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Abortion Coverage Remains Among Major Questions in Health Reform Talks

Abortion Coverage Remains Among Major Questions in Health Reform Talks

January 13, 2010 — Although more extensive negotiations on abortion coverage issues likely will not occur until more is known about a final health reform bill, opposition to the Senate bill (HR 3590) from antiabortion-rights House members, Roman Catholic bishops and other groups threaten to put House leaders in a "jam," Roll Call reports. Coverage of abortion in health plans that receive federal subsidies is among several unresolved differences in the House (HR 3962) and Senate versions of the legislation. A group of antiabortion-rights House members led by Rep. Bart Stupak (D-Mich.) are opposed to allowing insurance plans that receive federal subsidies to cover abortion services, while abortion-rights supporters are threatening to vote against any bill that includes Stupak's language.

Rep. Diana DeGette (D-Colo.), co-chair of the Congressional Pro-Choice Caucus, said that she has been involved in discussions with both sides and that the White House is trying to reach a compromise. "We don't want to kill the bill over abortion," she said.

Negotiators are expected to first address other elements of the bill that will affect the abortion coverage issue. A House Democratic leadership aide said, "We have to deal with the core issues of the bill first." For example, the House bill includes a proposed national health insurance exchange, while the Senate bill would create state-based exchanges. If the House's version of the exchange is adopted, it would "appear to blow up" the Senate bill's abortion coverage agreement that was drafted to gain the support of Sen. Ben Nelson (D-Neb.), Roll Call reports. The Senate bill would require people to send two separate checks -- one to cover the cost of abortion coverage and one to cover the cost of all other services -- a plan that was rejected by Stupak and other abortion-rights opponents. Some abortion-rights supporters in the House have also opposed this provision, which they say will decrease the likelihood that insurers will offer abortion coverage.

While Stupak cites the federal employee health insurance program -- which does not cover abortion except in cases of rape, incest or to save the woman's life -- as precedent for his language, DeGette cites the federal tax exemption for health insurance as precedent against it. The tax exemption provides tax breaks to companies for insurance plans without regard to abortion coverage.

DeGette said that she has the signatures of 42 House members saying they will oppose a final bill that includes Stupak's language, adding that a compromise would have to be the solution. "I don't think there's any way to get the votes for what I want or what [Stupak] wants," she said, adding, "What I want is a bill that doesn't talk about abortion. What [Stupak] wants is a bill that goes far beyond current law" in restricting abortion (Dennis, Roll Call, 1/13).

Stupak on Tuesday said that he has had two broad discussions with House leaders on the issue and that he believes his amendment to the House bill has popular support. However, he did not rule out a compromise, saying, "How we work that out I guess remains to be seen, but I think in the long run it can be worked out" (Fram, AP/Yahoo! News, 1/13).

According to CQ Today, Stupak could be House Speaker Nancy Pelosi's (D-Calif.) "biggest problem," as he claims that 10 to 12 of his supporters will oppose a final bill without his language (Angle, CQ Today, 1/12). However, DeGette said, "There are also a lot of people who voted against the bill the first time in the House who will vote for a final agreement" (Roll Call, 1/13).

House, Senate Negotiators Divided on Other Issues

Meanwhile, negotiators are facing a "serious problem" in finding agreement on differences between the two versions and might not have a final piece of legislation until early February, House Ways and Means Committee Chair Charles Rangel (D-N.Y.) said Tuesday evening, Roll Call reports. Among the remaining differences are a Senate tax on high-cost insurance plans, differing methods of generating revenue and antitrust provisions regarding health insurance plans, Roll Call reports. House Democratic aides challenged the notion that talks were at an impasse (Bendery, Roll Call, 1/12).

The Hill reports that House Democrats have chosen five of their top caucus members to negotiate the final bill with the Senate, including Pelosi, Majority Leader Steny Hoyer (Md.) and Rangel. Also included in the negotiations are House Energy and Commerce Committee Chair Henry Waxman (Calif.) and Education and Labor Committee Chair George Miller (Calif.). It is not clear who will represent the Senate besides Majority Leader Harry Reid (D-Nev.), Finance Committee Chair Max Baucus (D-Mont.) and Banking Committee Chair Christopher Dodd (D-Conn.). Although Nelson is not expected to attend the discussions, he has remained in close contact with Reid, spokesperson Jake Thompson said (Allen/Young, The Hill, 1/12). House and Senate leaders are scheduled to meet with President Obama on Wednesday (Montgomery, Washington Post, 1/12).

Lawmakers said negotiations are likely to continue into February (Bendery, Roll Call, 1/12). The delay could set back Obama's second budget request, which is due to Congress by Feb. 1, according to lawmakers (Washington Post, 1/12).

Stupak Considering Bid for Michigan Governor

Stupak on Tuesday said that he is strongly considering a gubernatorial bid in his home state and that he will be traveling across Michigan in the coming weeks to see what kind of support he would receive, Roll Call reports. However, Stupak said his position on issues like abortion rights and gun rights could make for a difficult Democratic primary, which "would not be good" (Dennis, Roll Call, 1/12). While Stupak did not set a timeline for his decision, he "needs to decide soon if he's going to raise enough money to be competitive," Politico reports (Hohmann, Politico, 1/12).