Debra Ness, President, and Andrea
          Friedman, Director of Reproductive Health Programs, the
          National Partnership for Women & Families..................   151
        Prepared Statement of the Planned Parenthood Federation of
          America....................................................   155
        Prepared Statement of Nancy Stanwood, MD, MPH, Board Chair,
          Physicians for Reproductive Health.........................   158
        Letter from Frank Knapp, Jr., President & CEO, South Carolina
          Small Business Chamber of Commerce.........................   161
        Prepared Statement of Judy Waxman, Vice President for Health
          and Reproductive Rights, the National Women's Law Center
          (NWLC).....................................................   163

                      NO TAXPAYER FUNDING FOR ABORTION ACT

                                  ----------

                           THURSDAY, JANUARY 9, 2014

                            House of Representatives

                       Subcommittee on the Constitution
                               and Civil Justice

                           Committee on the Judiciary

                                Washington, DC.

        The Subcommittee met, pursuant to call, at 10:05 a.m., in
    room 2141, Rayburn House Office Building, the Honorable Trent
    Franks (Chairman of the Subcommittee) presiding.
        Present: Representatives Franks, Jordan, Chabot, Forbes,
    King, Gohmert, DeSantis, Smith, Nadler, Scott, Cohen, and
    Deutch.
        Staff Present: (Majority) Paul Taylor, Subcommittee Chief
    Counsel; Tricia White, Clerk; (Minority) Heather Sawyer,
    Counsel; and Veronica Eligan, Professional Staff Member.
        Mr. Franks. Committee will come to order. Want to welcome
    everyone to the Committee. Happy new year to you all. Welcome
    to the panelists, especially. And welcome back to my colleagues
    on both sides of this podium.
        For well over 30 years, Congress has prevented the Federal
    funding of abortions through a patchwork of amendments that are
    added to various appropriations bills during each budget cycle
    prohibiting the Federal funding of abortions through their
    funded programs. Now is the time to pass one piece of
    legislation that puts Members on record supporting a
    prohibition on any Federal funding of abortion no matter where
    in the Federal system that funding might occur.
        In poll after poll, the American people have overwhelmingly
    expressed their opposition to the Federal funding of abortions.
    H.R. 7 will ensure that American taxpayers are not involved in
    funding the destruction of innocent human life through abortion
    on demand. The No Taxpayer Funding for Abortion Act will
    establish a government-wide statutory prohibition on abortion
    funding by making permanent the various policies Congress has
    implemented on a case-by-case basis, including: The Hyde
    Amendment, which prohibits funding for elective abortion
    coverage through any program funded through the annual Labor,
    Health and Human Services Appropriations Act; the Helms
    Amendment, which prohibits funding for abortions as a method of
    family planning overseas; the Smith Amendment, which prohibits
    funding for elective abortion coverage for Federal employees;
    the Dornan Amendment, which prohibits the use of
    Congressionally appropriated funds for abortion in the District
    of Columbia, and other policies such as the restrictions on
    elective abortion funding through the Peace Corps and Federal
    prisons.
        Now, absolutely nothing in the Democrats' unpopular health
    care law prevents the Federal funding of abortions under the
    program it creates. Representatives Joe Pitts and former
    Representative Bart Stupak offered an amendment to the bill
    during the 111th Congress that would have prohibited government
    funding of abortion, had it been included in the final Health
    Care Reform Act. But that provision was stripped out of the
    Senate bill the President signed into law.
        In the last-minute effort to work a face-saving political
    deal, the President said he would sign an executive order that
    claimed to limit Federal funding of abortions in some way. Then
    in an interview with the Chicago Tribune editorial board,
    former White House chief of staff Rahm Emanuel emphasized that
    the executive order signed by President Obama does not carry
    the force of law, and as such, was approved by the former House
    Speaker Nancy Pelosi and others who oppose a ban on taxpayer
    funding of abortion. Mr. Emanuel said, I quote, ``Came up with
    the idea for an executive order to allow the Stupak Amendment
    not to exist in law.''
        There you have it. In the words of the President's chief of
    staff at the time, ``the Obamacare law provides for the Federal
    taxpayer funding of abortions.'' Any Member who opposes that
    policy must support H.R. 7, which would at last put back into
    law the principle of the bipartisan Hyde Amendment and place a
    Federal Government-wide ban on the Federal funding of the
    destruction of innocent human life.
        Now, I am fully aware of the controversy surrounding the
    underlying issues here. And throughout history, there has often
    been great intensity surrounding the debates over protecting
    the innocent lives of those who, through no fault of their own,
    find themselves obscured in the shadows of humanity. It
    encourages me greatly that in nearly all of those cases, the
    collective conscience was finally moved in favor of the
    victims. The same thing is beginning to happen in this debate
    related to innocent, unborn children. We are beginning to ask
    ourselves the real question: Does abortion take the life of a
    child? And we are beginning to finally able to realize as a
    human family that it does.
        Ultrasound technology now demonstrates to all reasonable
    observers both the humanity of the victim and the inhumanity of
    what is being done to them. And we are beginning to realize as
    Americans that brutally taking the lives of the innocent unborn
    does not liberate anyone, and that 50 million dead children is
    enough. I look forward to hearing from the witnesses.
        And I now recognize the Ranking Member of the Subcommittee,
    Mr. Nadler, for his opening statement.
        [The bill, H.R. 7, follows:]

                                   __________
        Mr. Nadler. Thank you, Mr. Chairman. Today's hearing
    concerns what may be the most difficult and divisive issue we
    will have the opportunity to consider: A woman's right to make
    decisions about her own body. The right of a woman to decide
    whether to become pregnant and whether to continue or terminate
    her pregnancy is protected by the Constitution. Whether or not
    you think that is a good idea or a fair reading of the
    Constitution, it remains the law of the land. The Supreme Court
    has also determined that neither Congress nor a State may place
    an undue burden on that right.
        Now comes H.R. 7, the ``No Taxpayer Funding for Abortion
    Act,'' which is misleading and misnamed because the bill seeks
    to burden all women's health care choices in a variety of ways
    that have in nothing to do with Federal funds. Contrary to the
    assertions of its supporters, H.R. 7 is not the mere
    codification of existing law. This bill seeks to extend current
    funding restrictions in the Hyde Amendment that are limited in
    time and scope and to apply them to all Federal laws without
    any effort to determine how such a sweeping and permanent
    expansion would impact American women and their families.
        If this were all, that would still be enough reason to
    oppose it. But H.R. 7 actually goes much further. This bill,
    for the first time ever, denies tax deductions and credits for
    women who use their own money to pay for an abortion or to
    purchase insurance that covers abortion, and in so doing,
    increases taxes for women and families with respect to one of
    the most personal, private decisions that they may face. So in
    effect, it imposes a tax increase on women who choose to use
    their own money for abortions, under certain circumstances. In
    particular,H.R. 7 denies the itemized tax deduction that
    otherwise is available for medical expenses if the expense is
    an abortion and treats as taxable income any distribution from
    a flexible spending account or health savings account that is
    used to pay for abortion expenses.
        H.R. 7 denies small employers the ability to use tax
    credits to provide health coverage if that coverage includes
    abortion. The bill also denies income-eligible women the use of
    premium tax credits available under the Affordable Care Act if
    selected insurance coverage includes abortion. In first
    opposing and then voting to repeal the Affordable Care Act--not
    once, not twice, but I think we are up to 47 times now--my
    Republican colleagues have complained that government should
    not meddle in the private insurance market or in private health
    care choices. But this legislation obviously is designed to do
    just that.
        It seems that many Republicans believe in freedom, provided
    no one uses that freedom in a way that they do not approve of.
    That is a strange understanding of freedom. Even more stunning,
    this bill increases taxes on families, businesses, and the
    self-employed if they spend their own money--let me repeat
    that, their own money, not Federal money--on abortion coverage
    or services. As we know, the power to tax is the power to
    destroy. And here the taxing power is being used to destroy the
    right of every woman to make private health care decisions free
    from government interference. This tax increase is being
    championed by Republicans, almost all of whom have taken a
    pledge not to raise taxes on individuals or businesses, except
    here.
        I am equally surprised to find out that my Republican
    colleagues think that a tax exemption or a tax credit is a form
    of government funding. Should we now consider every tax
    exemption or credit as a form of government funding for the
    recipient? I am sure there will be many businesses, charities,
    and religious denominations that will be alarmed to discover
    this.
        I also join many other Americans in being absolutely
    horrified that the majority of this Committee seems to not know
    what rape is. When this bill was introduced in the last
    Congress, its sponsors sought to limit the Hyde Amendment rape
    exception to instances of ``forcible'' rape. Many in Congress
    and across America were outraged. According to the bill's
    champions, date rape drugs, and sex with minors were not really
    rape.
        In the face of public outcry, the majority removed the term
    ``forcible'' from the bill before this Committee marked it up
    in the last Congress. But let no one misunderstand or be fooled
    by that change. My colleagues still seek to narrow the rape
    exception, as they made clear in the Committee report
    accompanying H.R. 3 in the last Congress, where they explained,
    ``Reverting to the original Hyde Amendment language should not
    change longstanding policy. H.R. 3 with the Hyde Amendment
    language would still appropriately not allow the Federal
    Government to subsidize abortions in cases of statutory rape.
    The Hyde Amendment has not been construed to permit Federal
    funding of abortion based solely on the youth of the mother,
    nor has the Federal funding of abortions in such cases ever
    been the practice.''
        The majority's assertion, as explained in a memo from the
    National Women's Law Center is false. In fact, a 1978
    regulation clarified that funding is required for all cases of
    rape, whether statutory or forcible. Nothing in the language of
    the Hyde Amendment qualifies the term ``rape,'' and Congress
    rejected a proposal to limit the amendments to cases of
    forcible rape. It rejected it then, but this Committee would
    seek to change it now.
        I ask unanimous consent that the National Women's Law
    Center memo be entered into the record.
        Mr. Franks. Without objection.
        Mr. Nadler. Thank you.
        [The information referred to follows:]

