Health Care

What's Next For Health Care Overhaul

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While the House has passed a landmark bill, the measure's prospects in the Senate are anything but assured.

STEVE INSKEEP, host:

NPRs Cokie Roberts joins us for analysis, as she does every Monday morning. Cokie, Good morning.

COKIE ROBERTS: Hi Steve, Hi Julie.

INSKEEP: Whats likely to happen with this abortion dispute now?

ROBERTS: Well, in the Senate, they are already having problems getting the bill passed with moderate Democrats, and actually, this anti-abortion language is likely to help bring on the moderate Democrats. You have to understand, here, the role of Catholic bishops. They have been among the strongest supporters of health care for decades. For many, many years, the Catholic Bishops Conference has said that universal access to health care is, quote, a basic human right. So, when they said that without this anti-abortion language they could not support the House bill it became a real problem, because this is an issue where they have credibility.

And, in fact, the bishops were pushing for more coverage for immigrants, which was the other issue that had bollixed up the House at the last minute, and the bill they passed does explicitly exclude illegal immigrants from coverage.

But the pro-choice Democrats who voted for the bill are holding their noses, hoping the anti-abortion language might go away in the Senate. I think they have a slim reed to lean on. I cant imagine the end though that they dont eventually go ahead and vote for a health care coverage bill.

INSKEEP: So, were the abortion restrictions basically the price for some essential support here then? Is that a fair way to think of it?

ROBERTS: Of course, exactly. I mean, the speaker was very clear on that. She couldnt pass the bill without the votes of the Democrats who were brought on board with the anti-abortion language.

INSKEEP: Julie Rovner is still listening to us. And, Julie, Id like to know of once they get out of the specific tactical situation, if there could actually be other changes on abortion in the coming months.

ROVNER: Well, its hard to tell. You know, the one thing about the abortion issue is that its not a single issue, its a continuum. You know, you talk about things like family planning and you get, really, an enormous amount of support, even from a lot of Republicans.

But you talk about funding - and this is a funding vote. This is the issue thats the hardest issue for abortion rights forces, or the easiest issue for anti-abortion forces, if you will. This was a funding vote. So, you cant really read into this vote, that, you know, abortion rights support is slipping.

But I think Cokies right. You would certainly expect, in the Senate, where theres probably less support for abortion rights than there is in the House, I would expect that the Senate would probably adopt this amendment too, now that the House has.

INSKEEP: Julie, thanks very much. Thats

ROVNER: Youre very welcome.

INSKEEP: thats NPRs Julie Rovner. Cokie Roberts is still with us, because I want to ask about another part of this. There was a lot of talk after Republicans won a couple of governors races on Tuesday, that this would send a message in Congress, that it would or should - Republicans were hoping - affect the health care debate in some way. Did you see any sense of that or any sign of that as the House prepared to vote on Saturday?

ROBERTS: Well, the House majority leader, Steny Hoyer, went out of his way to make the point that only Congress, not governors, vote on health care and that the two congressional races, last Tuesday, went to the Democrats. Yeah, obviously, theres a lot of skittishness. Look at the vote. They needed 218 votes to pass the bill and they only got 220.

And there was one Republican who went along, from my hometown of New Orleans. He represents a thoroughly Democratic district and got elected as a result of a Democratic scandal. So, hes obviously thinking that this is something that be good for his reelection.

But the look of joy on Nancy Pelosis face, late Saturday night, as she announced the final tally was quite something to see, Steve, because she knew that it would not have happened. She couldnt have passed this bill without her own politicking. And the basic calculation that she and the president kept making to the Democratic caucus was that the voters said, last Tuesday, is they still want change - and doing nothing is not change, so go for it.

The White House is constantly making the case that theyre better off being bold. But, of course, House members are nervous. Most Americans are happy with their health care. Change could disrupt them rather than help them. And the Senate is even more nervous, as you just heard from Julie, you know, a higher percentage of senators represent heterogeneous constituencies and its a problem to them.

INSKEEP: Very briefly, a lot of these lawmakers, regardless of the party, must be looking at the economic numbers and wondering what that means for them.

ROBERTS: And thats where Tuesdays election really has had an effect, because people are so worried about the economy, and the presidents people say every day hes saying, give me ideas, give me ideas; tell me how I can help to stimulate the economy. They dont want to bandy this about too much until they get health care done.

INSKEEP: Thanks very much. Thats NPR News analyst Cokie Roberts who joins us every Monday morning.

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INSKEEP: Youre listening to MORNING EDITION from NPR News.

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