Key deal in House's health care vote centered on abortion

WASHINGTON, D.C. — As President Obama and Democratic lawmakers basked in the glow of legislative success this weekend, following the narrow passage of landmark health care legislation in the U.S. House late Saturday, noticeably absent from much of the celebratory rhetoric was any talk of the deal that made it all possible.

The critical, but precarious, agreement made between the party's liberal lawmakers, like Rep. Keith Ellison of Minneapolis, and its usually quiet pro-life members, like Rep. Jim Oberstar of the Iron Range, came together in the 11th hour of negotiations and centered on a politically sensitive issue: abortion rights.

On one side, Oberstar and about 40 pro-life Democrats made it clear by the end of last week that they would not support any legislation that might make it possible for federal taxpayer dollars to go to fund abortions.

On the other side, Ellison and other abortion rights advocates argued that the legislation already ensured that would not happen and that additional language might illegally infringe on a woman's right to choose.

But with 218 votes needed to pass the legislation, House Speaker Nancy Pelosi — a liberal from San Francisco who supports abortion rights — could not ignore the sizeable Pro-life Caucus.

So she agreed to let longtime pro-life advocate Rep. Bart Stupak, D-Mich., bring an amendment on abortion coverage to the House floor.

The amendment stipulated that any government-run insurance option and any private insurance plan on the proposed exchange that accepts people using government subsidies would be barred from offering abortion coverage.

The federal employees' health benefits program and most state Medicaid programs also ban coverage of abortion, in keeping with a more than three-decade ban on federal dollars going to fund the procedure.

Proponents of the amendment highlighted that women who received subsidies could still pay out of pocket for the procedure or purchase supplemental insurance coverage with their own money.

'Beyond the status quo'
Opponents of the provision, however, argued that the language would not only impede working-class women's access to the procedure, but that it could also affect women who don't use government subsidies.

"I really resent being pulled into this issue in a historical moment like this," Ellison said in an interview this weekend. "The Stupak amendment goes beyond the status quo… and I don't know if it will survive."

Planned Parenthood condemned the amendment.

Rep. Betty McCollum, D-Minn., said in a statement: "This amendment is wrong, it is dangerous, and it should be defeated." 

But the amendment ultimately passed with the support of 64 Democrats, or about a quarter of the party caucus.

"This is not a perfect bill but a good bill," Oberstar, who voted for the measure, said from the House floor on Saturday evening. "The three committees have worked hard to address the needs of the people of my district, and my own concerns, regional disparities in Medicare reimbursement that penalize Minnesota health care providers, and ensuring taxpayer dollars are not used to fund abortion services."

Minnesota Democratic Rep. Collin Peterson and Minnesota Republican Reps. John Kline, Erik Paulsen and Michele Bachmann joined Oberstar in voting for the amendment.

Meanwhile, Democratic Rep. Tim Walz joined McCollum and Ellison in voting against it.

But in the end, despite the amendment, the three Democrats voted in favor of the bill, which ultimately passed the House by a 220 to 215 vote.

Peterson, Kline, Paulsen and Bachmann voted against the health-care reform legislation.

In a statement, Kline said that the bill would lead "to new government mandates, bureaucratic red tape, and stifling tax increases."

"What passed today fails to even come close to the commonsense, bipartisan reform the American people need and deserve," Kline said.

Paulsen added in a statement: "When it comes to health care, I continue to believe the status quo is unacceptable. For months, many new members of Congress have expressed a willingness to work on bipartisan measures to lower health care costs for families and small businesses. This bill was pushed through on a partisan basis, with bipartisan opposition."

Calling the bill "flawed," Peterson also said in a statement that it would do nothing to control costs.

"Eventually the final bill has to look different than what was considered today because we have to get costs under control," Peterson said.  "As I said at the beginning, we need health care reform and most Minnesotans know it.  We're going in the right direction, and although the current bill wasn't something I could vote for, I think that if we continue to work together and listen to one another we can write and pass something that will do all of what we need to do — and that will be something I'll vote for."

Meanwhile, Walz, McCollum, Ellison and Oberstar voted in favor of the legislation, though they acknowledged that it was not perfect.

"There is a big difference between being a legislator and being an activist," Ellison said. "An activist raises a moral imperative. The legislator has to weigh a diverse set of interests and try to keep as many people under the tent as possible in order to move forward legislation. We need health care reform. We got to have it. And, in my opinion, we can solve this [the Stupak amendment] in the future, but this may be our only chance on health care reform."

Fight ahead
Democratic Rep. Diana DeGette of Colorado, however, has already promised a fight if the final bill comes back with the same language.

But that may not be something that House Democrats will have to worry about for a while. Whatever emerges out of the Senate, which is still working out its bill with the Congressional Budget Office, will likely look significantly different from what the House passed.

So, for a moment on Saturday —  as they counted down to passage of the bill, New Year's Eve-style — Democrats tried to focus on the moment as opposed to the likely intra-party battles ahead.

"I think we have been able to add a good touch of Minnesota to this and a good touch of real reform," Walz said in a press call with reporters.

"This legislation may not be perfect, but it is very good," echoed McCollum in a statement.  "It will make our country stronger, our economy more productive, and every American family healthier."

Cynthia Dizikes covers Minnesota's congressional delegation and reports on issues and developments in Washington, D.C. She can be reached at cdizikes[at]minnpost[dot]com.