A Cautionary Tale
I’ve mentioned before that I like podcasts. I do a lot of walking and running, and I often listen to various podcasts at the same time.
One of my favorites is “Cautionary Tales,” a narrative podcast by Tim Harford. I can best describe “Cautionary Tales” by likening it to the shows that dissect place crashes. The podcast doesn’t always deal with plane crashes, but Harford, a master storyteller, usually relates the tale of something gone terribly wrong. The stories often include a surprising twist and a lesson about life.
I’m not nearly as good a storyteller as Tim Harford, but I do have a cautionary tale.
Abortion became legal in 1973 and a pro-life movement began seeking to overturn the Supreme Court precedent that struck down state anti-abortion laws.
They had some success. New technologies showed life within the womb in ways that had not been seen previously. Over the years, the share of Americans considering themselves pro-life rose from about a third to half the country. The number of abortions was in a long-term decline for almost 30 years. There was a pretty strong argument that pro-life was winning the argument by winning hearts and minds.
Then came Donald Trump.
To be fair, what happened next wasn’t all Trump’s fault. The conservative movement had been trying to appoint constructionist judges to the Supreme Court for decades and even many on the left – Ruth Bader Ginsburg among them – agreed that Roe v. Wade was bad law. The new conservative justices overturned Roe. Overnight, states were granted the authority to ban abortion.
And there was a backlash. Since the Dobbs decision was handed down, there have been seven state referendums on abortion questions and the pro-life side lost every one of them. There is also evidence that, rather than the decision being “baked into the cake” as many pundits had argued, abortion was a deciding issue in the 2022 midterms in which the expected red wave was blunted.
My theory is that a lot of pro-lifers weren’t really pro-life when the chips were down. It was easy to oppose abortion when everybody knew that the Supreme Court would block any law limiting abortion that state legislatures passed. In 2022, that changed and suddenly people had to live with the consequences of their legislation.
Ironically, that’s a lot like what happened in 1973. The court ruling short-circuited the process of working out a national consensus on abortion. The same thing happened again in 2022. The same forces that sparked the growth of the pro-life movement have now awoken and invigorated the pro-choice movement.
Now let me take a moment to say I’m personally pro-life. I’ve been opposed to abortion ever since I first heard that it existed in the early 1980s. The very idea seemed inconceivable.
But the country is not where I’m at. There was a sharp jump in pro-choice and a corresponding decline in pro-life identification that tracks closely with the composition of the new Supreme Court and the Dobbs decision. At about the same time, midway through Donald Trump’s presidency, that long-term abortion decline reversed and started trending upward.
Now, the Republican Party has removed the longstanding plank from its platform that had called for a national abortion ban, and the party’s nominee has pledged to be “great for women and their reproductive rights.” Of course, Donald Trump sometimes changes policy positions like he changes his suit so his actual beliefs and goals if he is returned to office are anybody’s guess.
It’s telling that he said that he plans to vote to overturn Florida’s strict abortion law when it goes before the voters in November. Trump reversed himself pretty quickly amid the Republican backlash, but who knows what he will do in the privacy of a voting booth?
But the truth is that this would probably have happened even without Trump. Any Republican president would have appointed similar (or possibly even the same) justices to the Supreme Court. Roe was destined to fall. It was just a matter of time.
There are a few lessons within this cautionary tale. One big one is that you can’t impose an unpopular rule on the country without creating a backlash. Big social changes need to work their way up from the grassroots.
Most Americans aren’t purely pro-life or pro-choice, instead favoring legal abortion with restrictions. Left to their own devices, the states might well have arrived at compromises that allowed early abortion but outlawed the practice at later stages. That’s where most Americans are.
Maybe we would have found a consensus on abortion, but we’ll never know. As it is, Roe is dead and a popular Christian Nationalist account on the platform formerly known as Twitter still asks, “Since Roe was overturned why hasn’t a single Republican governor banned abortion in their state?”
It’s a fair question with an easy answer: Republicans don’t want to ban abortion. It would be political suicide.
A second lesson is that you have to have a plan for victory. It took half a century to reverse Roe and Republicans still became the proverbial dog that caught the car. The Republicans want to press the attack in order to keep the pro-life base engaged but doing so also turns off general election voters and keeps the pro-choice opposition engaged. It’s a trap of their own making. The pro-life movement’s greatest victory has become its undoing.
This is the mix that has led Donald Trump, the heir apparent to the pro-life movement, to proclaim, “I’m very strong on women’s reproductive rights.”
The caution here is that a principled movement needs principled leaders who are capable of communicating their party’s vision and winning over the opposition. Donald Trump has not been that leader for the pro-life movement, perhaps because he doesn’t believe in its principles himself. Trump’s participation in the pro-life cause was transactional and he is ready to abandon it now that it is politically inconvenient.
It is easy to ridicule the Republicans for being out of step with the majority of Americans, but it wasn’t so long ago that Democrats were in the same boat. The Democrats forced their vision of healthcare reform on the country and paid for it with a string of electoral losses.
