As is now widely known, added to the health care reform bill just passed by the House of Representatives was a provision barring access to abortion called the Stupak-Pitts Amendment. Passed with the support of sixty-four Democrats, Stupak-Pitts doesn’t merely prohibit coverage of abortion in a public option. It also forbids women who receive a federal subsidy from purchasing any health insurance plan that covers the procedure, even if the abortion is paid out of a separate pool of private premium dollars (for all the background and details, see my colleague Emily Douglas’ post).

If this highly regressive amendment makes its way into the legislation that Barack Obama eventually signs, millions of less affluent women who obtain access to affordable health insurance will thus join the ranks of low-income women on Medicaid, most of whom live in states that don’t cover abortion procedures. The two-tiered system that dictates who in America has "choice" (more privileged women do, less affluent women do not) will be further entrenched.

But if the social consequences of Stupak-Pitts are clear, the logic is not. Supporters of the provision evidently want to assure taxpayers that they will not be forced to subsidize abortion in any way. But if they are serious about this, why haven’t they drawn up an amendment abolishing tax breaks for employer-sponsored health insurance? As Jonathan Cohn has pointed out, this is by far the largest subsidy in health care policy today. (It is also a regressive subsidy, but that’s another story.) If the employer-sponsored insurance that a worker gets happens to cover abortion – which, in roughly half the cases, it does – than that taxpayer already subsidizes abortion.

The purists who don’t want any of their dollars to subsidize abortion have another problem. As Amy Sullivan of Time has observed, plenty of pro-life people likely have no idea whether their private health insurance plans include abortion services (in which case their premiums indirectly fund the procedure). The same goes for pro-life organizations. Sullivan did a bit of digging and found out that Focus on the Family provides its employees insurance through Principal, a company that – you guessed it – covers abortion procedures.

"If health reform proposals have a fungibility problem, then Focus does as well," Sullivan notes. "And if they don’t think they do have a fungibility problem, then it would be interesting to hear why they think the set-up proposed in health reform legislation is so untenable."