Obama’s final push for health care votes could falter in battle over abortion coverage

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Abortion coverage dispute divides House Democrats

WASHINGTON — Just when President Barack Obama is striving to unite Democratic lawmakers for one last push to pass his health care overhaul, the divisive politics of abortion threaten to tear the party apart.

At issue is a Senate health care bill House Democrats are being asked to approve in a complicated maneuver seen as Obama’s last chance to get sweeping legislation expanding coverage and revamping the health insurance market. The dilemma is that House Democrats on both sides of the abortion debate have strong disagreements with the way the Senate bill attempts to restrict taxpayer funding for abortion. And there’s no easy way to fix it later.

Although each chamber is also supposed to pass a companion package of agreed-upon changes, abortion restrictions may not meet the test for inclusion, a requirement that such items be primarily related to the budget.

Both sides are negotiating to prevent an impasse that could undo the health care bill. But the talks could lead down a dark tunnel with no exit.

Speaker Nancy Pelosi vented her frustration Thursday, telling reporters she will not stand for health care legislation getting dragged down in a battle over abortion. “This is not about abortion,” said Pelosi, D-Calif. “This is a bill about providing quality affordable health care for all Americans.”

She may not have a choice, says a leading abortion foe.

Rep. Bart Stupak, D-Mich., says he and a dozen fellow Democrats who supported the House bill will vote against it this time unless the Senate language is replaced with stiffer restrictions previously adopted by the House. The House health care bill passed by 220-215 last November, only after Pelosi was forced to give Stupak a floor vote that incorporated his strict abortion funding provision in the measure.

Nothing has changed, said Stupak. “I don’t think they have the votes to pass it,” he said.

It’s not clear, however, that every lawmaker who voted with Stupak the first time will stick with him.

Rep. Dale Kildee said he’s keeping an open mind as he studies the Senate bill. “I’m looking at the language in the Senate bill to see if it carries out the purpose of the Hyde amendment,” said Kildee, D-Mich. “If it does so to my satisfaction, I think I could go along with it.”

The long-standing Hyde amendment bars federal funding for abortion except in cases of rape, incest or to save the mother’s life.

A spokesman for another Democrat who voted with Stupak, Illinois Rep. Daniel Lipinski, said Friday the lawmaker would vote against the Senate bill unless it’s includes stronger abortion restrictions. And the National Right to Life Committee warned that any House lawmaker who votes for the Senate bill would cast “a career-defining pro-abortion vote.”

Obama is pleading with Democrats to overcome divisions over abortion to seize a historic moment to remake the health care system. He says he doesn’t want the health care bill to change government policy on abortion, but convincing abortion foes he means it remains one of his biggest challenges. Government policy on taxpayer funding for abortion has been settled for years, following the Hyde amendment.

But the Democratic health care bills altered the balance by creating a new stream of federal money to help working households afford health insurance premiums. Those funds were not subject to the Hyde restrictions.

The House responded by adopting Stupak’s amendment, although it was opposed by most Democrats. It says no health insurance plan receiving federal subsidies can pay for abortion, except under the three exceptions already allowed by federal law. Women who want insurance coverage for abortion would have to buy a separate policy.

The Senate bill took a different approach. It says health insurance plans operating in a new consumer marketplace can cover abortion, but it may only be paid for with private premiums. Money from federal subsidies would have to be strictly segregated from any funds used to pay for abortion. Consumers would have to write two checks to their insurance plan, one for the regular premium, the other for abortion coverage.

Leading abortion opponents — including the nation’s Catholic bishops — say the Senate language is a fig leaf, opening the way for government subsidies for abortion. They’re urging defeat of the health care bill unless it takes Stupak’s approach.

Abortion rights supporters say both measures impose unreasonable restrictions on women’s access to a legal medical procedure now widely covered by health insurance.

Rep. Diana DeGette, a prominent abortion rights supporter, said Pelosi should call Stupak’s bluff.

“Ten or 11 votes is not going to kill the bill,” said DeGette, D-Colo., explaining that many of the 39 conservative Democrats who voted against the House bill could well find the moderate Senate version more to their liking. DeGette also wants to change the Senate language, saying it’s too restrictive.

Abortion rights supporters backed down once the last time. This time, if House Democratic leaders can’t line up enough votes without placating Stupak, it’s unclear how they will get the abortion language changed.

Pelosi says it can’t be done in a companion package that would move through both chambers as part of deal worked out with Obama. Under congressional rules, the elements of that package would have to have a significant budget impact. A third piece of legislation may be needed.

Abortion foes tried to use such a budget bill in the 1990s to outlaw all federal funding for abortion. The Senate parliamentarian, who acts as a referee in the process, ordered the provision dropped from the bill. “I thought it was there for a policy reason, not a budgetary one,” said Robert Dove, the parliamentarian at the time.

His ruling stood, and that precedent may loom large in the weeks ahead.