Democratic Leaders Discuss Plans To Advance Health Reform Without Changes to Abortion Language

March 12, 2010 — House leaders said Thursday that they will not include changes to the Senate health reform bill's (HR 3590) abortion-coverage language in a budget reconciliation bill that Democrats are expected to use as in their strategy to enact a health overhaul, Politico reports. Under the Democrats' strategy, the House is expected to pass the Senate bill, and then both chambers are expected to pass agreed-upon changes. The Senate would pass the changes through the budget reconciliation process. Because budget reconciliation measures can only include provisions that have a budgetary impact, there were always procedural obstacles to including abortion-related changes in that package (O'Connor, Politico, 3/11). Budget reconciliation requires only a simple majority, allowing Democrats to avoid a filibuster by Senate Republicans (Women's Health Policy Report, 3/11). Senate Republican leaders said on Thursday that the Senate parliamentarian had ruled that the Senate health reform bill must be signed by President Obama before the budget reconciliation package can be taken up (Murray/Montgomery, Washington Post, 3/12).

In an appearance on MSNBC's "The Rachel Maddow Show" on Thursday, House Speaker Nancy Pelosi (D-Calif.) addressed Rep. Bart Stupak's (D-Mich.) claims that the Senate bill would provide federal funding for abortion, as well as his push to include his own language on the subject (Maddow, "The Rachel Maddow Show," MSNBC, 3/11). The Senate bill would allow health plans that receive government subsidies to offer abortion coverage, although no government funds could be used to pay for that coverage. To ensure that only private funds are used to pay for abortion coverage, customers would be required to make two monthly premium payments -- one to pay for abortion coverage and one for all other services. Insurers also would be required to keep funds in separate accounts (Women's Health Policy Report, 3/11). Stupak and other antiabortion-rights House members would prefer language similar to his amendment, which was included in the House bill (HR 3962) and would prohibit insurance companies that receive federal subsidies from offering abortion coverage, even if paid for with private funds (Benson, CQ Today, 3/11).

In the interview with Maddow, Pelosi said, "It is the law of the land that we are prohibited from spending federal funds on abortion, and that is consistent in this bill." The bill "is not about abortion," it is "about health care for all Americans," she said.

Maddow noted that her program has "focused a lot on Bart Stupak as a person who is trying to hijack the [reform] process, to make it an abortion debate." Pelosi responded that she does not believe that Stupak "himself would be one to say, 'I'm taking down health care reform.' ... [B]ut I think others who are part of that, who have a stronger connections to the Republican Party, do want to bring down the bill." Pelosi said, "I cannot let the good intentions of some on a subject that is very important to them be hijacked by those who do not want health care reform."

Questions About Stupak's Supporters

Politico reports that by moving forward without changing the abortion coverage language, House Democratic leaders are "hoping to peel off" enough votes to pass the Senate bill in the House without Stupak and his followers, (O'Connor, Politico, 3/11).

House Energy and Commerce Committee Chair Henry Waxman (D-Calif.), who has held discussions with Stupak, said, "Most members feel that the abortion issue was dealt with in the Senate-passed bill," adding that "many people" who share Stupak's views on the issue "are voting for this bill."

Congressional Pro-Choice Caucus Co-Chair Jan Schakowsky (D-Ill.) said that that any concessions to Stupak on the abortion-coverage issue would ultimately cost Democrats more votes than they could gain. "We have more votes than he does to defeat that effort," Schakowsky said, adding, "There are no side deals that are going to be acceptable to the Pro-Choice Caucus."

Schakowsky added that she does not believe Stupak's claim that 10 or more Democrats who supported the House bill will oppose the Senate bill over abortion. "We don't think he has the votes," she said, adding, "He's never come out with names. There's a reason for that. They are not solid votes" (Dennis/Newmyer, Roll Call, 3/11).

Several antiabortion-rights House members "appear to be wavering" on their opposition to the Senate bill, thus "suggesting cracks" in Stupak's coalition, CQ Today reports. On Thursday, Rep. Charlie Wilson (D-Ohio) said that he is willing to vote for the Senate bill and that the abortion coverage language "is pretty clear that it is not something that pays for abortion." Earlier in the week, four other antiabortion-rights House Democrats -- Steve Driehaus (Ohio), Marcy Kaptur (Ohio), Dale Kildee (Mich.) and James Oberstar (Minn.) -- said they were reconsidering their opposition to the Senate bill. Two House Democrats -- Joe Donnelly (Ind.) and Daniel Lipinski (Ill.) -- have said they will not support the Senate bill because of the abortion issue (CQ Today, 3/11).

Dems Discuss Timeline

Pelosi and Senate Majority Leader Harry Reid (D-Nev.) so far have not committed to a timetable on votes for the bill. House Democrats said that Pelosi promised them at least one week to examine the text of the budget reconciliation bill before voting on it, although they have not received many details on what changes will be included.

Democratic aides said that House leadership is aiming to vote before a two-week recess scheduled to start on March 26 (Pear/Herszenhorn, New York Times, 3/12). Pelosi said Thursday that lawmakers are still waiting on a Congressional Budget Office score of the budget reconciliation package. She added that it could be a week or more before the bill goes to the floor (Babington, AP/Philadelphia Inquirer, 3/12).

St. Petersburg Times Examines Abortion-Coverage Debate

The debate over abortion coverage "hinges on philosophical difference more than finance," and it "has little to do with the reality of how abortions are funded today," the St. Petersburg Times reports. According to data from the Guttmacher Institute, there were about 1.2 million abortions in the U.S. in 2005, of which 74% were paid out of pocket by the woman. That statistic included all women -- insured or uninsured -- receiving abortion services and does not account for women who later sought reimbursement from their insurers, according to the St. Petersburg Times. While about 87% of all employer-provided health care plans include some abortion coverage, Guttmacher's study found that only 13% of women having abortions had the clinics bill their insurers (Hundley, St. Petersburg Times, 3/12).

Opinion Piece Says Abortion Care Should Be Considered Basic Health Care

In a Baltimore Sun opinion piece about the abortion debate in health reform, Sara Love -- president of the board of directors of the American Civil Liberties Union of Maryland -- writes that abortion services are "part of basic health care for women." Every woman faced with a choice regarding abortion is "different," and "[e]ach of these women should be able to decide what is best for her health and her family," Love says, adding that health reform "should improve women's health and lives -- not interfere in their ability to get the care they need" (Love, Baltimore Sun, 3/12).