Yesterday Gov. Kathleen Sebelius underwent her first confirmation hearing to become Health and Human Services Secretary, testifying before the Senate committee on Health, Education, Labor, and Pensions (HELP). The hearings largely avoided issues of reproductive health, but near the end of the hearing, Sen. Tom Coburn (R-OK), a self-described "pro-life obstetrician," asked Sebelius about the so-called conscience clause, implemented at the end of President Bush's days in office. The Obama administration has announced plans to rescind the regulation after a comment period, but Coburn wanted to know, "I would like is reassurance that we'll at least get a heads up on what that's going to be prior to unilateral announcement. Can you give us that assurance?" 

Sebelius, a Democrat who has worked in elected office for years in a state where registered Republicans far outnumber registered Democrats by about two to one, responded in a way that suggests she has taken a more conservative stance on this than the broader reproductive rights community has.

"I can tell you right now that the President supports and I support a clearly defined conscience clause for providers and institutions. I always have. It's been in place in Kansas the entire time I've been in elected office," Sebelius said at the hearing. "I know there was some concern about the regulation that was proposed and implemented at the very end of the previous administration that it was overly broad and frankly overly vague. So I don't think from the discussions that I've had that there is any intention of interfering with the underlying legal basis." 

The hearing comes on the heels of Sebelius's recent singing into law a piece of anti-choice legislation that will require women seeking abortions to be given the option of getting an ultrasound or hearing the fetus' heartbeat. The law also puts state funds toward producing literature and a video on abortion. Sebelius vetoed a similar bill a year ago; it seems likely that she signed this one to avoid an dust-up with anti-choicers just moments before her confirmation hearings.  Her approval of this bill, in conjunction with her comments about the HHS rule, raise questions about exactly how pro-choice Sebelius is and whether she'll prioritize health care reform over reproductive rights -- a question the reproductive health community had for previous nominee Sen. Tom Daschle, too.

Still, Sebelius has a long history of working with Planned Parenthood in Kansas, even attending a fundraising dinner (PDF) held by the organization in 2007, as well as an event held by Planned Parenthood just before the inauguration. The anti-choice right has also focused on her association with Dr. George Tiller, a doctor that has performed late-term abortions who won a fundraising dinner with Sebelius. (Tiller was acquitted of all 19 counts of misdemeanor in a state court last Friday. Abortions in Kansas also declined by about 10 percent while Sebelius was in office.)

Much of the hearing focused not on reproductive health but rather on health care reform. "I am and will remain staunchly pro-life, and will advocate for the lives of the unborn," ranking member Sen. Michael Enzi (R-WY) said at the hearing; yet Enzi said he preferred to focus on health care reform, something that he said is "not Republican or Democratic issue" but "an American issue." 

In an exchange with the former Republican nominee for President, Sen. Jon McCain asked if Sebelius would support a plan that would include a public insurance option. Sebelius, confirming that she supported President Barack Obama's plan, said she would support a public insurance option that would compete with private insurance plans. This is widely viewed by many progressive health care policy experts as one of the best ways to increase competition on health insurance and bring costs down. Although Sebelius didn't advocate a particular kind of public insurance option, she said she, like the President, supported having one to increase access to health care. 

It's true that the list of concerns for health care reform is long. Much of the debate will change depending on which plan is chosen for implementation. New proposals seem to surface almost monthly, including one billed by former presidential candidate Sen. Bob Dole, who appeared before the committee to testify in support of fellow Kansan Sebelius. "I can't think of a tougher job to step into now than the secretary of HHS," Dole said. He is working in conjunction with other former senators Daschle, Howard Baker, and George Mitchell to produce health care forums and a proposed plan to contribute to the health care debate. 

Health care reform has certainly been identified as a priority for the Obama administration, especially to counteract the long-term skyrocketing costs that are projected. It's clear that investment in health care reform will reduce costs in the long run.  

But it's unclear if Sebelius, who comes from a background as a legislator, a governor, and an insurance regulator, will first look to overall reforms before looking at expanding access to reproductive services, including abortion. Sebelius is used to working with Republicans, and even former Sen. Sam Brownback, a staunch anti-choice conservative, has endorsed her nomination for HHS Secretary. She's also earned the support of other Kansas-proud Republicans, like Dole and Sen. Pat Roberts.  

It will be essential that pro-choice women's advocacy groups and pro-choice health care reform groups keep pressure on Sebelius if confirmed as HHS Secretary as well as on Congress and the administration. Health care reform is such a multi-faceted issue that dozens of groups are already clamoring to get their perspective included. Let's hope Sebelius' bipartisan tendencies won't interfere with the right to reproductive choice.