Health Care Passes House With Abortion Amendment

House lawmakers on Saturday passed a sweeping bill that would overhaul the nation's health care system. The measure, supported mostly by Democrats, contained an abortion amendment that required the party to make a significant shift to the right.

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STEVE INSKEEP, host:

Its MORNING EDITION from NPR News. Good morning. Im Steve Inskeep.

Renee Montagne is in Boston, spending time in Americas test kitchen and well find out what they come up with on Thanksgiving week.

Right now, we have two radically different views on health care. The debate in Congress will likely range somewhere between these views in the coming weeks. The first comes from President Obama. He praised the House over the weekend for passing a bill that would extend coverage to millions of Americans.

President BARACK OBAMA: The Affordable Health Care For America Act is a piece of legislation that will provide stability and security for Americans who have insurance, quality affordable options for those who dont, and bring down the cost of health care for families, businesses and our government, while strengthening the financial health of Medicare. It is legislation that is fully paid for and it will reduce our long-term federal deficit.

INSKEEP: So, thats one view. Now the bill moves on to the Senate where the other view is represented by Republican Senator Lindsey Graham of South Carolina.

Senator LINDSEY GRAHAM (Republican, South Carolina): The House bill is dead on arrival in the Senate. Just look at how it passed. It passed 220 to 215.

INSKEEP: Lindsey Graham spoke on CBS. Were going to talk about these differing views and more, starting with NPR health policy correspondent Julie Rovner, whos with us once again. Hi, Julie.

JULIE ROVNER: Good morning.

INSKEEP: Whats in the bill the House passed?

ROVNER: Well, to take it in the order the president did: for people who have insurance, the bill would do things like ending the practice of denials based on preexisting conditions. It would end things like charging women more because they tend to use more health care. It would end imposing annual and lifetime benefit limits. At the same time, it would require everyone to have insurance. It would require most employers to help pay for it. And it would require the government to provide subsidies to poor and middle income people. For the uninsured, this is where weve gotten most of the attention, it would create these new marketplaces called insurance exchanges where individuals and small businesses could go to buy insurance. One option within that exchange would be a government-sponsored public option, although that public plan would have to negotiate its rates just like private plans - that was the compromise to get those moderate Blue Dogs on board.

Finally, as the president said, the bill would pay for itself, largely through reductions in Medicare spending and a new tax on high-income earners, generally those earning over a half a million dollars.

INSKEEP: So, it promises more to a lot of people. It expects more of a lot of people, including companies, the government, individuals and so forth. But there is the question of whether it could have squeezed some more money out of the health system and I understand thats one of the reasons that Republicans so strongly objected here.

ROVNER: Thats right and some Democrats. There were many Democrats who did not vote for the bill, too. Now Republicans, of course, tried to offer their own alternative. It included things that weve seen many times before: limits on medical malpractice lawsuits, letting people buy insurance across state lines. The Congressional Budget Office, though, said that they would only cover about three million people who didnt have insurance, as opposed to the 36 million people in the Democrats' bill. The Republican alternative went down fairly handily.

INSKEEP: Now, there are some other issues that were brought up here. Before the House bill was passed late Saturday night, there was a fight over abortion. What happened?

ROVNER: Yes, this was a fairly big deal. The effort in the bill was to basically freeze in place existing law on abortion, which is really the Hyde Amendment - which has to be, basically, reenacted every year. This is the ban on federal funding for abortion. And the amendment that passed not only would write into place permanent law, the Hyde Amendment, but it would also extend beyond the Hyde Amendment, which would ban federal funding directly for abortion, it would also ban funding for any private plans that offer abortion as a coverage service if those private plans gets subsidies. Remember; in these exchanges, there will be subsidies for people getting help to buy these private plans.

So there are abortion rights supporters that are furious about this amendment and that they were allowed to offer it.

INSKEEP: So, a Democratic House voted for restrictions on abortion. And, Julie, stay with us because we are going to bring another voice to the conversation.

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