In the end, there are two ways to advance your agenda in politics. One way is to win people over and form a majority. The other way is to force your faction’s will on the rest of the country from the top down. And the Christian Nationalists want to impose a lot more on the country than just an abortion ban.
The problem here is that if your faction is a minority – and MAGA and Christian Nationalists are a minority – when the majority gets tired of being dictated to, those doing the dictating have to either allow their power to wane or get violent. I think that’s why that same Christian Nationalist account tweeted a message a few weeks ago that said, “Christians must learn to hate.”
If you think that’s a very unchristian thing to say, you’d be right. Jesus said that the greatest commandments boiled down to love God and love people.
When a minority is determined to impose its will on the majority, sooner or later violence is necessary and violence is easier when people are taught to hate. It’s usually easier to teach people to hate than it is to build a consensus. Hate comes naturally to us. At some point, we are ready to kill in the name of God and the cause of life
And that’s the cautionary tale.
rewriting history when it doesn’t suit you is also a cautionary tale. To Wit:
Democrats took the the Republican system in Massachusetts, based on Heritage Foundation concepts first developed in response to Hillary Clinton’s universal healthcare plan. Then they spent 13 months meeting with Republicans negotiating the details of the bill, voted with Republicans to add 72 amendments – and then got abandoned by those same Republicans who wanted to prevent a Democrat from getting a legacy legislative achievement. The tell is in the fact that dozens and dozens of repeal votes were never followed by any better, more functional healthcare reform plan. Never mind all the people who now get healthcare access from that Republican concept passed by Democrats.Report
Keep in mind when telling yourself that the PPACA was a Republican Idea that Romney actually vetoed most of it, and those vetoes were overturned by the (Democrat) Massachusetts legislature.
Also, most of the revenue-generation side of the PPACA has been rescinded by now, and its only lasting effect on most peoples’ lives is that there’s another piece of paper you need to file with your taxes every year. Some people did get coverage who didn’t have it before, but they got it through Medicaid expansions (which were a good thing, but maybe not the “We Fixed Healthcare” that everyone imagines.)
The only really useful thing the PPACA would have done was a national single-payer system, which was deleted by Democrats in the Senate before the bill passed.Report
Force all HC providers to have only one rate and advertise it.Report
Mississippians getting healthcare off the ACA did not get it through Medicaid expansions as our state has not expanded Medicaid. Ditto Alabama, Florida, Georgia, Kansas, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming.
Its also worth noting that the expansion – while covering 18.6 million Americans – has nothing to do with the additional 21.4 Million Americans who buy insurance at some cost off the exchanges. I guess over 45 million Americans counts as “some people” getting additional coverage.Report
The “exchanges” are Medicaid. The guys writing the PPACA knew they couldn’t call it “Medicaid” because they knew that people would say “but that’s for poor people” and ignore it.Report
You’re gonna need to show your work there skippy.Report
And I know you are not going to be able to because again, here in Mississippi -you can buy insurance on ACA exchanges but the state has not expanded Medicaid. Sure, the programs are aligned, and complimentary even in states with an expansion. But insurance purchased on the exchange is not Medicaid.Report
If you think PPACA did nothing, I guess preexisting conditions just aren’t on your radar, then?Report
Medicaid doesn’t ban you for having a preexisting condition.Report
Sure, but until the ACA private insurance could and did. And very few people on private insurance qualify for Medicaid absent a serious change in financial fortune.Report
Medicaid doesn’t ban you for having a preexisting condition.
PPACA was a Medicaid expansion, with half of it having a non-Medicaid brand for marketing purposes.Report
You keep saying that, but massive ongoing repetition doesn’t make it true.
That aside, the ACA did require all insurance companies to drop all pre-existing exclusions from their insurance. Since, as you may have noticed, the majority of Americans still get health insurance from their employers.Report
“You keep saying that, but massive ongoing repetition doesn’t make it true.”
*shrug* I guess I don’t have a response to “nuh-uh“. But as we’ve established through discussion on this website, what anyone intended when writing the PPACA doesn’t matter, because we had to pass the bill to find out what was in it.Report
Well since we have the bill, you need to do the work of providing a citation that shows that private insurance obtained through the exchanges is somehow Medicaid. Cause everything I find says its not.Report
I don’t know, is being an adult male a preexisting condition?
Here are, literally, the requirements for Medicaid in Georgia:
These are, to be clear, the _current_ requirements for Medicaid. Right now, in 2024.
Note those _also_ require absurdly low income.
It is amazing how many Americans, especially those on the right, are flatly delusional about what Medicaid covered without the expansion.Report
They aren’t delusional. It’s how they separate the worthy from the unworthy. And if you are in the hole between work provided health insurance and Medicaid you are not worthy.Report
Georgia has not accepted the ACA Medicaid expansion.
ETA: Sorry, you already made the point and I missed it. There are, however, only 10 states left that have not accepted the expansion.Report
“Here are, literally, the requirements for Medicaid in Georgia”
Right, that’s for Walmart-brand “Medicaid”. The Target-brand “PPACA Exchange” is much less stringent.Report
Going further back, the Republicans wanted to ban something that the Supreme Court arbitrarily declared to be Constitutionally protected. The Republican leaders didn’t do it until they won the people’s hearts and minds.
