Abortion Rises To Threaten Health Care Bill

When it comes to the debate over health care, most of the talk has been about whether there will be a government-run health plan, the so-called public option. But there's another issue almost as divisive in the debate, abortion funding, and it could threaten to stop the entire bill in its tracks. Scott Simon talks to NPR health policy correspondent Julie Rovner for an update.

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This is WEEKEND EDITION from NPR News. I'm Scott Simon.

When it comes to the debate over health care, most of the talk's been about whether there will or won't be a government-run health plan, the so-called public option. There's another issue almost as divisive in this debate, and it could really threaten to stop the entire bill in its tracks.

NPR's health policy correspondent Julie Rovner joins us. Julie, thanks for being with us.

JULIE ROVNER: Nice to be here.

SIMON: And abortion, of course, is always a controversial issue in government. Tell us about the role it plays now in health care.

ROVNER: Well, it is a very big issue in this bill, and it's bigger than it is in many other bills because this time they're playing for keeps. You know, the vast majority of abortion policy, even though much of it is longstanding, is actually only temporary. Most of it's done in these annual spending bills and it has to be renewed every single year so it can be changed every time the president or the Congress changes positions on abortion.

This health bill, assuming that it passes and becomes law, will become permanent law. So, both sides to the abortion debate know that there is a lot at stake here.

SIMON: Now, both sides, I believe, say that their goal has been to just maintain the status quo of federal policy on abortion in this bill. Let me ask you to examine that. Is that what they're doing?

ROVNER: Well, that's what they say they would like to do, and how well they are doing that depends on who you talk to. Now, the main deal that's now in both the House and Senate bills was cut in the House Energy and Commerce Committee back in July. And here's how the abortion opponents put it. Their side was led by a Democrat, I should add, Bart Stupak of Michigan.

Representative BART STUPAK (Democrat, Michigan): Abortion must be explicitly excluded from the scope of any authority anywhere in this bill to define a mandatory benefits package. Secondly, we must preserve the longstanding principles that public funds do not pay for abortion procedures and do not flow to any plan that includes abortion.

ROVNER: And on the other side, we had Representative Jan Schakowsky of Illinois.

Representative JAN SCHAKOWSKY (Democrat, Illinois): Comprehensive health care does include reproductive health care, prenatal and maternity care, screening for breast, cervical and other cancers or STDs, abortion, contraceptive services. That these are all basic health care for women that we have a right to by virtue of our reproductive organs and our right to control our own bodies.

SIMON: Now, those are both Midwestern Democrats who don't sound like they're talking the same language.

ROVNER: No, they most certainly don't. The idea, remember, is to write language that freezes in place current law on abortion. So, the amendment says that all funds that will pay for abortion will have to come from premiums paid by individuals, not from the federal government. That within each exchange - these are the new marketplaces where people will go to buy their insurance, if they buy it on their own or if they're small businesses. In each exchange, there'll be one plan that does offer abortion as a benefit and one that doesn't. And that, in any case, funds that will pay for abortion will have to be segregated from any federal funds.

SIMON: How does this affect the bill that we might actually see voted on?

ROVNER: Well, the anti-abortion side say that this caps amendment is too permissive. It would still allow too much federal funding of abortion. In fact, they say it would expand the status quo, that it allows more abortion funding that is currently allowed. They're threatening to try to block the bill from even coming to the House floor, using a procedural vote.

They might well have the votes to do it. There are always and have been a lot of anti-abortion Democrats in the House - not just Republicans. They're...

SIMON: I'm eager in following up on this with you, because abortion is truly an issue that cuts across party lines.

ROVNER: Indeed, it always has. There have always been a number of Republicans who have favored abortion rights. That's kind of a dwindling minority, if you will. But there are a lot of Democrats who are very anti-abortion. They've never been shy about making that a single voting issue. The National Right to Life Committee, one of the lead anti-abortion groups, said this will be a key voting issue. So, this is a big problem for the Democrats as they go to put this bill together.

On the other side, I might point out, abortion rights backers say if the bill is compromised any further, it could mean that millions of women who currently have abortion coverage in their private plans could lose it. Estimates vary but somewhere between 46 and 87 percent of women who have private insurance coverage currently have coverage for abortion. So, if you were to say that no plans, no private plans that are subsidized by federal funds could cover abortion, a lot of those women could then lose that coverage. So, there is indeed a big fight brewing about this issue.

SIMON: NPR's Julie Rovner, thanks so much.

ROVNER: You're welcome.

SIMON: And what's your opinion: should the health care overhaul include federal funds for abortion services? To tell us what you think, please join our discussion group at Facebook.com/NPRWeekend. And if you're not on Facebook, you can also post comments at npr.org/soapbox.

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