A ban on federally funded abortions inserted into the House's health care reform bill late Saturday night already has lawmakers and interest groups on both sides of the issue promising to wage a battle that could threaten the fate of the entire health care reform effort.
Pro-choice supporters called the amendment, proposed by Rep. Bart Stupak, Michigan Democrat, a dramatic assault on a woman's right to choose and promised to fight for the ban's removal as the health bill proceeds. Pro-life supporters said the ban is the only way to ensure their dollars don't fund the procedure and said they'd work to keep the language intact.
It adds yet another firefight -- this one involving one of the most controversial issues in the nation -- to the already contentious health care reform bill as it heads to the Senate.
The reform bill squeaked through the House late Saturday night on a 220-215 vote, just two more votes than the 218 required for passage. The abortion amendment passed more easily, 240-194, with support from 64 Democrats and all but one of the 177 Republicans in the House. Rep. John Shadegg, Arizona Republican, voted "present."
The amendment, backed by the U.S. Conference of Catholic Bishops, would prohibit the new public insurance plan from covering abortions, except in cases of rape, incest or where the life of the mother is at stake. Without the ban, it would be up to the secretary of the Department of Health and Human Service to decide whether to cover it.
It would also prevent anyone who receives federal tax subsidies -- intended to help the poor and middle class meet the new requirement that nearly all Americans buy insurance coverage -- from buying a private insurance plan that includes abortion coverage. The original bill would have required patients to pay for abortion coverage with their own money.
Under the amendment, patients would have to use their own funds to purchase additional coverage, known as a "rider," if they wanted abortion coverage.
For more than 30 years, both sides of the abortion issue have lived under the Hyde Amendment, a compromise that prohibits federally funding of abortions in existing government-run health programs, such as Medicaid. Under those rules, patients receiving federal aid must pay the entire cost of any abortion out of their own pocket.
Pro-life supporters argued that the health bill as written didn't uphold the Hyde Amendment, named for its sponsor, the now-deceased Rep. Henry J. Hyde, Illinois Republican.
"Passage of the Stupak amendment does not impose a new federal abortion policy," Mr. Stupak said. "It simply continues what has been the law of the land since 1977, and I am pleased that with the addition of this amendment the House health care reform bill will continue that policy."
But pro-life supporters said the bill reached further. They argued that the amendment would restrict access to abortions to the poor and middle class, those most likely to purchase coverage through the public insurance plan or receive the tax subsidies.
"If enacted, this amendment would be the greatest restriction of a woman's right to choose to pass in our careers," said Rep. Diana DeGette, Colorado Democrat.
Planned Parenthood argued that the amendment amounted to a ban on abortion coverage because "abortion riders" would be illogical.
"Such abortion riders do not exist because women do not plan to have unintended pregnancies or medically complicated pregnancies that require ending the pregnancy," said Cecile Richards, president of the Planned Parenthood Federation of America.
The abortion issue nearly took down President Obama's goal to reform the nation's health care system.
A vote on the amendment only came up because House Speaker Nancy Pelosi, California Democrat, couldn't reach agreement with a pro-life group of 40 Democrats that threatened to block the bill from getting to the floor.
House Minority Leader John A. Boehner, Ohio Republican, questioned the three Democratic committee chairmen who crafted parts of the bill, asking them to promise the language would remain in the bill once the House and Senate plans are merged. None agreed.
The abortion amendment is likely to put new pressure on the Senate to either remove the language or tone it done. But Democratic leaders already have their hands full trying to pass the reform bill as planned. In the Senate, moderate Democrats are apprehensive of the reform plans and are awaiting to see the legislation that Majority Leader Harry Reid, Nevada Democrat, sends to the Senate floor, expected no sooner than next week.