                                   __________
        Mr. Nadler. In their Committee report, my colleagues
    displayed their true intent with regard to the exception for
    rape, which is to remove Federal assistance to children and
    teenagers who are the victims of predators. They have not been
    as transparent about the overall intent behind this bill, but
    it is nonetheless clear: it is to end insurance coverage for
    medically indicated abortions for all women, whether or not
    they obtain their insurance on an exchange, and even if they
    use their own money to purchase the insurance.
        My colleagues in the majority believe that if you like your
    insurance coverage you should get to keep it, unless it is for
    choices that they don't like. Then they have no qualms about
    taking your coverage away. That is the intended and likely
    result of this bill. Currently, the vast majority of insurance
    products cover abortion services. But as Professor Sara
    Rosenbaum of GWU's School of Public Health testified in the
    last Congress, insurance companies will respond to the tax
    penalties this bill imposes by dropping coverage for abortions
    from all of their plans. This will have a significant effect on
    all women, not just lower-income women, who have long felt the
    brunt of Federal restrictions on their health care choices.
        My colleagues blithely assert that coverage will be
    available if in no other way through supplemental insurance
    policies. But, as Professor Wood, the witness invited by the
    minority, can explain, there is no evidence that such product
    lines are being developed. H.R. 7 is not codification of
    existing law, nor is it just another attempt to enact the
    approach taken in the Stupak-Pitts Amendment to the House-
    passed Affordable Care Act. H.R. 7 is a radical departure from
    current tax treatment of medical expenses and insurance
    coverage. And it is neither justifiable nor necessary to
    prevent Federal funding of abortion.
        I yield back the balance of my time, and I look forward to
    hearing from our witnesses today.
        Mr. Franks. I thank the gentleman. And now I yield to the
    Chairman of the Committee, Mr. Goodlatte from Virginia, for an
    opening statement.
        Mr. Goodlatte. Thank you, Mr. Chairman, for holding this
    hearing. However stark Americans' differences of opinion can be
    on the matter of abortion generally, there has been long
    bipartisan agreement that Federal taxpayer funds should not be
    used to destroy innocent life. The Hyde Amendment, named for
    its chief sponsor, former House Judiciary Committee Chairman
    Henry Hyde, has prohibited the Federal funding of abortion
    since 1976, when it passed a House and Senate that was composed
    overwhelmingly of Democratic Members. It has been renewed each
    appropriations cycle with few changes over the last 38 years,
    supported by Congresses controlled by both parties and
    presidents from both parties.
        It is probably the most bipartisan, pro-life proposal
    sustained over a longer period of time than any other. As such,
    it warrants codification in the United States Code. H.R. 7, the
    No Taxpayer Funding for Abortion Act, would do just that by
    codifying the two core principles of the Hyde Amendment
    throughout the operations of the Federal Government, namely, a
    ban on Federal funding for abortions and a ban on the use of
    Federal funds for health benefits coverage that includes
    coverage of abortion.
        During the time the Hyde Amendment has been in place,
    probably millions and millions of innocent children and their
    mothers have been spared the horrors of abortion. The
    Congressional Budget Office has estimated that the Hyde
    Amendment has led to as many as 675,000 fewer abortions each
    year. Let that sink in for a few precious moments. The policy
    we are discussing today has likely given America the gift of
    millions more children and consequently millions more mothers
    and millions more fathers, millions more lifetimes, and
    trillions more loving gestures and other human gifts in all
    their diverse forms. What a stunningly wondrous legacy.
        Thank you, Chairman Franks, for convening this hearing and
    thanks also to representative Chris Smith for sponsoring this
    vital legislation. I look forward to hearing from our witnesses
    today. However, I wanted to say just one more thing, Mr.
    Chairman. The gentleman from New York made reference to it
    being a radical departure from insurance policies. But the real
    radical departure here is the fact that now we will have, for
    the first time, Federal subsidies of health insurance policies
    in America. So that is the radical departure that we are
    facing, and that is why legislation is needed to address the
    fact that this will be a major substantial breach in the Hyde
    Amendment, the policy of the United States of America since
    1976.
        And I thank you and yield back.
        Mr. Franks. And I thank the gentleman.
        Are there any other opening statements?
        Then I would now yield to Mr. Chabot, the gentleman from
    Ohio, for an opening statement.
        Mr. Nadler. Mr. Chairman.
        Mr. Franks. When he finishes his opening statement, we will
    consider unanimous consent.
        Mr. Nadler. I'm sorry.
        Mr. Chabot. Thank you, Mr. Chairman. And thank you for your
    leadership on this issue for many years now.
        Protection of the most vulnerable among us, the unborn, is
    one of the most important and most solemn duties that we, I
    believe, as elected officials, undertake. Since Roe versus Wade
    was decided almost 41 years ago, this Subcommittee in
    particular has been the focal point in the effort to curb
    abortions nationally. Most notably, it was this Subcommittee
    that first considered and approved the Partial Birth Abortion
    Ban Act of 2003, which I had the honor to introduce, which
    later passed both Houses of Congress, was signed into the law
    by President Bush, and upheld as constitutional by the United
    States Supreme Court. But as thousands of Americans prepare to
    head to Washington in about 2 weeks for the annual March for
    Life in remembrance of the approximately 50 million American
    lives lost to abortions since Roe was decided back on January
    22, 1973, much more remains to be done. It is appropriate then
    that this Subcommittee again take the lead on legislation that
    will further limit the number of abortions performed in this
    country, especially with taxpayer dollars.
        The No Taxpayer Funding for Abortion Act introduced by our
    colleague, Chris Smith of New Jersey, would prevent any Federal
    funding of abortion, whether channeled through insurance plans
    or paid directly to abortion providers. The bill reaches back
    through history and seeks to make the Hyde Amendment, as has
    been mentioned a number of times already, and the Hyde/Weldon
    Conscience Protection clause and several other pro-life
    amendments permanent under Federal law. I would note that this
    bill is a legislative effort to actually implement Executive
    Order 13535 that President Obama issued back on March 24 of
    2010. And that order stated, in part, ``It is necessary to
    establish an adequate enforcement mechanism to ensure that
    Federal funds are not used for abortion services, consistent
    with the longstanding Federal statutory restriction that is
    commonly known as the Hyde Amendment.''
        Mr. Chairman, the No Taxpayer Funding for Abortion Act
    provides that enforcement mechanism and it has overwhelming
    public support. 2011 CNN poll found 61 percent of the
    respondents opposed public funding for abortion. And a 2010
    Quinnipiac poll showed 67 percent of the respondents opposed
    Federal funding of abortion.
        For these reasons, I would urge my colleagues to support
    this legislation. I thank you for holding this hearing today.
    Yield back.
        Mr. Franks. And I thank the gentleman.
        And I understand--go ahead.
        Mr. Nadler. Mr. Chairman, may I be recognized for a
    unanimous consent request?
        Mr. Franks. Without objection.
        Mr. Nadler. Thank you, Mr. Chairman. This Subcommittee
    received a request from the delegate from the District of
    Columbia, Eleanor Holmes Norton, to be allowed to testify on
    this bill. I understand that she has been told that her request
    would not be accommodated. I ask unanimous consent that our
    colleague be given 5 minutes to address the Subcommittee on the
    matter that uniquely affects her constituents and only her
    constituents. That has been the common practice in the House.
        Mr. Franks. I would have to have raise objection.
        Mr. Nadler. I regret that the Chairman objects. I would
    hope that he would reconsider what is normally a fairly
    pedestrian request. This bill contains a provision that singles
    out the District of Columbia for additional restrictions on how
    it may spend its own local tax funds, not Federal funds. This
    is the equivalent of barring a State from making its own
    choices about how it wants to spend its own State funds. No
    Member would tolerate Congress telling their State or their
    town how to spend their own tax dollars, yet this bill would do
    just that to the citizens of our Nation's capital.
        The exclusion of Delegate Norton, who is relegated to
    sitting in the audience today--and I want to welcome her and
    apologize for the manner in which she is being treated--is yet
    another example of an abuse of power. As I have said in the
    past, never in more than 20 years as a Member of this body have
    I seen a colleague treated as contemptuously as our colleague
    from the District of Columbia is being treated today. The
    gentlewoman from the District of Columbia is a Member of this
    body, and the people she represents are taxpaying American
    citizens. And yet this Committee can't be bothered to take 5
    minutes to hear our colleague, who will not even be permitted
    to vote on the bill. The District of Columbia is not a colony,
    it is part of the United States, and its people are entitled to
    be treated with the same respect that we demand for the people
    we represent.
        Now, I know that it will be said by the Chairman, because
    he has said it to me, and there is no secret, that while the
    Democrats get one witness and if we want Eleanor--or the
    delegate from the District of Columbia to be our witness--we
    are free to do that. That is true. But that gives us a Hobson's
    choice. Because Eleanor's testimony would be only about the
    specifics of how this affects her district in a way unique to
    that district. And that would leave us no witness on the basic,
    broad import of the bill. On the other hand, if we have a
    witness on the basic, broad import of the bill, we don't have
    the opportunity, or Eleanor doesn't have the opportunity, to
    present the specifics of her district.
        It is a common courtesy. There is no rule in the House that
    prevents this. And again, I ask that this be reconsidered. And
    that the common practice that has normally been common practice
    in this House that when a matter specifically affects a
    Member's district, she or he is given the opportunity to
    testify, be implemented here.
        Mr. Franks. I would join the gentleman in recognizing and
    welcoming Mrs. Norton, Ms. Norton to the audience today. And
    would remind the gentleman that it does indeed remain true that
    the minority was entirely free to invite Ms. Norton as their
    witness. In fact, I extended that invitation personally both to
    the Chairman and to the Subcommittee Chairman, Mr. Nadler. But
    they declined. Now, since the bill that is the subject of the
    hearing today only mentions the District of Columbia to make
    clear that funds appropriated by Congress for the District of
    Columbia shall be, of course, considered Federal funds, just
    like all other Federal funds, there was no reason for the
    majority to call Ms. Norton as a witness. Ms. Norton is, of
    course, welcome to submit any materials she would like for the
    hearing record, which will be made part of the record without
    objection.
        Mr. Nadler. Mr. Chairman. Mr. Chairman. With respect--what
    you just said is not completely accurate. This bill applies in
    a way that it applies nowhere else, to funds raised locally, by
    local tax funds in the District of Columbia. It does not apply
    to local tax funds raised in New Jersey, by the State of New
    Jersey, or anywhere else. Now, it does that by sleight of hand.
    It says, ``The term 'Federal government' includes the
    government of the District of Columbia,' for the purposes of
    this bill. For most purposes, the term 'Federal Government'
    never includes the District of Columbia.'' So this bill has the
    unique effect of--for the District of Columbia only--telling
    them how they may use local funds raised by local sales taxes
    or income taxes or property tax in a way that is not done
    anywhere else. And, therefore, it is a unique application. And
    the common courtesy of the House demands that Ms. Norton be
    able to testify--not as our one witness but as a specific
    witness with respect to the application to her district. A
    courtesy that I have seen granted many, many times in this
    House. And in this Committee, for that matter.
        Mr. Franks. The gentleman's objection is duly noted. And
    would just remind the gentleman that the District of Columbia
    is the seat of this government, according to the Constitution,
    and not a State. And consequently we will proceed.
        Mr. Nadler. Mr. Chairman.
        Mr. Franks. Now let me introduce our witnesses.
        Mr. Nadler. Mr. Chairman, Mr. Chairman, Mr. Chairman. Mr.
    Chairman, you stated to me that the rules of the House are the
    rules of the Committee do not permit the seating of Ms. Norton
    as a witness other than our one witness. Could you please point
    out to me the rules of the House, the rules of the Committee
    that so indicate?
        Mr. Goodlatte. Would the gentleman yield?
        Mr. Franks. Yes.
        Mr. Nadler. Would I yield?
        Mr. Goodlatte. Mr. Chairman, I appreciate the
    circumstances, and I, too, welcome Ms. Norton's presence here.
    But, last year, at the beginning of this Congress, I announced
    to the full Committee our policy regarding the participation of
    Members who are not a Member of the Judiciary Committee or its
    Subcommittees, and here is what I announced.
        ``I want to take the opportunity of this full Committee
    gathering to make Members aware of our new policy regarding
    participation in Subcommittee hearings. At the beginning of the
    Congress, I was asked whether Members who are not a Member of a
    Subcommittee would be allowed to participate in Subcommittee
    hearings. After giving it some thought, I have come up with
    what I think to be a reasonable solution that will allow our
    Members some level of participation without overly burdening
    the Subcommittees. A Member of the Judiciary Committee who is
    not a Member of a Subcommittee may attend a hearing and sit on
    the dais. That Member may also ask questions of the witnesses.
    But only if yielded time by an actual Member of the
    Subcommittee who is present at the hearing. I would ask that
    Members who intend to participate in this fashion let the
    majority staff know as far in advance of the hearing as
    possible so that we may prepare accordingly. It will remain the
    policy of the Committee that we do not allow Members to
    participate in our hearings if they are not Members of the
    Judiciary Committee.'' Thank you, Mr. Chairman.
        Mr. Nadler. Would the gentleman yield?
        Mr. Franks. Gentleman from New Jersey has the time. There
    is really no time. At this point, I think----
        Mr. Nadler. Gentleman from New Jersey?
        Mr. Franks. I'm sorry. Wherever you are from. New York.
        Mr. Goodlatte. You mentioned New Jersey a couple times in
    your statements.
        Mr. Franks. I apologize to people in both the States.
        Mr. Nadler. Mr. Chairman, I would like to point out that
    that policy statement, A, is not a rule, but, B, refers to
    participation as a Member of the Committee or Subcommittee in
    asking questions. It does not refer to testifying before the
    Committee. And again it has been the practice in the House that
    we afford the courtesy--we would have been well finished with
    this by now if you had done that, by the way--to a Member whose
    district is uniquely affected to testify. We have had panels of
    only Members. There is nothing that says you can't do this if
    you have the common courtesy to do it.
        Mr. Franks. I would just suggest to you to remind the
    gentleman, the House rules provide for the participation in
    hearings only by Members of that Committee or Subcommittee.
    House Rule 11 states, ``Each Committee shall apply the 5-minute
    rule during the questioning of witnesses in a hearing until
    such time as each Member of the Committee who so desires has
    had an opportunity to question each witness.'' Now I feel like
    I have----
        Mr. Nadler. Mr. Chairman, again, that is questions, has
    nothing to do with testifying.
        Mr. Franks. A UC is required in order to allow non-
    Judiciary Member to participate.
        Mr. Nadler. No, I'm not talking about participating.
        Mr. Franks. I have given the gentleman ample time to state
    his point and respectfully----
        Mr. Nadler. You are misstating my point. I am not talking
    about participating, I am not talking about asking questions. I
    am talking about testifying. It is an entirely different
    matter.
        Mr. Goodlatte. Will the gentleman yield?
        Mr. Franks. Please.
        Mr. Goodlatte. I want to reiterate the Committee's
    position, and not just in this Congress but in previous
    Congresses as well is that non-members of the Committee do not
    sit on the dais. That was the gentleman's subsequent request.
    His original request was that she be given 5 minutes to
    testify.
        Mr. Nadler. That is my request.
        Mr. Goodlatte. That requires unanimous consent. That was
    rejected by the Chairman. And the Chairman made it very plain,
    and I will again, that she is very welcome to submit any
    materials that she would like to for the hearing record, which
    will be made part of the record without objection.
        Mr. Franks. Thank you. And now I would like to introduce--
    --
        Mr. Nadler. Can I ask unanimous consent in view of the
    rudeness----
        Mr. Franks. Gentleman is not recognized.
        Mr. Nadler [continuing]. Ask unanimous consent to----
        Mr. Franks. Unanimous consent.
        Mr. Nadler. In view of the rudeness of the Committee, I ask
    unanimous consent to place the gentlewoman's written statement
    into the record. I assume there will be no objection to that.
        Mr. Franks. Without objection.
        Mr. Nadler. Thank you.
        [The prepared statement of Ms. Norton follows:]

