March 22, 2010 — The House on Sunday voted 219-212 to approve the Senate health reform bill (HR 3590) after President Obama agreed to issue an executive order to "ensure that federal funds are not used for abortion services," the New York Times reports (Pear/Herszenhorn, New York Times, 3/21). After Democratic abortion-rights supporters rejected the idea of any legislative changes to increase health reform's restrictions on abortion, the agreement was crafted to gain the support of a few antiabortion-rights House Democrats -- led by Rep. Bart Stupak (D-Mich.) -- who threatened to vote against the bill because of abortion-related issues (Murray/Montgomery, Washington Post, 3/22).
Stupak authored an amendment, approved as part of the House reform bill (HR 3962), that would have prohibited insurance companies receiving federal subsidies from offering abortion coverage, even if paid for with private funds. 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, 3/19).
The House's approval of the Senate bill means that the legislation will become law as soon as Obama signs the measure (New York Times, 3/22). The president will issue the executive order after the legislation is enacted (Benson/Ota, CQ Today, 3/21). The House on Sunday also approved a package (HR 4872) of changes to the Senate bill; the Senate will consider the package this week (New York Times, 3/22).
Details of Executive Order
White House Communications Director Dan Pfeiffer said in a statement that the agreement to issue the executive order "provides additional safeguards to ensure that the status quo [on abortion funding] is upheld and enforced, and that the health care legislation's restrictions against the public funding of abortions cannot be circumvented" (Hall/Fritze, USA Today, 3/22).
Obama's executive order will state that the health reform bill "maintains current Hyde Amendment restrictions governing abortion policy and extends those restrictions to the newly created health insurance exchanges." It also will state that "longstanding federal laws to protect conscience ... remain intact and new protections prohibit discrimination against health care facilities and health care providers because of an unwillingness to provide, pay for, provide coverage of or refer for abortions" (Benson/Ota, CQ Today, 3/21). The executive order also reaffirms that the Hyde Amendment prohibits community health centers from using federal funds to provide abortion services (Meckler, Wall Street Journal, 3/22).
Agreement Caps Days of Talks
The agreement was reached on Sunday after days of last-minute negotiations (New York Times, 3/21). On Friday, Stupak and his allies demanded a vote on a resolution that would have prohibited anyone who receives a federal subsidy to help pay for health insurance from purchasing a health plan that offers abortion coverage (Levey/Hook, Los Angeles Times, 3/20). The resolution would have required bicameral adoption before it could be added to the Senate health reform bill, and it could have been filibustered in the Senate. CQ Today reports that these issues "rais[ed] questions about whether Senate Republicans might join abortion-rights Democrats in holding up the resolution just to make a procedural mess of the health care debate" (Benson, CQ Today, 3/19).
Democratic abortion-rights supporters agreed to support the executive order if it did not expand current restrictions. Rep. Diana DeGette (D-Colo.), co-chair of the Congressional Pro-Choice Caucus, said, "We said we would compromise to current law in making this a health care bill, not an abortion bill, and that's exactly what the executive order does."
According to CQ Today, Stupak and his supporters agreed to the deal after "[r]ealizing that House Democratic leaders probably had the votes to pass a health care overhaul without them" (Benson/Ota, CQ Today, 3/21). In a Sunday news conference shortly before the House vote, Stupak said he was "pleased to announce that we have an agreement," adding that those involved "were able to come up with an agreement to protect the sanctity of life in the health care reform, that there will be no public funding for abortion in this legislation" (Seabrook, "Morning Edition," NPR, 3/22). Reps. Kathy Dahlkemper (Pa.), Steve Driehaus (Ohio), Marcy Kaptur (Ohio), Alan Mollohan (W.Va.) and Nick Rahall (W.Va.) joined Stupak at the news conference (Benson/Ota, CQ Today, 3/21).
House Dems Defeat GOP Antiabortion Resolution
House Democrats on Sunday also defeated a "last-minute attempt" by Republicans to defeat the health reform bill by adding Stupak's amendment to the bill, Politico's "Live Pulse" reports (O'Connor, "Live Pulse," Politico, 3/21). The Republicans' proposal was rejected 232-199, with 21 Democrats joining 178 GOP members in support of the motion (Kucinich, Roll Call, 3/21). Stupak said the GOP motion was "disingenuous," adding, "This motion is nothing more than an opportunity to continue to deny 32 million Americans health care" ("Live Pulse," Politico, 3/21).
Women's Groups React to Agreement
Several women's and abortion-rights groups reacted to the executive order on Sunday, Politico's "Ben Smith" reports. Planned Parenthood Federation of America President Cecile Richards said that the group "regret[s] that a pro-choice president of a pro-choice nation was forced to sign an executive order that further codifies the proposed anti-choice language in the health care reform bill." However, the group is "grateful" that the bill "does not include the Stupak abortion ban."
In a statement, NARAL Pro-Choice America President Nancy Keenan said that she is "deeply disappointed" that Stupak and his group "would demand the restatement of the Hyde Amendment." Sunday's events are "a stark reminder of why we must repeal this unfair and insulting policy," Keenan said in the statement, adding, "Achieving this goal means increasing the number of lawmakers in Congress who share our pro-choice values. Otherwise, we will continue to see women's reproductive rights used as a bargaining chip" (Smith, "Ben Smith," Politico, 3/21).
In a statement on Sunday, National Organization for Women President Terry O'Neill said Obama's executive order "breaks faith with women" and "suggest[s] that his commitment to reproductive health care is shaky at best." O'Neill added that NOW "has a longstanding objection to Hyde" and "was looking forward to working with this president and Congress to bring an end to these restrictions." However, "[w]e see now that we have our work cut out for us far beyond what we ever anticipated," she said, adding, "The message we have received today is that it is acceptable to negotiate health care on the backs of women, and we couldn't disagree more" (Franke-Ruta, "44," Washington Post, 3/21).
Catholic Bishops Remain Opposed While Other Catholic Groups Endorse
Sister Carol Keehan -- president and CEO of the Catholic Health Association, which endorsed the Senate bill earlier this month -- said, "We are confident that the reform law does not allow federal funding of abortion and that it keeps in place important conscience protections for caregivers and institutions alike," Keenan said. She added, "We are also pleased that the bill includes $250 million to fund counseling, education job training and housing for vulnerable women who are pregnant or parenting" (UPI, 3/22).
The U.S. Conference of Catholic Bishops maintained its opposition. USCCB Secretariat of Pro-Life Activities Richard Doerflinger said that the group's "conclusion has been that an executive order cannot override or change the central problems in the statute. Those need a legislative fix."
Meanwhile, the antiabortion-rights National Right to Life Committee also criticized the executive order, saying that it "was issued for political effect" and "changes nothing" (Werner, AP/Washington Post, 3/22).