Related documents

Paul Stam, Jr. v. State of North Carolina et al.

ACLU Analysis: “The Legal Ability of Cities and Counties to Provide Health Insurance which Includes Abortion Coverage to Employees”

⇒ This story has been updated; see “Wake County no longer covering elective abortions for its employees”

It’s probably just coincidence, but as filings begin for the 2010 elections, Republicans on the Wake County Board of Commissioners are dusting off their party’s favorite wedge issueabortion.

Specifically, the three Republican commissioners are pushing to remove coverage for elective abortions from the health insurance plan for county employees. Commission Chairman Tony Gurley put the issue on the agenda for the public meeting on Monday, Feb. 15. Gurley maintains that the coverage is illegal under North Carolina law.

Democratic commissioners want the subject removed from the agenda. Commissioner Lindy Brown said Gurley is making a mountain out of a molehill for political reasons. “It’s the Republican agenda issue.”

County Manager David Cooke should decide what’s covered by the insurance plan, Brown added, not the commissioners.

Gurley and Brown are running for re-election this year, as are Republican Commissioners Joe Bryan and Paul Coble. (See “It’s a pivotal year for elections.”)

Sarah Preston, legislative director for the state chapter of the American Civil Liberties Union, says Gurley is wrong about the law on insurance benefits and abortion. “Providing such health insurance is a perfectly sound and legal decision for any city or county to make,” she concluded in a written memorandum on the question.

Preston said she’ll attend the Feb. 15 meeting. So will members of Planned Parenthood of Central North Carolina, said spokesperson Paige Johnson. About 80 percent of health plans cover elective abortions, according to PPCNC. “[Women] who don’t need it or don’t want to use it can choose not to,” Johnson says.”

“Politicians should not be allowed to pick and choose what reproductive health care is available to women based on personal opinions,” Johnson argues. “Do we want to talk about fertility plans? Men’s sexual issues? There’s a whole variety of things. It’s a very slippery slope to be on.”

Gurley says 12 women who work for the county used the abortion coverage benefit over the last six or seven yearsor since the county switched to a self-insurance program and brought the payment of benefits in-house. The county pays Cigna to administer the program. The cost of an abortion is between $400 and $600.

Wake’s Republican commissioners raised the abortion issue after it debuted in Apex. There, a Republican town council led by Mayor Keith Weatherly voted in mid-January to eliminate coverage for abortions, unless they were deemed medically necessary for the health of the mother.

As The Cary News reported, while the issue in Apex “was couched initially as a decision of fiscal responsibility, moral and political undertones loomed large.” Weatherly was quoted in the newspaper as saying, “Apex can’t actually prohibit abortions, whether it’s for an employee or not. But our plan can.”

Weatherly, who worked for strident choice foe Jesse Helms years ago, now is an assistant to N.C. House Minority Leader Paul Stam, R-Wake, an opponent of abortion rights throughout his career.

Stam’s role in the Apex and Wake County maneuvers isn’t clear. He refused to be interviewed by the Indy.

But Stam’s Twitter feeds indicate that he’s been closely following the national debate on health insurance, so doubtless he’s aware of the Stupak-Pitts Amendment, which would make it illegal for any insurance plan to cover elective abortions if the federal government subsidized the purchase of the plan in any way.

The amendment, sponsored by Rep. Bart Stupak, D-Michigan, and Rep. Joseph Pitts, R-Pennsylvania, would expand an existing law that bars the federal government from paying directly for abortions under programs like Medicaid.

Debate over the Stupak-Pitts Amendment seems to have triggered the Wake Republicans’ sudden interest in abortion coverage, though Gurley himself points to the factmuch-discussed in connection with Stupak-Pittsthat the insurance plans for federal employees don’t cover abortions.

Gurley, a lawyer and a pharmacist, was elected chair of the Wake Commissioners by parliamentary trickery, despite the fact that the board has a 4-3 Democratic majority. (One of the Democrats was in the bathroom when the vote was called but not officially “excused” from the meeting, so her vote was counted in favor of a motion to elect Gurley.)

Gurley says he’s personally “on the fence” about abortions.

“I realize it’s a very complicated issue … Unlike most issues, I can see both sides of the question. I will say they shouldn’t be paid for with taxpayers’ money. But not so far as to say that abortions should be illegal.”

But it’s not his personal views about abortion that caused him to put the issue on the agenda, Gurley says. It was the “fact,” which he insists is “settled law,” that the N.C. Supreme Court decision in the 1981 case of Stam v. State bars the counties and municipalities from funding abortions. “We have no choice,” he says. “This is a slam-dunk case.”

(Yes, it’s the same Paul Stam. He was the plaintiff in a case against a Wake County program that subsidized indigent women choosing abortions. The state’s highest court rejected his view that an unborn fetus was a “person” entitled to constitutional protections. But he won a judgment that the county had no legal authority to “fund medically unnecessary abortions.”)

But if Gurley’s right, why has Wake County, like most counties and cities in the state, included abortion coverage in its benefit plans for employees?

“It’s just a mistake,” Gurley says. The standard insurance packages offered by Blue Cross Blue Shield or Cigna contain it, and local officials need to take it outwhich they’ve somehow forgotten to do.”

The Indy asked Wake County attorney Scott Warren whether he agreed with Gurley’s interpretation of the law. Warren asked us to submit our questions in writing, which we did on Friday. When we went to press Tuesday night, he hadn’t responded.

Sharon Scudder, executive counsel for the N.C. Association of County Commissioners, said her group is looking at the issue but has not advised its members about it, only alerting them that it may be coming their way.

The N.C. League of Municipalities has no position either, said Kelli Kukura, director of government affairs. Kukura said the issue will be discussed at an upcoming meeting of the league’s insurance board.

The ACLU’s Preston, however, says the Stam case “has only a tenuous connection” to insurance benefits. In fact, her memorandum argues, North Carolina statutes give the counties and cities broad authority to provide “whatever compensation and benefits package the local government deems appropriate.”

It’s unclear how this issue will play out on Monday. Brown seems prepared to argue that the women who work for Wake County have a right to choose an abortion, and the commissioners shouldn’t be “micromanaging” their health decisions. Employees contribute to their health coverage, she added, which is part of their compensation, the same as salary.But Brown also said, “This is an administrative issue, which is what we hire David Cooke to do.”

Commissioner Stan Norwalk, also a Democrat, dismissed the subject as “another political game” by the Republicans. “This is purely an administrative matter, and it is a waste of time and effort to bring it before the [board].

“The county attorney interprets the law for Wake County,” Norwalk said. “The county manager is responsible for obeying the law.” Gurley, he added, is not the county attorney.

Democrat Betty Lou Ward did not respond to our call or an e-mail on the subject.

The Wake Commissioners meeting begins at 2 p.m. Monday on the seventh floor of the Wake County Courthouse on Fayetteville Street in Raleigh. A public comment period begins at 3 p.m.