Several readers criticized my op-ed for not saying more about what government can do that might reduce abortion rates. For example, Michael Sean Winters:

[V]oters can recognize the vast difference between Ryans position and President Obamas, and those of us in the pro-life community should not be obfuscating those differences. Peppard would have been on sounder political ground by pointing to the potentially dire consequences for the abortion rate should Mr. Ryans proposed cuts to Medicaid be enacted, or Obamacare overturned, robbing dozens of clinics that help women facing crisis pregnancies of the $250 million in funding Obamacare gave specifically to help women in that situation...

Indeed, I would have liked to have said more on that point, but I was already making several other points in a short space. In about 800 words:- I explained the Catholic moral teaching about abortion, the fullness of which many people don't realize. The moral teaching is unwavering and nonnegotiable. (Emails from Jewish pro-life readers were especially interesting. There was a genre of emails there that can be summarized, "You don't have an exception for the life of the mother in Catholic ethics? Whoa!" (followed by quotations from Jewish ethics).- Paul Ryan has changed his position, now that he's running for national office -- an election which he couldn''t possibly win unless he changed it. With current demographics, a firm pro-lifer cannot win a national election. He backed away from his principled position and articulated a pragmatic one, as a way to try to satisfy firm pro-lifers but also potentially include a few from "the broad middle of the American population, who are deeply unsettled by abortion rates but more unsettled by attempts to criminalize it."- More importantly, I wanted to make clear that the "policy" articulated is not a policy. It's not a realistic assessment of what can be done. So another genre of email I've received has been, to paraphrase, "I'm pro-life, and I hated your article. But I will say that I had never thought before about the rape exception in actual practice, and I'll have to think more about that."- Now about abortion rates, which Winters and others wanted me to say more about in the article. During the editing process, I specifically said, "There is no way I will publish this without some discussion of lowering abortion rates," and I had two points related to that. First, I had built off Mr. Ryan's answer about the ultrasound. I wanted to cite the argument from Putnam and Campbell's American Grace, which proposes that the prevalence of ultrasound technology has been one of the two most important factors in stabilizing pro-life opinions in this country. That sentence was left on the cutting room floor. (The other major factor Putnam and Campbell cite is, of course, increased access to contraception.)Second, I wanted to make the point about the reasons women themselves offer for why they choose to have abortions. This data is not the easiest to come by, but studies that do exist show that reasons of economic insecurity (and health care insecurity) are at or near the top of the list. Abortion rates in general have been going down in our country, but among the poor the data are very different. During the 2000's, even before the recession, that abortion rate seems to have been going up. All of that is to say that one related point did make it in the article in the form of one sentence:

A far more realistic and, studies suggest, more effective, approach to lowering abortion rates would be to increase access to pre- and postnatal care for underinsured women and their dependents decreasing the likelihood that they would terminate their pregnancies because they cannot afford the care needed to bear and raise a healthy child.

Yes, it's only one sentence, but it is there.To conclude, for today, I want to continue elaborating on the main structure of my article: Paul Ryan's former position was very principled, if not very realistic, as public policy. It was the kind of stance that a member of the House representing a certain kind of district can hold and continue to be re-elected. Mr. Ryan's new position lost its firm principle and became even less realistic. It expresses sentiments, not principles or policies.A principled and realistic answer from Mr. Ryan might have concluded something like this:"As I just explained, my pro-life convictions are unwavering. But as we also know, Roe v. Wade is the current law of the land. The executive branch of government cannot do much about that. What we can do is work on proposals with Congress that seek to reduce abortion rates, something most Democrats (and admittedly, most Republicans before us) have not been doing. We can also offer federal support to local programs that provide pre- and postnatal care to uninsured and underinsured pregnant women. This impulse stems from my support for both solidarity and subsidiarity in the Catholic tradition. Gov. Romney is fully on board with this. And tonight I would like to announce that a Romney-Ryan administration is going to lead the way. We have been rethinking our proposed cuts to Medicaid, and we have decided that now is not the time to cut what has become a vital federal program -- especially for pregnant women living in poverty. In the richest country on earth, we would never want a pregnant woman to feel like she could not choose life. Therefore, I have approval from Gov. Romney to make news tonight: we will retain Medicaid funding. In addition, what we can further do, at the federal level, is -- and here I quote from the program description -- to oversee a competitive grant program to distribute 'funding to States and Tribes to provide pregnant and parenting teens and women with a seamless network of supportive services to help them complete high school or postsecondary degrees and gain access to health care, child care, family housing, and other critical supports. The funds are also used to improve services for pregnant women who are victims of domestic violence, sexual violence, sexual assault, and stalking.'"That would have been a principled and realistic answer. And wouldn't that be a great and pro-life federal program?Oh, wait, we already have that program! It's called the Pregnancy Assistance Fund -- an already implemented part of the Affordable Care Act.