The abortion pill is like the cotton gin: a change in technology that makes a bad thing more common. The increase in abortions isn’t a sign of the pro-choice side winning hearts and minds.Report
right, because 67% of American wanting abortion to remain safe and legal through between 22 and 24 week is all about technology advancement.Report
It’s not just technological change.
Forcing women to stay pregnant requires repression and control to make them do what we want.
Our tolerance towards state repression/control of minorities has gone down.
Ongoing informed personal consent is also a lot bigger in modern medical ethics than it was.Report
The technology component goes in a bunch of different directions. There were of course back alley abortions but my understanding is that enforcement of the laws was spotty. If someone had cash and a willing doctor there wasn’t any real way to track it or prove what happened. Now everything is digitized and there’s a real prospect of highly intrusive medical monitoring and investigation which people (read: women) understandably hate, regardless of personal feelings on intentionally terminating a pregnancy.
This all of course isn’t helped by the simple fact that the best thing people most upset about abortion could do to prevent it is hand out contraception anywhere and everywhere, not send cops and prosecutors poking around peoples’ private lives.Report
If someone had cash and a willing doctor…
Black market so-called medical care created lots of horror stories. CDC thought right before Roe we had 130,000 self induced or black market abortions. Every hospital had a care unit to deal with this.
https://en.wikipedia.org/wiki/Unsafe_abortion#Abortion_in_the_U.S._before_1973_(Roe_v._Wade)
the best thing people most upset about abortion could do to prevent it
Mostly they’re not interested in preventing pregnancy, they’re interested in forcing people to stay pregnant.Report
I’m aware of the horror stories. The point I’m making is that the pro life movement’s expectations about people’s willingness to tolerate what it would take to do what they want are totally misplaced, and that technology has made that problem for them far more acute.Report
Which is why I keep bringing up the statistics on abortion approval. The anti-abortion crowd lost the hearts and minds side of the debate, so all they have left is state coercion.Report
They absolutely failed and I think they ensured they would fail when they put all of their chips in with the party that otherwise treats healthcare as a strictly personal problem and state support of the same as a juicy target of spending cuts. Everyone who thinks about the issue for more than 5 seconds realizes that the sort of every man for himself thinking that animated the Republican party up until about 2016 is the polar opposite of what an actual ‘culture of life’ might look like, and it’s way too late now for them to change course.
My hunch is that personal feelings on the subject are as muddled as ever. I myself (much to my chagrin) am a semi-practicing Catholic. I think the truly elective terminations of healthy, no extenuating circumstances pregnancies, is, on balance, the wrong thing to do. But I also think trying to do something like criminalizing it in the context of the actual existing American healthcare system and actual existing criminal justice system is also quite self evidently the wrong thing to do, and Americans very understandably will never accept it over the long run.Report
There are always “extenuating circumstances” if we use normal rules and ethics.
Basic pregnancy involves damage to the woman’s body that is deeply illegal/unethical for one person to inflict on another without consent. Basic pregnancy is a deeply life changing event.
Basic medical ethics prevent me from being forced to give blood, even to save a dying child. That’s the normal standard.Report
This is a hopelessly shallow understanding of things.
To use your hypothetical I don’t think the state should force a person to give blood to a dying child. I also do not think that the healthy adult who refuses to do it has made the right choice. Not sure why that’s so complicated for some people. As if the state is somehow the source and foundation of human morality. It isn’t and never can be.Report
Your link indicates a fatality rate of .03% in 1972, using black market 1972 technology.Report
“the best thing people most upset about abortion could do to prevent it is hand out contraception anywhere and everywhere”
Did they stop doing that a few years ago? Because the abortion rate went up.Report
I’m not going to pretend to know why that’s happened and no one knows yet if it’s a trend or a blip.
Nevertheless the connection between abortion rates and female access to contraception which tends to be downstream of things having health insurance and other markers of socio economic status is pretty well established. The general demographics of who is having abortions is also easy enough to identify with Google and they’re mostly below or only slightly above the poverty line. Part of the reason abortions are still comparatively way down from where they once were is the availability of contraception for anyone who has consistent health insurance and a CVS nearby.Report
Colorado is the poster child for this:
https://www.yesmagazine.org/social-justice/2019/06/05/abortion-teen-pregnancy-decline-coloradoReport
For what it’s worth, in 2022, Roe v. Wade was no longer the controlling precedent. Planned Parenthood v. Casey had taken over that role. Because, as you say, the basis for Roe was not that solid.Report
Roe became a totem. It didn’t matter what it said. It doesn’t even matter that it was poorly reasoned.
Roe == Abortion.
When Roe was overturned, it wasn’t “returned to the states” (whatever the hell *THAT* means), it means that Abortion was overturned.Report
This is a whole host of bad faith and disingenuous post hoc reasoning which is all Republicans have; keep lying to yourself that being against Abortion is being Pro-Life, what we’ve seen in just 2 years is the Republicans salivating at the thought of women dying and being in pain and ecstasy at the thought of chaining women into sexual slavery. Any claims to the contrary of that is sophistry and lies.Report