From .......... GOVERNING AMERICA - An Insider's Report

By Joseph A. Califano, Jr.

67 ......................... ABORTION

When the President walked in to begin the Cabinet meeting two weeks later, on August 1, the first Costanza had attended after her women's meeting, he put his arm around her, kissed her, and said,

Whatever distance the President wanted from me on other policies, like school integration, the anti-smoking campaign. or Social Security cuts, he held me at his side whenever he spoke of abortion:

There were demonstrations, first in front of the building where my law office was located, then at the corner of Independence Avenue and Third Street, S. W., where the HEW headquarters and my offices were. The demonstrations, always peaceful but with increasingly sensational placards during 1977, were, as I looked out my window, a constant reminder of the potential of this issue to consume my energies to the detriment of other programs. A week after my confirmation, on January 31, 1977, Karen Mulhauser led a contingent of marchers from the National Abortion Rights Action League, carrying signs ("Califano Will Enslave Poor Women") that, however overdrawn they seemed to me, conveyed how many Americans felt. Coupled with the personal turmoil the issue stirred in several key managers I had recruited, both men and women, I decided it was imperative to set an overall tone and strategy from the beginning.

I was a bureaucratic child of the 1960s, acutely sensitive to the potential of an issue that touches on human life to kindle a consuming movement as the military draft fueled the anti-Vietnam War movement.

On abortion, the issue was life itself: If we all believed that life began at the same time, there would be no debate on abortion.

If all citizens believed life begins at the moment of conception, then they would consider it intolerable for their national government to permit, much less fund, abortion because it involves the elimination of life.

If, however, the body politic unanimously believed that life does not begin until the second or third trimester, or that there is no life until the fetus can be viable separate from the mother's body, then it would offend social justice for the government of such a single-minded people not to fund abortions for the poor when rich and middle-class women could easily obtain them to avoid serious illness or the later creation of retarded or physically handicapped life.

However, the American people are far from unanimous in their view of when life begins; indeed, disagreement on that issue has been so strong it spawned as bitter a social and political dispute as the 1970s produced.

68 .................... GOVERNING AMERICA

I concluded that it was not sufficient simply to express my view clearly and consistently, but that it was also essential to communicate the certainty with which I held it. Any hedging would only encourage those who disagreed to hope for a change that would not be forthcoming, and those who agreed to take steps to stiffen my resolve. By repeatedly and clearly setting forth my position, I could perhaps deflect the resources of some of the pro- and anti-abortion partisans to other targets they felt they had the opportunity to influence or the need to bolster.

My second conclusion was that I must do all I could to avoid unnecessary provocation. My obligation was to keep some measure of political decorum in this emotional debate. I did not have the luxury of an outside antagonist to be flip or hyperbolic. I refused to see or speak before pro-life groups who wanted to give me awards or roses, and I tried (not always with success) to avoid crossing picket lines or confronting demonstrators directly. In 1977, this involved going to a lot of places through the back door.

I had to display a calm and reasoned approach because of my obligation to enforce whatever law the Congress ultimately passed or the courts eventually declared constitutional. On this issue, above all, it was not enough for me to be fair; it was critical for the interested people to perceive they were being fairly treated.

Maintaining a sense of integrity was important not only to the Public, but to the professionals in the department. HEW's Center for Disease Control was charged with the surveillance of communicable diseases. Most commonly identified with monitoring and reporting on influenza or other communicable diseases, the center was also responsible for surveillance of abortions and abortion-related deaths in the United States.

In October 1977, at the peak of the legislative debate over Medicaid funding for abortion, there were reports that an Hispanic-American woman had checked into a McAllen, Texas, hospital with complications from an abortion improperly performed in Mexico. There were allegations that the woman was covered by Medicaid and had been told by a Texas doctor that if she had only come a few weeks earlier, she would have been eligible for Medicaid funding for an abortion, but now the law prohibited it. The woman died within a few days of being admitted to the hospital.

I called Bill Foege, whom I had recently appointed director of the center, and asked him to check out the reports. He came to Washington and nervously told me that while it was difficult to establish the facts because the woman might have gone to Mexico to keep the abortion secret, she had received two Medicaid-funded abortions before the Hyde amendment took effect.

Foege said, resting his paper on his lap as though trying to produce relief from a tension that still persisted.


GOVERNING AMERICA- An Insider's Report

From the White House and the Cabinet

By Joseph A. Califano, Jr.

Published by Simon and Schuster 1981

ISBN 0-671-25428-6