Dems Defend Health Reform Strategy; Undecided House Members Face Pressure as Vote Nears

March 17, 2010 — Democratic leaders on Tuesday defended their possible use of a legislative maneuver that would allow House Democrats to pass the Senate health reform bill (HR 3590) in the chamber without members actually having to vote on it, the Washington Post reports. Under this maneuver -- known as a self-executing rule or "deem and pass" -- House Democrats would craft a rule for debate on the budget reconciliation bill that would deem the Senate bill as "passed" upon approval of the budget reconciliation bill, thereby avoiding the need to vote on the Senate bill (Goldstein, Washington Post, 3/17).

The budget reconciliation bill includes a series of changes House Democrats want made to the Senate bill. According to the New York Times, the "idea is to package the changes and the underlying [Senate] bill together in a way that amounts to an amended bill in a single vote" (Herszenhorn/Pear, New York Times, 3/16).

On Monday, House Speaker Nancy Pelosi (D-Calif.) said she was in favor of using the rule (Washington Post, 3/17). However, during a press briefing on Tuesday, Pelosi declined to specifically endorse the deployment of the rule in the House and called it one of the options that she and other House Democratic leaders are considering. She said Democrats "have several options available to us and we've asked the parliamentarian of the [House] Rules Committee to tell us what our options are" (Norman, CQ HealthBeat, 3/16).

House Rules Committee Chair Louise Slaughter (D-N.Y.) said that the maneuver has been deployed since 1933 and that Republicans who claim it is unconstitutional "know better" (Dennis/Newmyer, Roll Call, 3/16).

Uncommitted Democrats Face Pressure

Meanwhile, Democrats who have not yet committed to supporting finalized health reform legislation are facing pressure from President Obama, other Democratic leaders and opposing Republicans, the Miami Herald reports. The lawmakers -- who disagree with certain proposals in the bill on issues such as abortion and cost -- also face multimillion-dollar ad campaigns and pressure from constituents who have criticized the reform process (Lightman, Miami Herald, 3/17).

Pelosi on Monday signaled that there will be no changes to the Senate bill's provision on abortion coverage, noting that it is not a budget-related issue that can be changed through budget reconciliation. She also said that she would not promise any House members that their concerns about the Senate language would be addressed in future legislation (Women's Health Policy Report, 3/17).

Much of the focus is on 39 House Democrats who voted against the chamber's original reform bill (HR 3962) in November 2009. According to the Herald, reform legislation cannot pass in the chamber unless some of them switch their positions (Miami Herald, 3/17).

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. Rep. Bart Stupak (D-Mich) and other antiabortion-rights House members would prefer language similar to his amendment, which was included in the House bill and would prohibit insurance companies that receive federal subsidies from offering abortion coverage, even if paid for with private funds. The House Budget Committee voted 19-17 against including the Stupak language in the reconciliation measure (Women's Health Policy Report, 3/16).

Some antiabortion-rights House Democrats have said they are unsure of how they will vote. Rep. Marcy Kaptur (D-Ohio) said that abortion coverage is one of several factors she is considering in deciding her vote, The Hill's "Blog Briefing Room" reports. Abortion is "of equal importance to all the others," Kaptur said, adding, "I'm in the center of this. I am not in the extreme wings in either camp. I'm saying, let's not change existing law" (Alarkon, "Blog Briefing Room," The Hill, 3/16).

Indiana Rep. Brad Ellsworth (D) -- who is expected to run for Senate -- in a statement Tuesday said he is unsure how he will vote, adding that he would not vote for a bill if he interprets it as allowing federal funding for abortion. "I am looking carefully at the current language in the bill to ensure it meets my pro-life principles, and I will continue to work to ensure pro-life concerns are addressed," Ellsworth said. In addition, Rep. Joe Donnelly (D-Ind.) in a statement Tuesday said that he is leaning toward voting against the bill in part because it "does not meet [his] standards for assuring that no federal funds are used for abortion-related services."

However, Rep. Baron Hill (D-Ind.) said in a statement that the Senate bill "accomplishes [the] same goal" as the House bill, which is that "no taxpayer funds can be used to pay for elective abortions." Hill said that although he supports the language on abortion, he remains undecided on how he will vote (Wilson, AP/Louisville Courier-Journal, 3/16).

Nuns Announce Support

On Wednesday morning, 60 leaders of religious orders representing about 59,000 Catholic nuns sent lawmakers a letter urging them to support the Senate health reform bill, the AP/Atlanta Journal-Constitution reports. The U.S. Conference of Catholic Bishops opposes the Senate bill over its approach to abortion coverage, but the nuns and the Catholic Health Association -- which represents about 600 hospitals -- say that the Senate language ensures that taxpayer money is not used to support the procedure.

The letter said, "Despite false claims to the contrary, the Senate bill will not provide taxpayer funding for elective abortions." It added, "It will uphold longstanding conscience protections and it will make historic new investments ... in support of pregnant women. This is the real pro-life stance, and we as Catholics are all for it."

Sister Simone Campbell -- executive director of Network, a national Catholic social justice group -- said, "This is politics; this isn't a question of faith and morals." She added, "We are the ones who work every day with people who are suffering because they don't have health care. We cannot turn our backs on them, so for us, health care reform is a faith-based response to human need" (Alonso-Zaldivar, AP/Atlanta Journal-Constitution, 3/17).

Wall Street Journal Highlights Stupak Interview

In related news, a Wall Street Journal column recently analyzed comments in a National Review article in which Stupak criticized the House leadership's abortion-rights position and its approaches to the issue during the health reform debate (Taranto, Wall Street Journal, 3/15).