IS it a mountain or is it a mole hill?
Activists on both sides of the abortion debate are sparring over a forthcoming federal directive that affects only a tiny fraction of the abortions performed in this country every year.
The directive, expected to be released this week by the Department of Health and Human Services, will require states to pay for abortions under the federal Medicaid law in cases of rape, incest, or a threat to the life of the mother. Since 1981, Congress has blocked the use of Medicaid money, an entitlement for the poor, for abortions except to save a mother's life.
Abortion foes are touting what they say is the directive's symbolic significance - and crying foul over alleged broken promises by Clinton administration officials.
Abortion-rights advocates say their adversaries are exaggerating the magnitude of the edict, which they call a straight interpretation of a change in abortion-related law. ``All of this is much ado about nothing,'' says Kate Michelman, executive director of the National Abortion Rights Action League. ``The other side is stirring up something silly.''
In fact, she says, the inclusion of rape and incest as acceptable circumstances for a federally funded abortion is a ``small but important step'' in the process of ``removing the barriers to choice for poor women.'' The anti-choice side is generating a stir to make the Clinton administration seem more extreme on abortion than it is, she says.
Of the 1.5 million abortions performed annually in the United States, only a few hundred are Medicaid-funded to save the life of the mother. The addition of rape and incest means ``we'll be talking, at most, 2,000 abortions a year,'' says Roger Evans, legal counsel for the Planned Parenthood Federation of America.
The law for Medicaid requires states to pay for all medically necessary procedures for the poor, Ms. Michelman points out, and until 1981, that included abortions. The so-called Hyde amendment of 1981 ruled out federal money for abortions, except to save a mother's life.
IN October, Congress voted to keep the Hyde amendment, but to eliminate the exclusion for pregnancies that result from rape or incest. About half of the states bar the use of state funds to pay for abortions except to save a mother's life.
The National Right to Life Committee (NRLC), the nation's largest anti-abortion group, maintains that the Clinton administration broke numerous promises that it would still allow states to refuse to fund Medicaid abortions. And, says Douglas Johnson, legislative director of NRLC, the administration has shown that it is serious about establishing a national policy of ``abortion on demand.''
The forthcoming directive is a harbinger of the big battle expected over whether abortion services will be included in national health-care legislation, Mr. Johnson suggests. The Clinton plan does not mention abortion directly, but hints that abortion coverage would be included. When asked, administration officials have stated that abortion services should be a part of the basic health-care package that Congress approves. What remains unclear is how hard the administration will fight to keep that in the plan.
But for Johnson at NRLC, the fact that the administration took a law that appeared ambiguous and has decided to issue an absolute edict, shows that the White House is serious about widening the use of abortion as a form of family planning.
Some abortion-rights advocates and foes are also debating among themselves the question of how states may decide to prove that a woman is pregnant because of rape or incest. Some pro-choice advocates are worried states will pass rules requiring documentation from police that a woman has been raped in order to obtain a Medicaid-funded abortion. Many sexual assaults go unreported to authorities.
On the anti-abortion side, the concern is that sympathetic doctors will grant an abortion to any pregnant woman who claims she was raped or is an incest victim. But Mr. Evans of Planned Parenthood does not consider this a flaw: ``It's not a loophole because it still requires a physician to be convinced that abortion is necessary.''
Government agencies track how often doctors prescribe certain Medicaid-funded procedures, Evans adds, so established monitoring systems will detect if a doctor suddenly turns up with an abundance of rape abortions.
Johnson of the right-to-life group cites press quotes from administration officials that, he says, indicate they will look the other way on such abortions. ``They're really inviting fraud,'' Johnson says.