                                   __________
        Mr. Franks. And I will now introduce our witnesses.
        Helen Alvare is professor of law at George Mason University
    School of Law. Professor Alvare teaches and writes scholarship
    and public essays in leading newspapers concerning law and
    policy affecting women, children, and the family. She is co-
    founder of the grassroots organization, Women Speak for
    Themselves, and a regular consultant to the official council
    advising Pope Francis on matters considering women in the
    church and in the world. We welcome you, Mrs. Alvare.
        Ms. Alvare. Thank you.
        Mr. Franks. Susan Wood is an associate professor of health
    policy at the George Washington University School of Public
    Health and Health Services, and the Director of the Jacobs
    Institute of Women's Health. Prior to joining George Washington
    University, Professor Wood served as Assistant Commissioner for
    Women's Health and Director of the Office of Women's Health at
    the Federal Drug Administration. Welcome, Ms. Wood.
        Richard Doerflinger is the Associate Director of the
    Secretariat of Pro-Life Activities, United States Conference of
    Catholic Bishops, where he has worked for 33 years. He is also
    Adjunct Fellow in Bioethics and Public Policy at the National
    Catholic Bioethics Center in Philadelphia. We welcome you, Mr.
    Doerflinger.
        Each of the witnesses' written statements will be entered
    into the record in its entirety. And I ask that each witness
    summarize his or her testimony in 5 minutes or less. To help
    you stay within that time, there is a timing light in front of
    you. The light will switch from green to yellow, indicating
    that you have 1 minute to conclude your testimony. When of the
    light turns red, it indicates that the witness's 5 minutes have
    expired.
        Before I recognize the witnesses, it is the tradition of
    the Committee that they be sworn. So if you will please stand
    to be sworn.
        [Witnesses sworn.]
        Mr. Franks. You may be seated.
        Let the record reflect that the witnesses answered in the
    affirmative.
        And so I would now recognize our first witness, Ms. Alvare.
    And if you would please turn your microphone on before
    speaking. Yes, ma'am.

     TESTIMONY OF HELEN M. ALVARE, PROFESSOR OF LAW, GEORGE MASON
                        UNIVERSITY SCHOOL OF LAW

        Ms. Alvare. Thank you very much. And I would like to thank
    the Committee for holding this hearing, which even 40 years
    after Roe versus Wade, is a sign of the power of a human rights
    dream that refuses to die. No matter how much abortion is
    legal, Americans, including American women especially, have
    never and will never make their peace with it. In my remarks
    today, I am going to address two points: First that neither
    American law makers, or citizens, especially women, understand
    abortion as a public good. And second, that abortion is not
    part of any women's health agenda, even out of the lips of our
    own Federal Government in its own statements.
        In my first point, it's understood by lawmakers and
    citizens that abortion is different from anything else the
    Federal Government might fund. It's unlike the use of the
    Federal budget, which is for things that support and promote
    human life versus death, versus insecurity and want. Our
    Supreme Court has said abortion is not like any other medical
    procedure. Perhaps this is because, as Justice Stevens and
    Ginsburg have acknowledged, some of these procedures are
    ``brutal or gruesome,'' or as Justice Kennedy in a majority has
    acknowledged, abortion kills. Finally, President Obama has
    opined that he wishes abortion to be rare and it's a tragic
    matter. The State legislatures recognize the same thing and
    have passed a record number of laws restricting abortion in the
    last 2 years.
        Even the most strenuous supporters of legal abortion,
    Planned Parenthood, has acknowledged that there is, in their
    words, a baby growing inside a pregnant woman such that
    abortion ends her life. How disturbing, then, it is that
    supporters of abortion would continue to urge its funding while
    acknowledging that it's killing. And the reason they claim is
    women's health and rights, which is the 800-pound gorilla in
    the room every time abortion is debated, including today, so
    let me turn to that.
        It's no longer contestable that for decades--and
    particularly good RAND Corporation study I've cited shows
    this--women have been more pro-life than men, lesser educated,
    are more pro-life than the privileged, and the poor are more
    pro-life than the wealthy. This translates also to the matter
    of abortion funding, where we have the particularly disturbing
    data point that the well-off support abortion funding for the
    poor more than the poor support it for themselves.
    Investigations of women's voting patterns turn up the same
    information. Women don't vote because of abortion or in favor
    of abortion funding.
        Finally, when you look at Federal sources or documents that
    are engaging in promoting women's health, you don't find any
    mention, let alone promotion, of abortion or abortion funding.
    The Centers for Disease Control doesn't even keep regular or
    required records on this. The Federal Government seems
    decidedly uncurious about abortion and women's health. After
    Surgeon General Koop in 1989 said studies on the relationship
    between these were insufficient and recommended long-term
    studies, the government never did them.
        I vividly recall my membership on the NIH council that
    addresses women's health and asked for one question about
    abortion and women's health to be put on studies and it never
    was. Despite the fact that increasingly, European studies,
    including meta analyses involving 900,000 women, are showing a
    relationship between abortion and mental health outcomes that
    are problems for women. In addition to the Federal Government's
    having no firm ideas about the numbers for abortions or its
    impact on women, or a lack of curiosity about it, if you look
    at all the major Federal reports on women's health issued from
    HHS, from NIH, from the White House, and they are all detailed
    in my testimony, what do you see in these? When the government
    is actually dispensing women's health advice? No mention of
    abortion or abortion funding. Rather, frank acknowledgment that
    a woman is carrying, in their words, unborn babies. You see
    them addressing what the CDC identifies as the serious threats
    to women's health, heart disease, stroke, cancer; not abortion.
    You see them recommending that women avoid substances during
    pregnancy that could ``damage your baby.''
        In conclusion, the Federal Government has collected no
    useful data about the relationship between abortion and women's
    health. When it does offer advice, it recommends health care
    for women and her ``unborn baby.'' Credible studies are
    indicating distress for women following abortion.
        By themselves, these facts indicate how H.R. 7 serves
    women. But there's another service H.R. 7 might perform.
    Regular squabbles over Federal funding for abortion too often
    take the place of debates about what women actually need and
    say they want. Debates about paid leave or Social Security
    benefits for women's care work. Instead of debating ideas about
    how to end poor women's cycle of poverty or non-marital
    childbearing, we continue to debate abortion in this country.
    It's time, once and for all, to settle the matter of abortion
    funding across Federal legislation and move on to a real
    women's agenda. Thank you.
        Mr. Franks. Thank you, Ms. Alvare.
        [The prepared statement of Ms. Alvare follows:]

