Set in 2009-2010, during the fractious U.S. Congressional debate over enacting the Obamacare health reform bill, this ethics case focuses on the choices and constraints facing Bart Stupak, a Democratic Congressman from Michigan's Upper Peninsula, who was both a dedicated advocate for healthcare reform and a lifelong opponent of abortion (as were the majority of voters in his rural, largely Catholic district). The case provides basic background about Stupak, his district, and the Obamacare debate but the heart of the story belongs to the abortion policy sub-plot of the larger healthcare reform drama, which culminated with the final, razor-close vote on the Affordable Care Act in the U.S. House of Representatives on March 21, 2010. At this critical moment, with the fate of the ACA hanging by a thread, the Democratic leadership pressed Stupak and his small group of pro-life House Democrats to abandon their controversial abortion stance and deliver their critically-needed votes to pass the Obamacare bill. At the same time, Stupak's traditional pro-life and Catholic supporters doubled-down on demands that he and his group hold the line, even if it meant dealing the death blow to health reform. Anti-Obamacare Republicans, meantime, maneuvered around the edges, seeking to leverage the abortion issue in a last-ditch effort to kill the bill. The case closely follows Stupak's own perceptions, conflicts, and choices as he tried to walk a middle path in this highly charged atmosphere. In the end, he made a deal with President Barack Obama, who agreed to put abortion restrictions in the form of an executive order in exchange for the support of Stupak and his bloc on the ACA.
The case was designed to examine ways of thinking about public sector ethics in a complex, even unsavory context: American Congressional politics. Stupak had to weigh competing values, loyalties, and practical considerations among them, those of personal conscience, personal career, constituent wishes, interest group demands, party fidelity, and collegial relationships. Ultimately, the case raises the larger question of when--and whether--it is ethically appropriate to make a compromise.