In a last-minute deal to win the votes of anti-abortion Democrats in a rare Saturday session, the House approved an amendment by Rep. Bart Stupak, D-Mich., that would strongly restrict the availability of abortion coverage.
The amendment would ban people who receive federal health insurance subsidies from purchasing plans that cover abortion services in a new insurance exchange marketplace. Instead, those who wished could purchase an extra "rider" to cover abortion services.
The legislation would also bar the new government-run public insurance plan from offering abortion coverage.
Abortion opponents say that the bill guarantees that no federal funds will be used to pay for abortions, part of U.S. law since Congress passed the Hyde amendment in 1976. The Hyde amendment must be reauthorized by Congress each year; the new legislation would be permanent.
But abortion rights advocates say that the bill goes further than the Hyde amendment ever has, by restricting private insurers' ability to offer plans that cover abortion. Opponents say that the bill will restrict lower- and middle-income Americans' access to abortion services, because under the House legislation, people making up to four times the federal poverty level, or $88,000 per year, are eligible for federal subsidies.
They also contend that the restrictions will affect even women who don't receive subsidies, because insurers who want to offer plans to people who receive subsidies could not include abortion coverage in those plans. So even people who wish to purchase insurance through the exchange using entirely their own money may find that the plans they wish to purchase receive government money through other subsidies and so cannot offer abortion coverage.
Abortion rights advocates have instead called for language first proposed by Rep. Louise Capps, D-Ca., that would have required insurers to keep the money received from federal subsidies and the money received from private copayments in separate accounts, and to pay for abortions only with the private money.
The focus of attention now shifts to the Senate, where Majority Leader Harry Reid is still negotiating the abortion language that will appear in the bill he will bring to the Senate floor. The bill approved by the Senate Finance Committee last month includes language based on the Capps proposal.
President Obama told ABC News today that he believes the language in the House bill needs to change.
"I laid out a very simple principle, which is this is a health care bill, not an abortion bill," he said. "And we're not looking to change what is the principle that has been in place for a very long time, which is federal dollars are not used to subsidize abortions."
Two advocates on opposite sides of the abortion issue discuss the House bill and the upcoming debate in the Senate.
Laurie Rubiner, Vice President for Public Policy at the Planned Parenthood Federation of America, a group that advocates for abortion rights:
And Richard Doerflinger, associate director of the United States Conference of Catholic Bishops' Secretariat of Pro-Life Activities. The USCCB is a long-time proponent of universal health care but had said it could not support the House bill without the Stupak amendment.
---- By Lea Winerman, Online NewsHour