This was supposed to be a Congress focused on jobs and the middle class, but Democrats have quickly turned it into a fight over abortion, the thorniest of social issues, which has already derailed a bipartisan anti-human trafficking bill and now threatens to undermine a long-sought deal on fixing Medicare.
Under pressure from pro-choice groups, Senate Minority Leader Harry Reid is balking at pro-life language designed to keep federal funds from paying for abortions in both bills, known as the Hyde amendment.
Hyde restrictions have been law for decades, but Democrats say they fear the GOP is trying to expand them to include other types of federal money beyond revenue collected from taxpayers, and to try to enshrine the restrictions into permanent law rather than the annual spending process.
Mr. Reid’s concerns place a new hurdle in the Medicare agreement reached this week by House Speaker John A. Boehner and Minority Leader Nancy Pelosi, Mr. Reid’s House counterpart.
Democrats have already filibustered to stop the anti-trafficking bill, arguing it extends the Hyde restrictions to include money collected as penalties from criminals. The Medicare bill language, meanwhile, would ban community health centers from using federal funds on abortion, but the provision would expire alongside the funding in two years.
Mr. Reid led the filibuster on the trafficking bill but waved off questions Tuesday over how he’ll handle the Medicare legislation, saying that he wants to wait until the House passes it and study how its abortion language differs from the trafficking bill’s provision.
“Whether that helps or not I don’t know,” Mr. Reid told reporters. “But they’re different.”
Senate Democrats also said they are intent on not making the same mistake they made on the trafficking bill, where they say they didn’t see the Hyde restrictions until the bill reached the Senate floor, forcing them into an embarrassing about-face.
The Medicare bill has deeply divided pro-choice advocates and split Mr. Reid and Mrs. Pelosi.
Leading House Democratic women said Tuesday the fight shouldn’t scuttle the Medicare deal, which also reauthorizes the Children’s Health Insurance Program for two years.
Language in the bill “does not further restrict women’s access to abortion, and the provisions expire along with funding — just as the current Hyde Amendment does,” Democratic Pro-Choice Caucus Chairwomen Diana DeGette of Colorado and Louise McIntosh Slaughter of New York said in a statement.
But NARAL Pro-Choice America said lawmakers should vote no, calling it “yet another in a long series of bills that are a premeditated, coordinated and sustained attack on women’s health care and advance the far-right wing goal of banning abortion all together.”
The House is set to vote Thursday on the bill, which would repeal a budget tool designed to limit payments to doctors who treat Medicare patients, known as the Sustainable Growth Rate.
Mr. Boehner said he expects the bill to pass, and said he isn’t working on any backup plan as Congress prepares to flee Washington for a two-week spring break. That suggests Mr. Reid will face a take-it-or-leave-it choice late this week.
Conservatives are conflicted over the bill because it released the Sustainable Growth Rate formula, or SGR, which was implemented in 1997 as a deficit-cutting tool designed to limit the growth of Medicare by limiting payments to doctors. But Congress regularly prevents the cuts from taking place, arguing doctors will dump senior citizen patients and spawn a health crisis.
Mr. Boehner and Mrs. Pelosi said it’s time to scrap the cuts permanently before April 1, when a 21 percent cut is due.
The bill would boost spending over the next decade by about $200 billion, but Congress would only pay for about $70 billion by increasing costs for wealthier Medicare recipients and cutting reimbursements to providers such as hospitals.
Against this backdrop, few would have expected abortion to be a major sticking point.
A Senate GOP aide said the caucus didn’t have a vote count yet among its members, but that it expected many Democrats to break with Mr. Reid over the abortion question.
“I think they realize that game’s not going to fly,” Senate Committee on Finance Chairman Orrin G. Hatch, Utah Republican, said.
Rep. Michael C. Burgess, Texas Republican and a doctor who has long fought for repeal of the SGR, said he’s hoping Congress doesn’t stumble at the finish line. Senate Democrats still want to reauthorize the children’s insurance program for four years — not just two — and the administration may resort to delaying Medicare claims if Congress can’t reach a deal.
“When something like this finally seems like it’s going to jell, there are lots of people who show up at the eleventh hour with, ‘What about this?’” Mr. Burgess said. “And that is inherently a problem.”