Abortion could stymie healthcare reform legislation

Will abortion wreck President Obama’s healthcare reform efforts?

It’s possible. Some anti-abortion House Democrats are threatening to vote against the healthcare bill because they believe it might allow federal funds to be used to pay for the procedure.

However, the leader of this group, Rep. Bart Stupak (D) of Michigan, said Monday he’s optimistic about resolving the problem. And White House spokesman Robert Gibbs Tuesday reiterated that when it comes to this explosive issue the administration just wants to maintain the status quo.

“This is not a bill about abortion. This is about healthcare reform,” said Mr. Gibbs in an ABC broadcast interview. (Monitor report: President Obama is in do-or-die mode on healthcare reform.)

Differences in legislative language

The dispute involves a subtle difference in language between the version of healthcare reform passed by the House and the version passed by the Senate.

In the House bill, insurance firms would be prohibited from offering coverage for abortion, except in isolated instances, to people who receive federal subsidies that help them buy coverage. If a woman wanted abortion coverage, she would have to buy a separate policy with her own money.

In the Senate bill, insurance firms would be able to offer policies that include abortion coverage to people helped by federal subsidies. However, none of Uncle Sam’s cash could be used to pay for the abortion-related portion of that insurance. A woman would have to write a separate check, with her own money, to pay for it.

In sum, when it comes to coverage for abortions, in the House version you’d need two different policies. In the Senate version you’d just need to write two checks – and anti-abortion House members think that’s getting awfully close to federal funding for the procedure. (Monitor report: House Democrats scramble to find a majority to vote for the Senate’s healthcare bill.)

The Senate bill language “basically says that your federal tax subsidies can be used to pay for abortion coverage,” said Rep. Stupak in a March 4 interview on National Public Radio (NPR).

(Again, all this refers only to insurance coverage purchased by small businesses and individuals through new exchanges that would be established by both bills.)

Could whole bill be blocked?

So why might that block the whole bill? Because Democratic leaders have decided their best, and maybe their only possible, strategy for enacting reform is for the House to pass a bill identical to the Senate’s, word for word.

The Senate would then pass a separate bill containing fixes to placate House members who don’t like some of the things in the Senate legislation. This repair legislation would be the part that gets done via reconciliation, a Senate procedure whereby budget-related items can be approved with a simple majority.

But it is hard to argue that the abortion language in question is budget-related. It’s likely the Senate parliamentarian would not allow it in a reconciliation package. That means the abortion issue might have to be dealt with in an entirely separate bill – making it that much harder to finesse.

And abortion is an issue on which both sides feel deeply the rightness of their position. Compromises are tough to reach. Simply arguing that Stupak and his 11 allies are mistaken, and that the Senate language isn’t really that different from the House version, is unlikely to work.

“There are certain principles and values you just don’t trade,” Stupak told NPR.