Closing in on compromises on some of the most costly provisions of the health care reform legislation, lawmakers plan to turn their attention this week on a less expensive but equally controversial issue — abortion.
Supporters of abortion rights say they hope to remove restrictions on abortion access from both the House and Senate bills before they are merged and sent to President Obama's desk.
"We think it's possible to come up with language that the Pro-Choice Caucus would not 'embrace,' but would be acceptable," said Rep. Jan Schakowsky, Illinois Democrat and supporter of abortion rights, declining to elaborate.
"It's really sensitive, and we need to figure it out," she said.
But the U.S. Conference of Catholic Bishops plans to put up a fight. For the second consecutive week, it urged churchgoers to call lawmakers in support of the House's plan and against the Senate's.
The House's bill bans anyone who receives federal tax subsidies from buying a private insurance plan that includes abortion coverage — they would have to purchase an additional side plan that includes such coverage. Opponents of abortion rights say the amendment is the only way to ensure that their dollars don't fund the procedure.
Rep. Bart Stupak, the Michigan Democrat who helped craft the House bill, opposes the Senate's less restrictive abortion language, proposed by Sen. Ben Nelson, Nebraska Democrat.
The Senate's plan would require women with insurance plans that cover abortion to pay entirely for their abortion coverage, keeping any federal tax subsidies separate. The insurance exchanges would have to have at least one plan that doesn't cover abortions. States would be allowed to pass a law prohibiting any plan in the exchange from providing abortion coverage.
There are exceptions in both bills for cases of rape, incest and the life of the mother.
Mr. Stupak said he doesn't expect the issue to derail health reform this time.
"It's not going to be the one that trips up this bill," he told reporters last week.
"We'll get it worked out. We worked it out last time, too," he said, not tipping his hand on whether he'll accept anything less than the language he got into the bill.
Groups that support abortion rights, such as Planned Parenthood, have been vocal in urging lawmakers to remove all abortion restrictions from both bills.
Lawmakers say abortion negotiations will start when both chambers return on Tuesday. For the past week, much of the conversations between the White House and House and Senate leaders has focused on how to pay for the bill and whether insurance should be sold through federal or state-based exchanges.
Last week, labor union leaders said lawmakers agreed to scale back a tax on high-cost insurance plans, but Democrats have not announced how they'll make up the revenue.
Those issues impact the final cost of the legislation — which the Congressional Budget Office will need days to analyze. Abortion, while controversial, won't change the bill's tab.
The debate over whether to allow women who receive federal tax subsidies to buy abortion coverage — and whether to allow insurance companies on the exchange to cover it — nearly torpedoed the whole bill in the House just weeks ago. Shortly before the House voted for final passage in November, a group of Democrats who oppose abortion rights said they would not support the bill unless they had a chance to vote to insert restrictions to prevent federal funding of abortions. Forced to allow a vote on the amendment or risk losing the whole bill, Speaker Nancy Pelosi allowed the vote and it passed with the help of all 176 Republicans.
The most controversial element of merging the bills, however, was whether to allow a tax on high-cost insurance plans. Labor union leaders strongly opposed the Senate's tax over concern that it would unfairly hit their middle-class members. A tentative deal emerged last week that would increase the threshold at which plans are considered "high-end," — a value of $8,900 for individuals and $24,000 for families — and delay implementation for some plans until 2018.
Lawmakers still have to decide whether to establish national or state-based exchanges, another difference in the House and Senate bills. Then, the plan will have to go to the Congressional Budget Office for a cost estimate.
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