                                   __________
        Mr. Franks. And I now recognize our second witness, Ms.
    Wood.

    TESTIMONY OF SUSAN FRANKLIN WOOD, ASSOCIATE PROFESSOR OF HEALTH
    POLICY, DIRECTOR, JACOBS INSTITUTE OF WOMEN'S HEALTH, SCHOOL OF
    PUBLIC HEALTH AND HEALTH SERVICES, GEORGE WASHINGTON UNIVERSITY

        Ms. Wood. Thank you, Mr. Chairman. And gentlemen of the
    Committee. I want to thank you for being able to present
    remarks on the bill before us today, H.R. 7. I need to point
    out that this sweeping legislation would affect nearly all
    women in this country and would do significant harm to many,
    especially those women and families who are struggling to make
    ends meet. While the bill is cloaked in the language of
    taxpayer rights and Federal appropriations, a close examination
    of its true impact reveals an attempt to interfere with a
    women's personal decision making by denying women insurance
    coverage for abortion care. And every woman deserves coverage
    for basic health care, including contraception, maternity care,
    and abortion coverage, should she need it.
        This legislation reaches far beyond the already troublesome
    Hyde Amendment, beyond the onerous restrictions that were
    proposed in the Stupak Amendment, in the Affordable Care Act,
    and beyond the restrictions that actually were enacted into the
    ACA by the Nelson Amendment. It would virtually eliminate
    abortion coverage from the private insurance market and impose
    unprecedented new tax burdens on business that want to offer
    abortion coverage to their employees.
        Moreover, it would provide exceptions only for rape and
    incest, or for conditions that put a woman in danger of death.
    Congress should reject this harmful and overreaching piece of
    legislation.
        Now, those who oppose abortion have tried and failed to
    make it illegal. So instead they have worked to make it almost
    impossible to obtain. Indeed some object to even insurance
    company of contraception, which is the most effective way to
    prevent unplanned pregnancy and reduce the need for access to
    abortion care. This bill is the most recent attempt. And it is
    not enough that they have tried to deny abortion coverage to
    the women who qualify for Medicaid. It is not enough that this
    denies coverage to veterans, Federal employees, Native American
    women, disabled women, and women who participate in other
    Federal insurance plans and programs.
        No, to cut off access to affordable abortion care for the
    rest of the women in the country, we need this bill as the
    final piece of the puzzle. If Congress enacts this bill, you
    are taking away coverage from women who live in places where
    private insurance plans that include abortion coverage are sold
    today. And you would take away a woman's ability to use her own
    health savings account to cover her medical costs related to
    abortion care, an unprecedented insertion of abortion politics
    into tax policy.
        Historically, the vast majority of insurance plans have
    typically covered abortion services. It's no coincidence, it's
    where health policy--good health policy meets good financial
    policy and meets a woman's health care needs. In our analysis
    of both the Stupak and Nelson Amendments, which I would like to
    enter into the record, we raise the concern that Congress would
    create a chilling effect which would lead many more women to
    lose abortion coverage. Further changing the tax benefits for
    employees and for employers providing health coverage as
    proposed in H.R. 7 could create a tipping point in the nature
    of insurance whereby women lose abortion coverage because
    insurers may no longer provide plans that include it.
        Since approximately 60 percent of women of reproductive
    age, 37 million women, get their health care coverage through
    private insurance, this legislation could have a far-reaching
    effect. It represents more than just meddling in their personal
    decisions, by making it unaffordable, it effectively bans
    abortion for some women. And while it may not seem like a big
    expense to a Member of Congress, in these tough financial times
    for many people, abortion care costs more than their monthly
    rent, putting it out of reach for their family's pocketbook.
        Moreover, cutting off access to abortion has profoundly
    harmful effects on the public health. Based on the experience
    with the ban that has long been imposed on women who qualify
    for Medicaid, we know that some who seek an abortion are forced
    to carry a pregnancy to term, due to lack of coverage and cost.
    And we also know that births that result from unintended or
    closely spaced pregnancies are associated with delayed prenatal
    care, premature birth, low birth weight, and other negative
    health effects on the children. We know that a woman who wants
    to get an abortion but is denied it is less likely to have a
    full-time job and twice as likely to be a victim of domestic
    violence. Denying abortion care to these women who are least
    able to afford out-of-pocket medical expenses will further
    exacerbate existing health disparities.
        And although most of the women affected by these bans will
    still find a way to end their pregnancies. Many are forced to
    delay their procedures for 2 or 3 weeks or longer while they
    pull together enough money to pay for the care they need. By
    banning abortion coverage for even more women through private
    insurance, as this bill would do, Congress would expand the
    number of women and families struggling with budget dilemmas,
    including many middle-class families still recovering from the
    great recession. And even with the primary assistant provided
    by the Affordable Care Act, families have to stretch their
    budgets to pay for health insurance, and women are more likely
    to fall into poverty if they are not able to get the abortion
    they need.
        Importantly, the H.R. 7 also extends very narrow exceptions
    for abortion coverage now allowed for Medicaid. If private
    plans decided to continue to provide such coverage, both they
    and the IRS would need to evaluate coverage decisions to ensure
    that they were in compliance. Neither the private market nor
    the IRS is suited for such determinations about a woman's risk
    of death or determination of rape or incest. Women potentially
    could be required to provide evidence of rape or incest to the
    insurer or to the IRS as part of a claim.
        Furthermore, health conditions, such as diabetes,
    hypertension, epilepsy, or others would not necessarily fit the
    definition of placing a woman in danger of death, but could
    have potentially serious consequences for her health. Health
    insurance now routinely covers the range of pregnancy and other
    health services that may be needed by the individual woman. But
    by denying abortion coverage, it would not only change the
    current insurance women have, but would put some women's health
    at risk.
        In conclusion, this bill would impose a sweeping and
    unprecedented ban on abortion coverage with far-reaching and
    harmful consequences for women's health and for their economic
    security. When it comes to the most important decision in life,
    such as whether to become a parent, it is vital that a woman be
    able to consider all of her options, no matter what her income
    or source of insurance. It makes sense that health insurance
    covers the whole spectrum of women's health needs, including
    birth control, abortion, maternity care. Because when people
    can plan if and when to have children, it's good for them, it's
    good for their families, and it's good for society as a whole.
    Thank you.
        [The prepared statement of Ms. Wood follows:]

                                   __________
        Mr. Franks. Now recognize our third and final witness, Mr.
    Doerflinger. Please turn on your microphone, sir.

       TESTIMONY OF RICHARD M. DOERFLINGER, ASSOCIATE DIRECTOR,
    SECRETARIAT OF PRO-LIFE ACTIVITIES, UNITED STATES CONFERENCE OF
                            CATHOLIC BISHOPS

        Mr. Doerflinger. Thank you, Mr. Chairman, for this
    opportunity to voice the support of the U.S. Conference of
    Catholic Bishops, for H.R. 7, the ``No Taxpayer Funding for
    Abortion Act.'' This bill will write into permanent law a
    policy on which there's been strong popular and Congressional
    agreement for over 35 years: the Federal Government should not
    use its funding power to support or promote abortion. This
    principle has been embodied in the Hyde Amendment, and numerous
    other provisions governing a wide range of domestic and foreign
    programs. It has consistently had the support of the American
    people. Women oppose federally funded or federally mandated
    abortion coverage as strongly as men or more so. Low-income
    Americans oppose it more strongly than the affluent.
        And even courts insisting on a constitutional right to
    abortion have said this alleged right ``implies no limitation
    on the authority of a State to make a value judgment favoring
    childbirth over abortion, and to implement that judgment by the
    allocation of public funds.'' In 1980, the U.S. Supreme Court
    said the Hyde Amendment is an exercise of ``the legitimate
    congressional interest in protecting potential life,'' adding:
    ``Abortion is inherently different from other medical
    procedures because no other procedure involves the purposeful
    termination of a potential life.''
        In other words, the Federal Government is perfectly within
    its moral and legal rights, to say that abortion is not basic
    health care. The only mistake in the quote from the Supreme
    Court is its use of the phrase ``potential life.'' That has no
    clear biological or medical meaning. In fact, unborn children
    are actually alive until they are made actually dead by
    abortion. More recently, the Supreme Court has said simply that
    the government may express ``profound respect for the life of
    the unborn'' by regulating abortion.
        So the Supreme Court and the actions of Congress simply
    contradict Dr. Wood's testimony. She's talking about the
    government ``meddling,'' ``interfering,'' ``denying,'' ``making
    women lose'' coverage--setting aside the fact that the vast
    majority of women don't want abortion in their coverage, so
    saying you are losing the coverage is like saying you're losing
    a tumor--``banning'' abortion, ``forcing.'' This is simply a
    governmental decision to put its support behind the life-
    affirming options for mother and child and not to subsidize the
    lethal option.
        Congress's policy has been consistent for decades, but its
    implementation in practice has been piecemeal, confusing, and
    sometimes inadequate. Gaps or loopholes have been discovered in
    its patchwork of provisions over the years, highlighting the
    need for a permanent and consistent policy across the Federal
    Government.
        In 2010, Congress passed major health care reform
    legislation, which, as has been mentioned, puts Federal funds
    into an entirely new part, a much larger part of the health
    care system for the first time. And that legislation has, as my
    longer statement details, at least four different policies on
    abortion funding, ranging from a ban on such funding in one
    section, on school-based clinics, to a potential mandate for
    such funding in another. These problems have arisen partly
    because various sections of the Affordable Care Act not only
    authorize but appropriate their own funds, thus bypassing the
    Hyde amendment and similar longstanding appropriations
    provisions.
        Recent developments underscore a need to correct the
    abortion funding problems in the Affordable Care Act. In 2010,
    the Act was used to approve direct Federal funding of elective
    abortion coverage in the State high risk pool program until
    that was uncovered by pro-life groups.
        As State health exchanges have begun to operate, Americans
    are finding it difficult to find plans without abortion
    coverage or even to get clear answers as to which plans those
    are. And they are discovering that despite public assurances to
    the contrary, they may, in fact, be forced by the government to
    subsidize other people's abortions as a condition for obtaining
    the health care their families need.
        Congressional employees and Members of Congress are finding
    that if they want a plan without abortion in D.C., they only
    have a choice of nine out of 120--more than 120 plans. Members
    and staff of Congress, previously assured they are free to
    choose from a full range of plans without abortion, are being
    deprived of that freedom or having it greatly narrowed--
    contrary, in our view, to longstanding Federal law. We have
    submitted comments to the Federal Government on that point.
        If a bill like H.R. 7 had been enacted before the health
    care reform debate began, that debate would not have been about
    abortion funding. A major obstacle to support by Catholics and
    other pro-life Americans would have been removed, and the
    legislation would not have been so badly compromised by
    provisions that place unborn human lives at great risk.
        H.R. 7 would prevent problems and confusions on abortion
    funding in future legislation. Federal health bills--and I
    think a lot of us would be relieved at this--could be debated
    in terms of their ability to promote the goal of universal
    health care, real health care, instead of being mired in
    debates about one lethal procedure that most Americans know is
    not truly health care at all.
        Finally, in our view, and we'd be happy to discuss this,
    H.R. 7 does not eliminate private coverage for abortion, but
    specifically allows it when purchased without Federal subsidy.
    And it does not create an unprecedented policy of denying tax
    benefits to abortion. The Affordable Care Act already broke
    that precedent by creating a system of tax credit subsidies for
    coverage, which the Act itself referred to as Federal funding.
    My prepared text provides additional details, and I'd be happy
    to answer questions. Thank you.
        [The prepared statement of Mr. Doerflinger follows:]

