House Dems Mobilize To Pass Health Reform

Main Category: Health Insurance / Medical Insurance
Also Included In: Abortion
Article Date: 16 Mar 2010 - 2:00 PDT


House Speaker Nancy Pelosi (D-Calif.) on Saturday dismissed Republican claims that she did not have enough votes in her caucus to pass health care reform, the AP/Yahoo! News reports. Pelosi said lawmakers are "on the verge of making history," adding that Democrats are "very excited about where we are and will not be deterred by estimates that have no basis in fact" (Thanawala, AP/Yahoo! News, 3/13).

Under Democrats' strategy for passing health reform, the House is expected to pass the Senate bill (HR 3590), and then both chambers are expected to pass a budget reconciliation bill that includes agreed-upon changes, the Washington Post reports. Because budget reconciliation measures can only include provisions that have a budgetary impact, there are procedural obstacles to including abortion-related changes in that package. The budget reconciliation process requires only a simple majority vote and the procedural rules effectively shield such bills from a filibuster in the Senate.

In an appearance on NBC's "Meet the Press" Sunday, House Majority Whip James Clyburn (D-S.C.) said that although he is "very confident" the Senate bill will pass, House Democratic leaders have not gotten the 216 votes required to approve it. "We don't have them as of this morning, but we've been working this thing all weekend," he said.

According to the Post, House Democrats expect to receive final cost estimates from the Congressional Budget Office by Monday afternoon. The House Budget Committee is then scheduled to vote on the budget reconciliation bill, after which it would go to the House Rules Committee to be packaged with the health care reform bill passed by the Senate. The full House could vote on both bills as early as Thursday, but aides say it is more likely to be Friday or Saturday (Eggen, Washington Post, 3/15).

One of the "largest potential pitfalls" in the Democrats' effort to get the votes needed for passage continues to be the issue of abortion coverage, Politico reports. Antiabortion-rights Rep. Bart Stupak (D-Mich.) has said about 12 House members will vote against the Senate bill if the language on abortion coverage is not changed but the Democratic leadership is making the case that concern over the abortion provision should not derail their top domestic priority (O'Connor, Politico, 3/15). 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. Stupak and other antiabortion-rights House members would prefer language similar to his amendment, which was included in the House bill (HR 3962) and would prohibit insurance companies that receive federal subsidies from offering abortion coverage, even if paid for with private funds (Women's Health Policy Report, 3/12).

Last week, Democratic leaders signaled that they will not include changes to the Senate bill's abortion language in the budget reconciliation bill. House Majority Leader Steny Hoyer (D-Md.) on Friday said, "We don't want to go without their votes, but we do want to forge ahead." Hoyer added that Stupak "has made it very, very clear that he's very strongly in favor of achieving health care reform in this Congress. And I think that a lot of his colleagues feel the same way" (Politico, 3/15). Clyburn on Sunday predicted that Stupak "will end up voting for this bill" (Murray, Roll Call, 3/14).

Catholic Group Endorses Senate Bill, Despite Abortion Language

Meanwhile, the Catholic Health Association on Saturday endorsed the Senate health reform bill, which contains the abortion coverage provisions opposed by Stupak, the AP/Philadelphia Inquirer reports. Carol Keehan, the group's CEO, wrote on the CHA Web site that the legislation is not perfect, but it represents a "major first step" toward providing health care for all U.S. residents. CHA's endorsement of the bill "widens a split" among antiabortion-rights groups on whether the bill includes enough protections against federal funding for abortion services, the AP/Inquirer reports. Groups like the U.S. Conference of Catholic Bishops and the National Right to Life Committee are opposed to the Senate bill and have said they prefer the Stupak amendment language.

However, Keehan said that she thinks the Senate bill's approach would successfully prevent federal funding of abortion services. "On the moral issue of abortion, there is no disagreement," Keehan said, adding, "On the technical issue of whether this bill prevents federal funding of abortions, we differ with Right to Life." Keehan also said that CHA is "trying to respect other people's conscience and views," but "we also weigh in with our conscience and views. We think this bill is a good first step to health care reform" (Alonso-Zaldivar, AP/Philadelphia Inquirer, 3/14).

Washington Post Examines State-Mandated Abortion Coverage Riders

The experience of five states that permit insurance coverage for abortion only if a rider is purchased "offers a test" for federal policymakers as they continue to debate abortion coverage in health reform, the Post reports. Such policies have been suggested under various health reform proposals throughout the debate, including the provision favored by Stupak.

According to the Post, requirements for abortion riders exist in Idaho, Kentucky, Missouri, North Dakota and Oklahoma. However, very few, if any, insurance providers offer abortion policies to their customers because "no one has asked to buy one," the Post reports. Denise Kolpack, vice president of Blue Cross Blue Shield of North Dakota, said, "We have no member[s] who elected to have abortion riders." According to the Post, in the states that have the rider policy, "it is unclear how customers who purchase group insurance, typically for their employees, learn about the abortion coverage option." When asked whether Anthem Blue Cross and Blue Shield advertises the availability of abortion rider policies to customers in Kentucky, spokesman Tony Felts said, "I'm not sure if an employer would know that or not,” adding that if a customer requested a rider policy they would offer it "in compliance with state law."

Elizabeth Nash, a researcher for the Guttmacher Institute, said, "There's an information gap, clearly," adding, "A lot of people don't know if their health plan covers abortion because nobody wants to be in that situation" (Slevin, Washington Post, 3/14).

Broadcast Coverage

MSNBC's "The Rachel Maddow Show" on Friday featured a discussion on Stupak's abortion coverage language. In addition, the program featured comments from Citizens for Responsibility and Ethics in Washington's Melanie Sloan, who discussed the legal and ethical implications of Stupak renting a Washington, D.C., house that is linked to a conservative Christian group (Maddow, "The Rachel Maddow Show," MSNBC, 3/12).

Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

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