Speaker Nancy Pelosi (D-CA) has scheduled a press conference tomorrow morning at 10am to release the final House health care bill with hopes of voting on the legislation sometime next week. According to early reports, the bill will cost approximately $900 billion/10 years, include a national public option that will reimburse providers at negotiated rates, cover 36 million Americans (6-7 million more than the Senate Finance version) and “be paid for, in part, with a 5.4 percent surtax imposed on those with incomes over $500,000 for individuals, $1 million for families.”
But while media attention has focused on these top line compromises, behind the scenes, some observers are concerned that an impasse over abortion funding could derail the entire reform effort. Yesterday, during an appearance on Washington Journal, Rep. Bart Stupak (D-MI) said said he is “considering teaming up with Republicans to block House health reform legislation (HR 3200) unless Democratic leaders allow a floor vote on an amendment that would add new restrictions on the use of federal funding for health plans that cover abortion with private dollars”:
STUPAK: I still gets down to, under HR 3200 — the house bill, the one I am most familiar with — there is these affordability credits. In other words you’ll get a refund if you will from the federal government to help pay for this tax, to help pay for this health care. So, what we’re saying is, if you are receiving an affordability credit, tax payer subsidies, you cannot buy a plan that has abortion coverage in it and we just can’t get by that. They once said, “no no,” if you get a subsidy from the federal government you should be allowed to buy abortion coverage with that subsidy. And that’s where we can’t go. It’s called the Hyde Amendment — no public funding for abortion. It’s been the law since 1976. If you wanna do health care that’s one thing but let’s not be changing the law on abortion coverage.” [...]
Somewhere in this process we have to have an opportunity to vote our conscious, in other words we have to have a vote or we’re gonna try and take down the rule. If we do not have the vote most members of the forty will not vote for the bill.
But Stupak is misrepresenting the House legislation and the existing federal restrictions on abortion funding. Currently, the House bill contains what’s called the Capps Amendment — a compromise that maintains Hyde Amendment restrictions. The arrangement protects Hyde by specifying that subsidy dollars could only be used to abort pregnancies that threaten the life of mother or result from rape or incest (Hyde allows for this). Other kinds of abortions would have to be funded with private premiums. The provision also requires that at least one plan in each market area offer abortion services and one plan not. No abortion services—even those allowed by the Hyde Amendment — can be mandated as part of a minimum benefits package.
Stupak and his allies want to go beyond Hyde. They’re arguing that the current firewall between public and private money is inadequate. If a woman uses federal subsidies to pay for a basic benefit, she would have more private money available to fund her abortion, they claim. Or, alternatively, “premiums paid to that plan in the form of taxpayer-funded subsidies help support that abortion coverage even if individual abortion procedures are paid for out of a separate pool of privately-paid premium dollars.” Sen. Orrin Hatch (R-UT) proposed a similar amendment, during the Senate Finance Committee’s mark-up, leading Sen. Debbie Stabenow (D-MI) to say, “with all respect to my friend, as a woman, I find it offensive.” Stabenow stressed that further restrictions on abortion funding would drastically change existing law and levy an undue burden on women who seek access to abortion services. Under Hatch’s amendment, women who purchase comprehensive private insurance packages — that include abortion services — would have to pay for the entire cost of the package (even if they qualify for subsidies).
As Pelosi prepares to unveil the bill, “leadership aides admit that they still need to find compromise wording on abortion but are confident the issue will be resolved by the time the bill gets to the floor.” Reps. Tim Ryan (D-OH), Mike Doyle (D-PA), Rosa DeLauro (D-CT) and Lois Capps (D-CA) are hoping to find a compromise before the measure comes to a vote, but conservatives are already organizing around the Stupak provisions.
WJ: “Mr. Stupak, Generally are you in support of the overall direction of the health care debate?”
STUPAK: “The overall direction? Yes. The overall direction of the health care debate I am in support of where we’re going with it”
WJ: Which means to you what exactly? With regard, for example, to the pubic option which is at the center of the health care debate”
STUPAK: “I have no problem with public option. I think the Senate added a provision last night or yesterday in which states would opt out. I think that’s a positive step. I think that it makes the public option much more palatable for some members who are opposed to the public option. But I do think we need something to bring some competition to the insurance industry. The public option is one way. The other way that I hope would be included would be to take away the anti-trust exemption the insurance companies enjoy. Right now they can raise rates like they are in my home state of michigan, 22 to 40 percent on individual policies. People just can’t afford that.They’ve priced themselves out of the market. So, I think you have to have some robust plan to compete here with that insurance industry to make sure that health insurance stays affordable and accessible for people.”
WJ: “What we do know you do have a concern with is the whole debate over federal funds for abortion procedures.”
WJ: “You are the leader of as many as forty like-minded members of the House of Representatives. Will you talk to us about some of your concerns?”
STUPAK: “Sure. We believe in what the majority of the American people believe that we should not be using public funds to pay for abortion coverage in health care. That’s been federal law since 1976. We want that law to continue. The President came before the Congress and said in his plan there would be no public funding for abortion. We’re holding the President to his words. We do not want to see tax payer funds being used to pay for abortion. And again, that’s not only the view of forty of us who have said, if you’re going to bring this issue up we want a vote on the floor whether or not there should be public funding for abortion. I sit on the Energy and Commerce Committee, as you said, we lost the amendment to knock out public funding for abortion. I think it was 30 to 28. I think it was two votes. And we want the right to bring this issue forth on the floor and decide as a nation, is this going to be a paid for benefit by tax payers dollars? We don’t believe that’s where the majority of Americans are. We believe that if we get a vote on the floor we will knock that part out — the public funding for abortion.”
WJ: “And what is the leadership telling you?”
STUPAK: “Not a lot. We talk back and forth trying to find some common language we could all agree on. Unfortunately there has been no agreement. I still gets down to, under HR 3200 — the house bill, the one I am most familiar with — there is these affordability credits. In other words you’ll get a refund if you will from the federal government to help pay for this tax, to help pay for this health care. So, what we’re saying is, if you are receiving an affordability credit, tax payer subsidies, you cannot buy a plan that has aboriton coverage in it and we just can’t get by that. They once said, “no no,” if you get a subsidy from the federal government you should be allowed to buy abortion coverage with that subsidy. And that’s where we can’t go. It’s called the Hyde Amendment — no public funding for abortion. It’s been the law since 1976. If you wanna do health care that’s one thing but let’s not be changing the law on abortion coverage.”
WJ: “Are you and your forty colleagues willing to vote ‘no’ on the entirety of the big piece of legislation if this language is in it?”
STUPAK: “Somewhere in this process we have to have an opportunity to vote our conscious, in other words we have to have a vote or we’re gonna try and take down the rule. If we do not have the vote most members of the forty will not vote for the bill. I still want to see how it plays out, I’m still somewhat optimistic somehow we’ll get a vote. Either through a rule or on the floor or a motion to recommit or somewhere along the line we’ll get to have that vote. I for one would like to vote for health care, but I really do have this hang-up that we should not have public funding for abortion. I don’t think it has any role to be in here. The President indicated the bill would not have it so why are we even having this discussion? Let’s go back and just keep current law.”