                                   __________
        Mr. Franks. We will now go into the time for questions. And
    I would thank each of the witnesses for their testimony. And we
    will proceed under the 5-minute rule. And I will begin
    recognizing myself for 5 minutes.
        Ms. Alvare, I would note that Mr. Doerflinger quoted Harris
    versus McRae in the court. And the court said, ``No other
    procedure involves the purposeful termination of a potential
    life.'' And affirmed that Roe versus Wade had created a
    limitation on government, not a government entitlement. Three
    years earlier, the Supreme Court had ruled that the
    government's refusal to fund abortion placed no restriction on
    the ``right to choose abortion.''
        Your testimony was especially compelling when you mentioned
    about women's attitudes toward abortion in the coming days. And
    my friends on the left, oftentimes when they are faced with an
    indefensible position try to change the issue to something else
    entirely. And it is very difficult then to debate the issue in
    any effective way.
        Can you tell me how both of those stated concerns coincide
    with H.R. 7, in your opinion?
        Ms. Alvare. If I could clarify, the stated concerns
    regarding what is said in Harris versus McRae?
        Mr. Franks. The court's decision and also women's attitudes
    toward abortion.
        Ms. Alvare. Yes. I mean, the court's decision is very
    clear. It's established as a matter of law. But I think it also
    seems as a matter of common sense to many people in the United
    States that refusing to fund something is not a statement that
    the government has done away with what is still in this country
    a constitutional right, and the court just drew that line very
    clearly. It's mystifying to me sometimes when people make this
    argument; from the common sense perspective, it seems as if
    they're saying that somehow 1.2 million abortions a year isn't
    enough. That in order really for us to say we have some robust
    right of abortion, we have to have an even higher rate than
    3,300 abortions a day. We already know that poor women are
    getting a disproportionate number of these, and that they
    disfavor abortion more than the well off. Right? We also have
    minority and immigrant women disfavoring it more than majority
    American women.
        And so the idea that it is an interference is problematic.
    The other statement that comes to mind in connection with this
    is, you know, if you look at Planned Parenthood, the largest
    abortion provider's most recent balance sheet, I mean, in
    addition to the giant amount of government funds they have,
    they have $500 million a year of nongovernmental funding. If
    it's so important to them that there be more abortions among
    the poorest women in the United States, I would wonder why they
    don't follow the example of the over 3,000 crisis pregnancy
    centers who are contributing private funding to women, about
    $25,000 per woman per year in the residential facilities, and
    there are over 350 of those. So that entire argument that
    somehow a right has to equal funding it and the funding has to
    come from the government, it is neither legally supported, nor
    is it supported in common sense, nor would poor women in
    particular support that.
        Mr. Franks. Yes, ma'am.
        Thank you very much.
        Mr. Doerflinger, I know some States have made their own
    decision on what to do about abortion coverage on their
    exchanges. Can you give us an update on what has happened in
    that regard?
        Mr. Doerflinger. Yes, Mr. Chairman. Since the Affordable
    Care Act passed, 24 States have acted to opt out of the
    abortion policy on the State exchanges set out by the Federal
    Government, the presumptive policy in which Federal funds are
    used to subsidize plans that cover elective abortions. Then
    there's a little bit of separate bookkeeping, separate
    accounting for the funds used for abortion. But everybody in
    those plans is forced to pay that surcharge for abortion.
    States have looked at that policy and said, no, we're going to
    take elective abortions off the exchange altogether in our
    State. And that policy goes farther than H.R. 7, which only
    removes elective abortion from plans receiving the Federal
    subsidies.
        Now, of the 13 Members of this Subcommittee, 10 of you are
    from States that have made that decision to simply take
    abortion off the exchanges, and four of the five Democrats on
    this Subcommittee, are from States that have made that
    decision. You passed the bill with this abortion policy, and
    your own States have said no. That's the trend now. In fact,
    more States than ever have taken this opportunity to actually
    reach out and say that abortion will not be available in
    private plans off the exchanges--except, in most cases by
    supplemental riders. Ten States have done that.
        So the trend out there in the country is that about half
    the States now have said, no, we want a firmer policy against
    abortion on these State exchanges.
        Mr. Franks. I thank the gentleman. And I will now recognize
    Mr. Nadler for his 5 minutes of questioning.
        Mr. Nadler. Thank you. Professor Wood, the Affordable Care
    Act requires participating insurance plans to segregate monies
    for abortion services from all other funds, a measure my anti-
    choice colleagues insist was necessary to prevent Federal
    funding of abortion. To aid in identifying these funds, both in
    terms of premiums being paid for coverage and costs for
    services provided, the law requires companies to estimate the
    cost of abortion coverage at no less than $1 a month. Some have
    characterized this segregation of funds as an abortion
    surcharge. Is this an accurate description?
        Ms. Wood. The short answer to that question is no. As you
    have correctly stated, this is a general premium to provide for
    all health care services. And because of the Nelson Amendment
    to--it both avoids use of Federal funds primarily to avoid the
    use of Federal funds, the segregation of the private dollar
    contribution of at least $1 a month is to be set aside to pay
    directly for those services. And indeed, there are accounting
    responsibilities of the insurers to make sure that they can
    demonstrate to their State insurance commissioners that they
    have indeed complied with the statute.
        So I think in this case, it's clearly not a surcharge. It's
    a segregation of the premium. And women who or family plans who
    choose not to have a plan that does not provide abortion
    coverage, the option to purchase that is available to them.
        Mr. Nadler. You mean that plans that choose not to have a
    plan that covers abortion, don't you?
        Ms. Wood. I'm saying aside from the plans that cover
    abortion, there will be plans available to choose if that is
    such an important issue.
        Mr. Nadler. So it would be inaccurate to claim that an
    individual that objects to abortion will be forced to
    participate in or pay for a plan that covers abortion, or as
    Mr. Doerflinger put it, to subsidize someone else's abortion?
        Ms. Wood. That is correct.
        Mr. Nadler. And that would be inaccurate because?
        Ms. Wood. That is because plans in the statute, it does
    call--though there is no requirement to cover abortion, sort of
    in a balancing way, there is a requirement that there be plans
    available that do not cover abortion that an individual can
    choose. And, indeed, that information about coverage of
    abortion must be made available through the summary of benefits
    that would be provided upon purchase.
        Mr. Nadler. Okay. So now tell me, how common is it now for
    insurance plans to cover abortion services now, and how would
    that change if H.R. 7 is enacted?
        Ms. Wood. I think this is the crux of the matter. Since the
    beginning when people have been measuring this, abortion has
    been covered. And I think it is important----
        Mr. Nadler. Has been covered by private insurance.
        Ms. Wood. Has been covered by private insurance.
    Absolutely. And because it has sort of been--and it has not
    been called out or controversial. It has been part of the
    general medical and surgical benefits that are covered as
    needed by any individual. And it is important to remember that
    insurance is set up just as that. It is for those anticipated
    and unanticipated things that can happen in your life. We will
    all need health care at some point. We may not know what it is.
    Maternity care hopefully is planned anticipated coverage.
        Mr. Nadler. So that has always been included. How would
    that change if H.R. 7 is enacted?
        Ms. Wood. Okay, sorry. Yes, it would change dramatically, I
    think, and this is the analysis we did just in looking at the
    Stupak amendment, but we think it applies also even more so to
    H.R. 7, which is it will create a change in the insurance
    market because if insurers have to tease out not an entire
    class of benefit, but specific procedures under specific
    circumstances, they will likely, over time, begin to decide
    that this is not worth the effort, it is not worth the----
        Mr. Nadler. So in other words, this bill would have the
    effect of getting private insurance companies that now offer
    coverage to not do so?
        Ms. Wood. We project that eventually would change, and we
    have used the word tipping point. That historically plans have
    covered abortion under medical health insurance, and now it
    will tip to the norm being non-coverage.
        Mr. Nadler. And I would assume that that is really the
    point of the bill.
        Ms. Wood. Right. And the concern would be regulations that
    might be issued by the IRS, having to document, et cetera.
        Mr. Nadler. So last year we had concerns given the
    unprecedented tax provisions in the bill that this could
    require some pretty invasive regulatory enforcement procedures
    for women who are pregnant as a result of rape or incest and
    for women whose lives are endangered if they continue
    pregnancy. Is this a concern?
        Ms. Wood. Absolutely. Having to make that determination is
    not something that either the IRS, insurance companies or
    Congress should really be involved in.
        Mr. Nadler. And setting aside the privacy concerns, how
    might uncertainty over how an expense might be treated by the
    IRS impact women and how might it impact insurers?
        Ms. Wood. Well, I think impacting women, to have to
    document a rape or a condition of incest is traumatic at the
    minimum. I think in terms of insurers, they do not want to be
    in the place of having to make a determination of which is an
    acceptable exception to the ban on coverage, or whether it
    needs to be covered by either the woman herself or by this
    potential rider that would then need to be coordinated with the
    base plan.
        This raises a lot of regulatory and oversight and
    implementation concerns that insurers have traditionally never
    been involved in and would--in their traditional way would be
    to just cut out that entire set of coverage entirely and not
    want to go into making those determination, leaving all
    abortions uncovered.
        Mr. Nadler. My time has expired. I thank you.
        Mr. Franks. We will now recognize the gentleman from Ohio,
    Mr. Chabot, for 5 minutes.
        Mr. Chabot. Thank you, Mr. Chairman. Mr. Doerflinger, let
    me begin with you, if I can. Can you explain the stance that
    the Catholic Bishops Conference took on the Affordable Care Act
    and why that organization ended up opposing final passage of
    the bill?
        Mr. Doerflinger. Yes, sir. The bishops have been in favor
    of government involvement in ensuring people's access to health
    coverage since 1919, when they made a statement after World War
    I about social reconstruction. We were very much in favor of
    pursuing health care reform, and we put out a great many
    materials saying basically that we hope Congress will address
    this problem, we want to move to universal health coverage, but
    there are moral principles that that should respect.
        The coverage should be affordable and fair, it should
    extend to everyone-- and in that respect, the final bill, in
    our view, and I know I will disagree with some of the majority
    Members of this Committee on this, we felt it should fully
    cover immigrants, regardless of their legal status. We felt it
    should respect the existing longstanding policies in all of
    these other programs, that Federal funds do not get used for
