WASHINGTON — Furious liberals on Monday threatened to derail
the massive health care overhaul bill to protest a last-minute deal over
insurance coverage of abortions that had secured passage of the legislation in
the House.
At least 40 House members pledged not to vote for a final
health care bill if the abortion provision survives — endangering the
exceptionally fragile Democratic coalition that has kept the bill afloat.
At issue are the insurance policies offered in a new
“exchange,” or insurance marketplace, that the legislation would
create to help consumers purchase health plans, many using newly created
federal subsidies.
The House measure says the federal subsidies cannot be used
to buy health policies that cover elective abortion. But abortion rights supporters
say this would affect a broad set of consumers, because insurers would likely
abandon abortion coverage in all policies offered in the exchange.
The provision “represents an unprecedented and
unacceptable restriction on women’s ability to access the full range of
reproductive health services to which they are lawfully entitled,” the
House members wrote to House Speaker Nancy Pelosi.
It was a tougher line than they had adopted less than 48
hours earlier, when they had, almost to a member, voted to pass the health
legislation. The bill cleared the chamber late Saturday night by a mere five
votes.
The tumult over abortion now travels to the Senate, where it
promises to cause headaches for Democrats still wrestling with fundamental
issues of cost, coverage and revenues in its version of the health legislation.
Legislation before the Senate contains looser restrictions
on abortion coverage than was approved by the House. But, already, at least one
Senate Democrat, Ben Nelson of Nebraska, appears willing to work with abortion
rights opponents on language similar to that from the House.
President Barack Obama suggested Monday the House measure
might be altered as the legislation moves through Congress, though he did not
say he would push for changes himself.
Obama told ABC News the bill should uphold the principle
federal money may not be used to subsidize abortions.
“And I want to make sure that the provision that
emerges meets that test — that we are not in some way sneaking in funding for
abortions, but, on the other hand, that we’re not restricting women’s insurance
choices,” he said. “Because one of the pledges I made in that same
speech was to say that if you’re happy and satisfied with the insurance that
you have, that it’s not going to change.”
The House amendment would allow people buying insurance in
the exchange to purchase separate “riders” that would cover
abortions. Abortion-rights advocates say few would do so, because few women
anticipate an unplanned pregnancy and few insurers are likely to offer such a
separate service.
“No one counts on getting an abortion,” said
Rachel Laser, a lawyer with Third Way, a Washington think tank that advocates
centrist policies.
In 2001, 13 percent of abortions were billed directly to
insurance companies, according to the Guttmacher Institute, which studies
reproductive health. That figure, however, may understate insurance payments
for abortion, because it does not include cases where women paid for the
procedure out of pocket and later asked for reimbursement from their insurers.
Dr. Willie Parker, a board member at Physicians for
Reproductive Choice and Health, said the amendment could have the greatest
impact on women whose underlying health conditions require hospitalization in
order for a safe abortion to be performed.
Parker cited an example of a woman with a pregnancy that
involves abnormal attachment of the placenta. While a standard abortion may
cost just $350, the cost in that situation would range between $3,000 and
$4,000.
Via McClatchy-Tribune News Service.
