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CFC in the News - 2010

congressional quarterly

House Democrats Still in Search of Abortion Agreement on Health Care Bill

Clea Benson and Edward Epstein

9 March 2010

To listen to House Majority Leader Steny H. Hoyer tell it, negotiating with the anti-abortion Democrats led by Michigan's Bart Stupak is not at the top of his priority list for completing a health care bill.

"I've had no negotiations with Mr. Stupak," the Maryland Democrat said Tuesday. "Mr. Stupak came up to me on the floor and said, 'I would like to talk to you.' I said, 'OK.' We have not yet talked."

Although House Democratic leaders have downplayed abortion as a potential stumbling block for weeks, it is clear that they will have to reckon with the issue to get the 216 votes they need for passage -- just as they did last November when they brokered an eleventh-hour compromise incorporating Stupak's language, which prohibits insurance policies sold to people who receive federal subsidies from offering abortion coverage.

A month later, Senate Democrats were able to secure their decisive 60th vote only after agreeing to Nebraska Democrat Ben Nelson's similar, though less restrictive, provision on abortion coverage.

Now, as House members prepare to vote on the Senate bill (HR 3590), Stupak is claiming that he and 11 other Democrats who supported the House bill (HR 3962) in November will vote against the Senate bill unless the House's abortion language is part of the final product. Not all of them are likely to stand firm, but even a small group could prove decisive in a close vote.

Even Hoyer publicly acknowledged the problem. "Abortion has to be resolved," he said Tuesday. "I think it will be resolved one way or the other, and the bill will be passed."

In a statement, Stupak said Tuesday he "remains optimistic that language can be worked out." The day before, he told The Associated Press that he thought the prospects for compromise were good.

"The president says he doesn't want to expand or restrict current [abortion] law. Neither do I," he said. "That's never been our position. So is there some language that we can agree on that hits both points -- we don't restrict, we don't expand abortion rights? I think we can get there."

But resolving the abortion issue is likely to cause a major headache for all concerned. To get the overhaul through Congress, the House must pass the Senate bill unchanged. Both chambers will then take up a "corrections" bill making changes to the Senate bill, using the budget reconciliation process. Incorporating the Stupak language into that measure is considered unlikely. For starters, abortion is not a tax or spending issue -- the usual topics of a reconciliation bill. And lawmakers who support abortion rights are as likely to challenge the effort as Republicans eager to kill health care legislation.

Yet anti-abortion members say they are leery of any deal that would incorporate changed abortion language into a third bill that would be put to a vote after the Senate bill and the companion reconciliation measure are passed.

"I would not accept a promise that legislation will be acted upon in the future, because it's unlikely that something will get done," said Daniel Lipinski, D-Ill., who said he was one of the "Stupak Dozen." "In my eyes, it would have to be done beforehand."

Meanwhile, Diana DeGette, D-Colo., co-chairwoman of the Congressional Pro-Choice Caucus, said she had a letter signed by 40 members saying they would not vote for any bill that restricts abortion beyond current law, known as the Hyde amendment, which bars federal funding for abortion unless the pregnancy results from rape or incest or threatens the woman's life.

"We are not going to further erode a woman's right to choose," she said.

The dispute boils down to small differences in language between the bills already passed by the two chambers.

In the House bill, insurance companies would be prohibited from offering abortion coverage to women who receive federal subsidies to help them pay their premiums. If a woman wanted abortion coverage, she would have to buy a separate policy with her own money.

Under the Senate bill, insurers would be able to offer policies that include abortion coverage to women helped by federal subsidies -- but only as long as those policies were paid for with private funds collected directly from the policyholder. People who want such coverage would have to write two checks.

Interest Groups Chime In

Beyond that issue, the U.S. Conference of Catholic Bishops and the National Right to Life Committee contend that the Senate bill would also provide a $7 billion increase in funding for abortions through federally funded health programs, such as community health centers and Indian health programs, and they are urging lawmakers to vote against anything that falls short of a blanket prohibition on abortion funding.

"A House member who votes for the Senate bill will forfeit any plausible claim to pro-life credentials," said Douglas Johnson, legislative director of the Right to Life Committee.

Democratic staff members dispute that analysis, however. "The Public Health Service Act prescribes what community health centers can do, and abortion is not among their prescribed activities," said Lisa B. Cohen, DeGette's chief of staff. "It's all part of their campaign to muddy the waters on the health care bill."

Meanwhile, the Susan B. Anthony List, a group that supports anti-abortion women in politics, last week launched what it said was a $500,000 effort to persuade Democrats in conservative districts in Ohio and Pennsylvania to oppose the Senate bill. The group released polling showing that voters in those districts said they were likely to oust lawmakers who voted for the abortion language in the Senate bill.

Groups that support abortion rights are also raising their voices. "When the bishops speak, they do not speak for Catholic voters in the United States, or the vast majority of Americans," said Jon O'Brien, president of Catholics for Choice.

But especially in some Midwestern districts with large Roman Catholic populations, the loudest voices appear to be those of anti-abortion voters.

"The other day, I was jogging down the street, and I had someone yell to me, 'Vote no on health care reform,'" Lipinski said. "There's no getting away from it, because the passions are very high."

This article originally appeared in Congressional Quarterly.