    abortion or any part of a health plan that covers abortion.
    That is current law now in the Hyde Amendment, in Federal
    Employees Health Insurance, in the SCHIP program. And, thirdly,
    we felt that it should have strong protections for rights of
    conscience, which of course, it does not, as witness two cases
    that are going up to the Supreme Court now.
        So in the end, we were very encouraged by the House bill.
    The Stupak amendment was approved with the support of 64
    Democrats, including House Appropriations Committee Chair David
    Obey. We had a bipartisan agreement that we are going to set
    this abortion issue aside and talk about health care. And then
    the Senate changed it back.
        I don't know why we are talking about a Nelson amendment. I
    think Mr. Nelson convinced Harry Reid to put in some additional
    accounting procedures, but what is in the bill now is basically
    the Lois Capps amendment that was prepared by----
        Mr. Chabot. Let me stop you there, if I can, just because
    we have got limited time. Despite claims from the
    Administration that the Affordable Care Act abides by the
    principles of the Hyde amendment, we know that health care,
    Federal tax subsidies are paying for health care plans, or
    will, including elective abortions.
        Is it your belief that additional tax subsidies like this
    to individuals to pay for health care plans which could have
    elective abortions will, in all likelihood, increase the number
    of abortions performed in this country?
        Mr. Doerflinger. Of course. You know, Dr. Wood said that
    most plans have abortion, and that is true, but that is not
    because people want it. Sixty-eight percent of women, in the
    last poll we did on this, are against having abortion in their
    coverage. And so those decisions are being made largely by the
    for-profit insurance companies because abortion is cheaper than
    a live baby. Wow. Imagine that. Live babies are more expensive
    than dead ones. So the insurance companies have an economic
    incentive to promote abortion coverage and they include it.
        Mr. Chabot. Let me cut you off there if I can at this time.
        Mr. Doerflinger. But what this bill says is we are not
    going to put Federal funds into encouraging that bias.
        Mr. Chabot. Thank you. Ms. Wood, let me turn to you real
    quickly. Why did President Obama issue his executive order
    which purported to curb abortion funding or stop funding?
        Ms. Wood. I think it is clear that the Affordable Care Act
    already through the Nelson amendment ensures that no Federal
    dollars are going toward abortion. And that certainly is a
    conversation we can have about, you know, my opinion that those
    bans are not appropriate, but that that is, in fact, what is in
    the Affordable Care Act. And his memo merely confirmed what was
    already in the statute.
        Mr. Chabot. Thank you. Ms. Alvare, let me turn to you if I
    can here. You had stated in your testimony that, and I am
    putting this in my words, you said that women really don't
    support abortion overall, even though we sort of think
    politicians think that, the press kind of says women are for it
    and men are against it, you know. Would you clarify that a
    little bit?
        Ms. Alvare. Yes. The best study I have seen on this with
    really great cross-tabs, very detailed on women at every income
    level, women of different racial and educational background,
    was the RAND Corporation in cooperation, I think it was with
    the Packard Foundation, Rockefeller Foundation. You know, these
    are groups that are supportive of population control policies
    generally, including often abortion.
        But what you see, and you see this in not only the
    quantitative but also the qualitative studies of poor women,
    the best book ever on this, Promises I Can Keep, Why Poor Women
    Put Motherhood Before Marriage, that there is this disapproval
    particularly among poor women, of abortion, just a moral
    disapproval of it and a desire that it not be normalized or
    encouraged. If you look at the ratio of unintended or out-of-
    wedlock births among the poor, they abort a lower ratio of
    those than do people who are better off.
        So not only is it that women are not supportive of this. I
    mean, this is a top-down sort of groups claiming to represent
    women sort of proposal. It is a political thing, it is not a
    health care thing, and it certainly does not speak for
    grassroots women, particularly poor women in America.
        Mr. Chabot. Thank you very much. I yield back, Mr.
    Chairman.
        Mr. Franks. I thank the gentleman. I now recognize Mr.
    Cohen for 5 minutes.
        Mr. Cohen. Thank you, Mr. Chair.
        Ms. Alvare, let me ask you a question. Do you believe this
    bill, H.R. 7, would include birth control in making it illegal?
        Ms. Alvare. No. My understanding is that it addresses
    abortion.
        Mr. Cohen. Only abortion. Okay. Let me ask you this too.
    Does this bill ban a State like Arizona from spending its local
    funds on abortion?
        Ms. Alvare. It is my understanding that if a State wants to
    spend its own money on abortion, that a State can do that.
    States already do that.
        Mr. Cohen. So it doesn't ban a State like Arizona from
    doing that, or Arizona hospitals from performing abortions. It
    doesn't ban that either?
        Ms. Alvare. The question in this bill is taking Federal
    funds out of it. If you are really--you have to be speaking,
    and I am sure a particular hospital, a particular locale would
    be able to give you, sort of an Arizona expert would be able to
    give you statements about whether their hospitals, their
    locales, et cetera, how or how much or in what way they
    interact with Federal funding. But, again, the purpose of this
    is to draw the lines between Federal funding for abortion----
        Mr. Cohen. How about D.C.? Would it affect D.C. hospitals
    and D.C. from spending its local funds on abortion?
        Ms. Alvare. It is my understanding because of the
    definition of D.C. for the purposes of this bill and obviously
    in connection with a longstanding relationship between the
    Federal Government and D.C., that, yes, it would prevent D.C.
    from spending money that it wished to spend, which is a good
    thing.
        Mr. Cohen. I know you were not a Member of Congress and you
    weren't here during the Republican shutdown, but during that
    shutdown, the Republicans almost were unanimous in favor of
    letting D.C. spend its local funds, even during the shutdown.
    So there seemed to be kind of a bright chink in the armor of
    D.C. being a Federal----
        Ms. Alvare. I am not actually political on these question.
    I try to take a principled or a legal or empirical view. I am
    not about recognizing the political----
        Mr. Cohen. Let me ask you a question. You mentioned a lot
    of polls about lower income people and pro-life----
        Ms. Alvare. I am sorry, I couldn't hear you, sir.
        Mr. Cohen. You mentioned a lot of polls about low income
    people and their positions on pro-life.
        Ms. Alvare. On abortion and abortion funding.
        Mr. Cohen. And that most low income people you said, poor
    people, were pro-life. And you talked about pro-life and the
    Federal Government, and because it was death and it was
    gruesome and it was ugly and all those things. Most polls, and
    there are more polls that I can name, show that most pro-life
    people, women, are also in favor of the death penalty. How do
    you reconcile that, because that type of death is gruesome?
        Ms. Alvare. Two things. Number one, I could not personally
    or principally reconcile it myself and that is why I have been
    publicly on record against any Federal support for killing,
    whether it is the death penalty or abortion.
        Mr. Cohen. How about war? How are you on war?
        Ms. Alvare. Number two, I guess I haven't written anything
    on it outright. Because of my background, which is an overlap
    of both philosophy, theology and law in the area, I am--I guess
    you would say my general position would be, in case this
    matters to you or would help shape your opinion on the bill, I
    am not sure how it relates to anyone else's opinion around
    here, I am in favor of life. And in my knowledge of the church,
    its just war theory in particular, which I think is a very good
    outline of the theory, would probably be an explanation of my
    position, if that is influential to you. I hope it would be.
        Mr. Cohen. Right. Just for time limits. Mr., is it----
        Mr. Doerflinger. Doerflinger.
        Mr. Cohen. Doerflinger. You work for the church, is that
    correct, for the bishops?
        Mr. Doerflinger. That is correct.
        Mr. Cohen. And Ms. Alvare is a consultant. Now, the Pope
    has been real good on saying that these issues concerning gays
    and abortion are part of the Catholic history, but that they
    should be kind of lessened in terms of the real big issues,
    which is the great disparity in wealth between the wealthy and
    the poor, and we need to do more things about taking care.
        I wonder what you or either of you all are doing to try to
    influence my colleagues to do things about unemployment
    insurance, to do things about food stamps support and Meals on
    Wheels and things like that, and maybe tax policy that kind of
    levels the playing field out so you can do the Pope's work here
    in the United States Congress? I am a big fan of the Pope's new
    positions. I am just wondering what you were doing to move
    those forward.
        Mr. Doerflinger. I have to begin by differing with you on
    the interpretation of what Pope Francis has said, because what
    he has said is that all of these issues are important, but it
    is better to put them in a deeper context as a consistent
    message about the dignity of all human beings than to treat
    them as individual political positions. What he said about
    abortion is that----
        Mr. Cohen. Let me ask first, what did he say about the
    disparity in wealth?
        Mr. Doerflinger. He said there is a huge problem in the
    disparity of wealth. And I would say this. Yesterday was the
    50th anniversary of President Johnson's announcement of the War
    on Poverty. That is an issue that is very close to the bishops'
    hearts. The bishops just yesterday sent up a letter encouraging
    Congress to increase the minimum wage. We are celebrating
    Poverty Awareness Month--January is Poverty Awareness Month--by
    educating Catholics about the need to fight poverty. Our
    Catholic Charities, our Campaign for Human Development, our
    Catholic Relief Services are out there providing help to
    millions of people in poverty, and I think doing--no offense
    intended--doing so more effectively than many government
    programs do.
        We are very much in favor of the War on Poverty. But we
    also insist, and so does Pope Francis, that the War on Poverty
    must never become a war on the children of the poor. Pope
    Francis has said it is not progressive to try to solve our
    problems by eliminating a human life.
        Mr. Franks. The gentleman's time has expired.
        Mr. Chabot. Mr. Chairman, I would ask unanimous consent
    that the gentleman be granted an additional 30 seconds and I
    would ask the gentleman to yield to me if he would.
        Mr. Franks. Without objection.
        Mr. Cohen. I don't have a problem. I yield.
        Mr. Chabot. I thank the gentleman for yielding. My only
    point was he was just about to say on abortion the Pope said,
    and then you cut him off and we never heard, and I would be
    interested to hear what the Pope said on abortion.
        Mr. Doerflinger. Oh, I am sorry. Just that this dignity of
    life, even from the very beginning, is so intimately linked
    with all our other human rights, that if you take a wrong turn
    on that, it undermines the basis of all the other rights we are
    trying to fight for. That has been said by Pope John Paul II
    and Pope Benedict and it has been said by Pope Francis as well.
    He said the church is not going to change its position on this.
    If it changes its position on this, its whole moral logic about
    the dignity and rights of every human being falls down.
        Mr. Chabot. I thank the gentleman for yielding.
        Mr. Franks. I would now recognize the gentleman from Ohio--
    I am sorry, the gentleman from Iowa, I am getting the folks
    mixed up here, Mr. King. I am sorry, we have got the list here.
    I recognize the gentleman from Virginia, Mr. Forbes, for 5
    minutes.
