House Dems Release Manager's Amendment to Health Reform Bill, Consider Further Abortion Compromises

November 4, 2009 — House Democrats late Tuesday night released a manager's amendment with final changes to the chamber's health care reform bill (HR 3962), starting a 72-hour review period before the lawmakers can bring the bill to a floor vote, CQ Today reports (Wayne, CQ Today, 11/4). The manager's amendment does not include any changes related to abortion coverage provisions, an issue that divided Democrats as the bill neared completion. The delay in reaching a compromise on the matter "caused the timetable for debate to slip again," pushing the completion of the manager's amendment late into the evening, CQ Today reports. Floor debate on the bill could begin as early as Nov. 6 (Wayne [1], CQ Today, 11/3).

According to the New York Times' "Prescriptions," a group of Democratic opponents, led by Rep. Bart Stupak (Mich.), had threatened to block the bill if their concerns about funding for abortion coverage were not addressed (Herszenhorn/Kirkpatrick, "Prescriptions," New York Times, 11/3). However, negotiations between Stupak and House leaders "went nowhere," and the issue was left unresolved by Tuesday night, The Hill reports (Soraghan, The Hill, 11/4). Stupak said he "will oppose bringing the bill to the floor until an amendment can be offered or language agreed to that will prevent public funding for abortion" (Oliphant, Los Angeles Times, 11/4). He also said, "I have had some serious conversations over the past few days with the White House and House leadership, and I will continue to make every attempt to resolve the issue of public funding for abortion" (Feldmann, Christian Science Monitor, 11/3).

House Leaders Consider Ellsworth Compromise

With abortion provisions absent from the manager's amendment, House leaders are now working with Rep. Brad Ellsworth (D-Ind.) on an abortion-coverage compromise to be included in the "rule," which must be approved by the House before consideration of the health care reform legislation can begin, The Hill reports. Although the exact language has not yet been made public, according to The Hill, lawmakers say the compromise seeks to strengthen a provision already in the bill that is intended to ensure that federal dollars do not subsidize abortion coverage, The Hill reports (Soraghan, The Hill, 11/3). House Energy and Commerce Committee Chair Henry Waxman (D-Calif.) said some Democratic leaders were "looking at refinements in the language that would clarify the central point: that no taxpayer funds would be used to pay for abortions" (Wayne [2], CQ Today, 11/3).

Ellsworth said, "The bottom line is we're going to exhaust every avenue to ensure pro-life concerns are addressed in this legislation" (Hunt/House, CongressDaily, 11/4). Ellsworth's amendment would make five changes to the current bill, including "[e]xplicitly prevent[ing] all federal tax dollars from being used to provide abortions in the public option" and prohibiting "any funds from the U.S. Treasury from paying for abortion services in any of the plans purchased through the proposed health insurance exchange -- public or private." His amendment adds "clear, strict rules for separating public funds from the premiums of private individuals (ensuring that no public funds are ever used to pay for an abortion in any health plan offered on the health insurance exchange)"; "[g]uarantees every American participating in the health insurance exchange will always have access to a pro-life insurance option"; and "[e]xpands conscience protections to prevent the government from discriminating against pro-life health insurance plans" (O'Connor [1], "Live Pulse," Politico, 11/3).

Ellsworth said he wants assurance that the bill's restrictions on abortion coverage would not depend on annual renewal, as it is with the Hyde Amendment, a rider attached to annual appropriations legislation that restricts states' use of federal Medicaid funds for abortion services (Herszenhorn/Kirkpatrick, "Prescriptions," New York Times, 11/4).

Laurie Rubiner, vice president for public policy at Planned Parenthood Federation of America, said Ellsworth's amendment "purportedly seeks to amend a carefully crafted and balanced compromise that should have put this issue to rest months ago." She added that the bill's current language "assures that access to abortion care is neither mandated nor prohibited and that women will not lose the health care benefits they have had for decades," while also "stipulat[ing] that no federal funds can be used for abortion care." PPFA is "concerned that this new language could tip the balance away from women's access to reproductive health care" (O'Connor [2], "Live Pulse," Politico, 11/3).

According to CongressDaily, the House Rules Committee could meet as early as Thursday to organize the floor debate, which may include Ellsworth's amendment. However, Rules Committee Chair Louise Slaughter (D-N.Y.), who is also co-chair of the Congressional Pro-Choice Caucus, said she is opposed to including abortion compromise language in the rule for debate on the bill. Kristofer Eisenla, a spokesperson for Rep. Diana DeGette (D-Colo.) -- Slaughter's co-chair on the caucus -- added, "The health care bill already includes language that restricts federal funding of abortion. The issue was addressed with the adoption of the Capps amendment during the Energy and Commerce Committee markup of the legislation" (CongressDaily, 11/4).

Repercussions of Reform Vote Worry Some Dems

There are a "handful" of moderate House Democrats "from relatively stable districts who aren't yet on board with the health care bill and whose 'no' votes could force colleagues in more marginal districts to cast offsetting -- and potentially perilous -- 'yes' votes," Politico reports. House members still weighing their votes include Reps. Jim Costa (D-Calif.), Dennis Cardoza (D-Calif.), Brian Baird (D-Wash) and Kathy Dahlkemper (D-Pa.), according to Politico. Dahlkemper, in particular, said abortion is the "one major issue" holding her back from supporting the bill. Waxman said, "A lot of pro-life members are talking to each other about how they think this thing can be resolved. It may not satisfy everybody" (Allen, Politico, 11/4).