President Obama's health care bill would change federal policy on abortion, but not open the spigot of taxpayer dollars that some abortion opponents fear. Abortion rights groups such as Planned Parenthood and NARAL Pro-Choice America say the House and Senate versions of the bill represent the biggest expansion of abortion restrictions in years, yet they're not trying to defeat the measures. Instead, a bitter dispute among abortion opponents over which version is stricter could derail Obama's quest to remake the health insurance system.
Major anti-abortion groups such as the U.S. Conference of Catholic Bishops and the National Right to Life Committee say the Senate provisions expected to come before the House shortly are a backdoor taxpayer subsidy for abortion. Other abortion opponents disagree.
"I actually think the Senate bill will more effectively prohibit federal funds from going to abortion," said Stephen Schneck, director of the Institute for Policy Research & Catholic Studies at Catholic University of America in Washington. "That legislation will actually reduce the demand for abortion in the United States."
Here's a look in question and answer form at a simmering conflict that is vexing House Speaker Nancy Pelosi, D-Calif., as she and other Democratic leaders try to find enough votes to pass health care:
Q: Obama said he wouldn't tamper with the status quo on abortion, so what's the problem?
A: That's what he said, but it's not exactly what happened.
Current law -- known as the Hyde amendment -- prohibits federal funding for abortion except in cases of rape, incest or to save the life of the mother.
The first drafts of the Democratic health care bills, written by abortion rights supporters in Congress, would have allowed health insurance plans receiving federal subsidies to cover abortion as a legal medical procedure. They couldn't get the votes to advance, so eventually Democratic abortion foes took over writing the language. But any trust abortion opponents might have had in the administration was gone.
The House and Senate ended up passing different provisions.
Q: OK, what are some of the differences?
A: Both bills would set up a new health insurance marketplace for small businesses and people buying coverage on their own, with government subsidies to help keep premiums affordable. That's the similarity.
Here's the key difference: The House provision, written by Rep. Bart Stupak, D-Mich., would prohibit health plans receiving subsidies from covering abortions, except as allowed by the Hyde amendment. Women who want coverage for abortion would have to buy a separate policy.
The Senate language, written by Sen. Ben Nelson, D-Neb., would allow the plans to cover abortion with private funds collected directly from policyholders. People who want the coverage would have to write two checks to their health insurance plan, and the plans would keep the money in a separate account from taxpayer funds.
With the Senate bill going back to the House, Obama is asking Democrats to unite behind it.
Q: Would the Senate bill change the status quo?
A: Yes. The federal employee health benefits program is seen as the model for the new insurance marketplace, and none of the plans available to government workers may cover abortion, except as allowed by Hyde.
"It would be a pretty significant change," said Kristen Day, executive director of Democrats for Life of America. Stupak and Nelson, both longtime abortion foes, serve on the group's advisory board. Day said Stupak's approach is preferable, because it closely follows existing law. But the Senate rejected it, forcing Nelson to develop his plan as a fallback.
Q: Does that mean the Senate bill allows taxpayer money for abortions?
A: Douglas Johnson, legislative director for the National Right to Life Committee, says money is fungible, and the separation between taxpayer funds and private premiums is only a fig leaf.
US House of Representatives; US Senate; Planned Parenthood; NARAL Pro-Choice America; U.S. Conference of Catholic Bishops; National Right to Life Committee; Catholic University of America.
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