        Mr. Forbes. Thank you, Mr. Chairman. I want to thank all of
    our witnesses for being here. I know you are all incredibly
    good people, smart people, passionate about your issues. These
    are complex issues. Sometimes in these hearings, we do truly
    the forest for the trees when we get off on poverty, war,
    peace, death penalty, those kinds of things, and we have to
    keep trying to bring it back to something we can get our hands
    around.
        Ms. Wood, I would just like to ask you a question if I
    could to try to get at that core. I had someone the other day
    that is a friend of mine and they showed me a small video of
    this new baby they were going to have that is going to be their
    grandchild. And it was only a few weeks old and they were just
    amazed at what they could see.
        What do you call that? And I want to use the nomenclature
    you want so that I am not offensive to you. But before that
    entity is born, which I would call an unborn baby, but what
    would be the vernacular that I should use that would be
    appropriate?
        Ms. Wood. Depending on the stage, it would be an embryo or
    a fetus.
        Mr. Forbes. Okay. In that embryo, and I will use that
    terminology because it is the one that you pick, or we could
    use fetus, either one, is there no procedure, no action that
    could be taken against that embryo, no harm committed, no
    matter how horrendous it might be, that you would feel should
    be prohibited?
        Ms. Wood. I think the key perspective we have to take here,
    and this is, again, one of the unknowables, is what is the
    circumstance of the individual woman that is trying to decide
    whether to become a parent, what is her circumstances, what is
    her health needs. And therefore, I think there is real--taking
    it from that thinking where I don't stand in her shoes and none
    of us can really know what is going on in any particular----
        Mr. Forbes. And I appreciate that. I am sorry, I think my
    volume----
        Ms. Wood. And those decisions are made based on her health
    needs and that of her physician----
        Mr. Forbes. And I fully understand that. I am not arguing
    with you. I am just saying it would be your position, as I
    understand it, that there would be no procedure, no action
    taken, no harm committed to that embryo by your definition,
    that would be so egregious or so bad that we would prohibit it
    so long as that mother or that woman said it was okay to do it.
    Is that a fair interpretation?
        Ms. Wood. I don't think it is a really relevant--I mean, I
    don't fully grasp the question, because I think it is important
    to say that there are--things need to be done with good medical
    care in the context of high quality medical care.
        Mr. Forbes. But that is not where we are. Where we are at
    is trying to, one, get the baseline and then determine the
    continuum and then determine what Federal dollars can be spent
    on it. But as I understand your position, there is no
    procedure, there is nothing that we could do to that embryo, in
    your vernacular, as long as that mother or that lady said it
    was okay, there is nothing we could do that you would feel
    would be a bridge too far that should be prohibited?
        Ms. Wood. I think I would still say that it would be
    something within the determination of the woman and her health
    professional, and if they came up to some--and I am not a
    medical professional. I don't want to say what medical
    procedures are correct or incorrect.
        Mr. Forbes. I understand. But I am just saying that as I
    understand you, there is no procedure, nothing, that would----
        Ms. Wood. I think you are misconstruing my testimony.
        Mr. Forbes. Then please clarify that for me. Tell me what
    procedures you think would be too egregious to that embryo,
    that even if the mother or the wife said it is okay that you
    would think would be too far and shouldn't be allowed?
        Ms. Wood. I think if the woman is getting unsafe abortion
    care, that is egregious. I think there are medical procedures
    which are not acknowledged or shown by evidence to be safe and
    effective. And I think those need to be----
        Mr. Forbes. But nothing as far as that embryo is concerned?
        Ms. Wood. I think you don't separate in this case the
    embryo and the mother. They are--the woman is in the
    circumstance with her health care provider to make those
    determinations.
        Mr. Forbes. Mr. Chairman, since my time is running out, I
    would simply allow Mrs. Wood, if she has such procedures, such
    actions that could be taken to the embryo that she thinks
    should be prohibited, even if the mother says it is okay to do
    it, if she would submit those for the record. But at this point
    in time, through all my questioning, I have heard none. And so
    if the record could just state that. And then if she would like
    to supplement that, we would love to give her that opportunity.
        With that, I yield back, Mr. Chairman.
        Mr. Franks. Without objection, we would ask Ms. Wood to
    provide us with that answer.
        I would now recognize Mr. Deutch for 5 minutes.
        Mr. Deutch. Thank you, Mr. Chairman.
        Mr. Chairman, I am struggling some to figure out why we are
    here today. As the Ranking Member pointed out earlier, Federal
    funds haven't been used for abortion in 30 years. Federal funds
    have not been used for abortion in 30 years. So if the problem
    that we are truly trying to solve is to keep taxpayers from
    footing the bills for abortions, mission accomplished. However
    you feel about it, mission accomplished.
        But keeping taxpayer funds away from abortion isn't why we
    are here. Instead, this Committee, on a regular basis, seems
    intent on picking away at a constitutionally protected right
    with misleading backdoor legislation. Whatever your personal
    feelings about abortion, and whether you would want a woman in
    your family to make that choice or not, we must all recognize
    that that woman has a constitutionally protected choice to make
    about her own body. To create new restrictions on the coverage
    of abortion by private insurance companies in the guise of
    taxpayer protection I think is outrageous, and I have some
    questions for the witnesses that I just would like to probe.
        Mr. Doerflinger, starting with you, I respect entirely your
    belief based on sincere and strongly held religious tenants
    that abortion is wrong, and I have the same respect for my
    colleagues, for so many of my colleagues on this Committee. But
    here is where we disagree. America is a multicultural society.
    We don't all subscribe to same religion. I don't believe that
    one religious view should be imposed on others, and using the
    massive power of the Federal Government to force others to
    share your religious views or penalize those who view
    differently is a dangerous approach. So I just would like to
    explore that with you, some.
        If a majority in Congress had strongly held religious
    belief that blood transfusions were immoral, would it be
    appropriate for that majority to ban blood transfusions?
        Mr. Doerflinger. We are not talking about banning anything,
    sir.
        Mr. Deutch. Would that be appropriate for the majority to
    do that? That is the question I am asking you. We are just
    engaging in some hypothetical situations, Mr. Doerflinger?
        Mr. Doerflinger. No.
        Mr. Deutch. And what about vaccinations? Some have strongly
    held beliefs on the matter of vaccinations. In your view, would
    it similarly be permissible for a majority in this Congress to
    ban vaccinations?
        Mr. Doerflinger. No.
        Mr. Deutch. And for people who hold religious objections to
    alcohol and tobacco, there is insurance, maybe this one gets
    more at this issue that we are talking about today, there are
    insurance plans that provide coverage for smoking cessation and
    treatment of diseases borne out of alcohol and tobacco use. If
    a majority of this Congress felt that there is no reason
    taxpayer dollars should be used to support treating disease
    borne out of alcohol addiction, should we be able to take that
    action akin to what this legislation does with respect to
    abortion?
        Mr. Doerflinger. No, nor should the government force people
    to fund those addictions.
        Mr. Deutch. And let me just go on because I have a few more
    and only limited time. I am sorry.
        Mr. Doerflinger. But this is all irrelevant to the bill at
    hand.
        Mr. Deutch. It is not irrelevant. Ultimately, sir----
        Mr. Doerflinger. You are making a fundamental----
        Mr. Deutch. No, no, let me explain my own position, which I
    thought I had already done but I will do it again. The
    suggestion in this bill, what this legislation does is despite
    the argument that we are protecting people from the Federal
    Government, it says that the massive power of the Federal
    Government can be used to shut down a constitutionally
    protected right.
        Mr. Doerflinger. That is absolutely false.
        Mr. Deutch. That is what this legislation does.
        Mr. Doerflinger. Have you read the bill, sir?
        Mr. Deutch. I had, indeed, read the bill, Mr. Doerflinger.
        Mr. Doerflinger. Section 304 says you are wrong.
        Mr. Deutch. I appreciate your asking. And the other thing
    that is so troubling to me, I have one more question, it is on
    the same topic, just to finish out the list, embryonic stem
    cell research. Now, I know that embryonic stem cell research,
    despite its potential lifesaving revelations, is controversial
    in some parts. Should Congress be able to impose tax penalties
    on people who purchase insurance policies that cover cures that
    were devised from embryonic stem cell research?
        Mr. Doerflinger. There aren't going to be any cures from
    embryonic stem cell research, and this is not about penalizing
    it.
        Mr. Deutch. Mr. Doerflinger, I don't have the time to
    engage in that debate, but I would respectfully suggest to you
    that perhaps as you have encouraged me to take another look at
    the book, that you might well take a look at the research that
    is being done right now in research centers across the country
    before you suggest that there will be no treatments or cures to
    come from embryonic stem cell research, and for all of the
    people, for all the advances which have been made and the
    people whose lives could be improved by it, I would ask you to
    reconsider.
        And, finally, I would just suggest to Professor Alvare that
    she is exactly right, exactly right, when she says that what we
    ought to be doing is focusing on a real women's agenda. I
    agree. And my hope is, Mr. Chairman, that as we go forward in
    this Congress, we might focus on a women's agenda that
    acknowledges that women earn 70 cents on every dollar earned by
    men, and that minimum wage increases is a women's issues
    because two-thirds of minimum wage workers are women, and that
    if we raise the minimum wage, which is 30 lower than what it
    was in 1968, that we will see an immediate reduction in poverty
    among women, and that workers in 145 countries in the world
    have earned paid sick days, and the U.S. has no mandatory paid
    family medical leave policy. We are one of three counties in
    the world and the only industrialized country to not have
    mandated maternity leave.
        This is an agenda for women that this House of
    Representatives ought to take up. I appreciate your making that
    point, Professor Alvare, and I yield back.
        Mr. Franks. I thank the gentleman. And just for the record,
    this bill does not cause the massive power of the Federal
    Government to force people to make any decision. It simply
    prevents the massive power of the Federal Government to force
    taxpayers to pay for the killing of innocent unborn children.
        I would now recognize Mr. King for 5 minutes.
        Mr. King. Thank you, Mr. Chairman. I thank the witnesses.
    And I would first disagree with Mr. Deutch on the statement
    that the Federal Government hasn't funded abortions for 30
    years, and I would ask Mr. Doerflinger if he could speak to
    that.
        Mr. Doerflinger. Yes, sir. It is for 35 years that the
    Federal Government has been barred from using Federal funds for
    the vast majority of abortions. What has changed, what is new,
    and it is not a new effort by a cabal of mean-spirited
    conspirators as Dr. Wood would like to say, is that Federal
    funds have now moved into a vastly broader arena of the health
    care system. We are no longer talking about Medicaid just for
    the poor, we are talking about tax subsidies for the middle
    class--who, by the way, are presumably far more able than the
    poor to use their own money for abortion if they are not
    getting Federal funds.
        Mr. King. But I would ask you----
        Mr. Doerflinger. Now we are beginning to get into this
    arena----
        Mr. King. I would take you back 30-35 years and speak to
    Medicaid funding of abortions for rape and incest, and funding
    for Planned Parenthood while we are at it.
        Mr. Doerflinger. I am sorry, I didn't understand the
    question.
        Mr. King. Okay. First of all, has the Federal Government
    funded abortion through Medicaid funding in the cases of rape
    and incest over the last 30 years?
        Mr. Doerflinger. Yes, for many years.
        Mr. King. So those would be exceptions to Mr. Deutch's
    statement----
        Mr. Doerflinger. Certainly.
        Mr. King. As the Federal Government, I don't want to say
    ``we'' in this case, the Federal Government has consistently
    funded abortion.
        Mr. Doerflinger. Since 1993.
        Mr. King. Under Medicaid funding for the cases of rape and
    incest?
        Mr. Doerflinger. Yes.
        Mr. King. I thank you. And then we look at something like,
    I am pulling this number out of my head, I will say in the
    upper $300-plus million a year that goes into Planned
    Parenthood, is there a way that one could contrive, make the
    argument that none of that funding goes to abortion that funds
    Planned Parenthood?
        Mr. Doerflinger. Well, the Title X family planning program
    says that none of those funds can go to a program where
    abortion is a method of family planning. I don't have evidence
    that those funds are being directed toward abortion. I think
    what Planned Parenthood usually does is have its Title X
    program on family planning done at one clinic and then that
    clinic refers women for abortions to another Planned Parenthood
    clinic that is not a Title X clinic, and it does the abortions.
    So there is some separation.
        But even a Title X program, 1970 it dates from, put the
    funding ban broader than just the procedure of abortion itself:
    We don't want to put Federal funds into a program where these
    are done. So the idea that by just not funding the abortion
    procedure itself and taking that dollar out and switching it
    around, that that respects the history of American law in this
    area, is not true.
        Mr. King. And you wouldn't have to have a Ph.D. in money
    fungibility in order to figure out that $370-some million, some
    of that spills over into funding abortion through Planned
    Parenthood, even if it goes into administrative funds that in a
    broader perspective administer the upper side of that program.
        Mr. Doerflinger. Well, I don't want to get into funding
    Planned Parenthood. I think that is a different issue.
        Mr. King. I am happy to change the subject and I thank you
    for your response.
        Mr. Doerflinger. It is a little relevant. It is relevant to
    this extent, that by giving all this money to Planned
    Parenthood, we are giving money to the organization that does
    hundreds of thousands of abortions a year, more than any other,
    and I, for one, would like to see those funds devoted to
    organizations that are more clearly committed to the needs of
    women as well as their children.
        Mr. King. I agree, and I thank you. And I would turn to Ms.
    Wood and thinking back on your testimony, and part of your
    testimony was the statement to the effect that in the case of
    some women, abortion care costs more than their monthly rent. I
    have trouble calculating that equation. Could you explain that
    statement to the Committee?
        Ms. Wood. Yes. Particularly because of the nature of the
    very narrow exceptions that are allowed under H.R. 7, which is
    life endangerment, rape or incest, those women who have health
    concerns or fetal abnormalities may be facing later term
    abortions which can cost in the thousands of dollars.
        Mr. King. So you answer, then, would be, I think, in
    exceptional cases, it may cost a woman more for a single
    abortion than it does for her 1 month of rent check. Is that an
    accurate way to depict what you said?
        Ms. Wood. That is correct.
        Mr. King. Okay. I wonder how many abortions a month does
    she need at the going rate to keep up with the rent check?
        Ms. Wood. I do know that it pushes women into poverty.
        Mr. King. I accept your answer and I think it is fine. I
    want to, in the seconds I have left, speak to this issue
    because I have an opportunity to speak to it from the
    perspective of the church. And I am a Roman Catholic, I believe
    in good standing with the church and a faithful follower of
    much of the teachings. I was very concerned about the Catholic
    Church's involvement in the ObamaCare legislation as it moved
    through this Congress and the accepting of the Stupak
    amendment.
        Here in the middle of this political arena, I believe that
    the church was operating in a legislative arena that they
    didn't quite understand; that they didn't see that there was
    going to be a bait-and-switch on the Stupak amendment. That is
    what happened. And I think the Church's desire on the principle
    of trying to serve people and trying to get more people covered
    by health insurance, the things that you talked about, Mr.
    Doerflinger, about the dignity of every human person, which I
    believe, I think they got too far ahead of themselves on this
    and failed to understand that abortion was going to be part of
    this package and that Rahm Emanuel was the person that came up
    with the executive order that was going to amend ObamaCare
    after the fact.
        So I wanted to make this point in this hearing that I would
    ask the Church to come talk to some of us on the inside of
    these Chambers when these things come up and understand that we
    should first put the principle, it is the church's principle,
    of life first, and remember there is a principle of
    subsidiarity too. And we can serve people better many times the
    closer to the individuals that we can get those services than
    going broadly with a national policy that turns this over to a
    pro-abortion president.
        My heart is sick at what happened with ObamaCare. The
    conscience protection, the litigation with the conscience
    protection is a result of this desire as is the abortion
    questions before us today. And I think if we would reassert the
    principle of subsidiarity, we would better protect the
    principle of human life.
        Thank you, and I yield back.
        Mr. Franks. I would like to thank all of the individuals
    for their questions----
        Mr. Deutch. Mr. Chairman, I wonder if you could yield just
    10 seconds for Mr. King to clarify that it is his position that
    the Federal Government through Medicaid should not spend any
    dollars on an abortion in the case of rape, incest or to
    protect the life of the mother. Is that correct?
        Mr. King. I didn't state a position.
        Mr. Franks. So I would thank the witnesses for their
    answers. I would thank the Members here for their questions. I
    would suggest that the two most important questions asked today
    here is does abortion take the life of a child, and, if so,
    should taxpayers be forced to pay for it. And with that,
    without objection, all Members--I am sorry, we have been joined
    by Mr. Gohmert. I will now yield to him for 5 minutes.
        Mr. Gohmert. Thank you, and I appreciate the time and I
    appreciate the witnesses' patience. I was at another hearing.
    But I want to make sure that when my colleagues were bringing
    up the Supreme Court mandated authority to abortion, that
    people don't misunderstand. This hearing is not about the
    elimination of abortion, but as the Supreme Court said in Rust
    v. Sullivan, that in upholding Federal limits on abortion
    funding, they said, ``By requiring that the grantee engage in
    abortion-related activity separately from activity receiving
    Federal funding, Congress has, consistent with our teachings,''
    which I don't appreciate teachings from the court, they are
    supposed to make decisions, not be teaching, especially being
    lectured from people that are so duplicitous at times, but
    separately from this Congress consistent with our teachings,
    ``not denied it the right to engage in abortion-related
    activities. Congress has merely refused to fund such activities
    out of the public fisc.''
        And that is what we are talking about. And I hear people
    across America that have been--they have had the wool pulled
    over their eyes and they have been led to believe that some of
    us are moving laws that will end the ability to get an
    abortion, when actually what we are talking about here today is
    the right of religious beliefs, the right of conscience.
        And I know all three of our witnesses, from what I have
    been hearing, has come over the television, you know, you are
    all three very sympathetic to the plight of women, and nobody
    is more so than I am. I have three daughters, and when my first
    one I held in my hands, I could have held her in one but I
    didn't want to risk, she was so premature, I would do anything
    to keep her alive. And it is hard for me to fathom someone
    wanting to kill what I call a child, what some may call an
    embryo, when she is living in my hand at the same time a child
    of the same age is living in someone's womb.
        So I have been married for 35 years. I have three
    daughters. There is no war on women. But when I hear of
    countries around the world, and it seems to be creeping, the
    thought creeping into America, that we could give a woman the
    right to destroy a child in her womb because it happens to be a
    female. It is happening all over the world, China especially,
    babies being killed because they are a female? How long before
    some who support abortion with all of their heart, mind, and
    soul will say, wait a minute, wait a minute; the war on women
    has become a war on women in the womb, and at some point, at
    least please don't make people who see that as killing a child
    pay for others to kill that child. That is what we are talking
    about.
        Legislation, we talk about Supreme Court rights, my friends
    across the aisle about you can't go against Supreme Court
    rights. The Supreme Court has said over and over and over that
    forcing somebody to pay, against their religious beliefs,
    against their heartfelt beliefs, to pay for someone else's
    abortion is where the problem is. So I just think that hasn't
    been made clearly enough from what I had been hearing.
        And with regard to the Stupak amendment, Bart Stupak is my
    friend, I haven't seen him in a long time, but what he didn't
    know is what Mr. Rahm Emanuel said. ``I came up with an idea
    for an executive order to allow the Stupak amendment not to
    exist in law.'' Mary Poppins, a fictional character that I
    never saw until I had kids said that is something easily made
    and easily broken. It is not in law. We are trying to get it in
    the law. And I appreciate all of you being here today. Thank
    you.
        Mr. Franks. Once again, there is always tremendous
    intensities related to this debate, and sometimes people on
    both sides want to suggest that the one side doesn't care about
    the mother or the other side suggests that the one side doesn't
    care about the child. But ultimately it is my belief that
    history and time will point out that abortion on demand has
    been the ultimate war on women and America is better than this.
        With that, it concludes today's hearing. I want to thank
    our witnesses for attending. Without objection, all Members
    will have 5 legislative days to submit additional written
    questions for the witnesses and additional materials for the
    record.
        I thank the witnesses and I thank the Members and the
    audience, and this hearing is adjourned.
        [Whereupon, at 11:45 a.m., the Subcommittee was adjourned.]

                                A P P E N D I X

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                   Material Submitted for the Hearing Record

    Material submitted by the Honorable Jerrold Nadler, a Representative in
     Congress from the State of New York, and Ranking Member, Subcommittee
                     on the Constitution and Civil Justice

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