Abortion looms as possible block to health bill

WASHINGTON — The Senate is expected to give final approval to its health care reform bill early today, setting the stage for negotiations to reconcile that bill with the House's version that are expected to stretch into February.

But the way abortions are covered under health care reform is a major obstacle to finalizing the legislation, even though the House and Senate both agree that no federal money should be used.

The stumbling block is whether insurance plans that get federal money are completely barred from covering abortions, or whether they can cover it as long as they require customers to write separate checks for the procedure using their own money.

Why does that matter?

Because the House and Senate solved the dispute in different ways, neither of which makes everyone happy, and now they have to find a further compromise.

"Something's going to have to give," said Rep. Bart Stupak, D-Mich., author of the abortion language in the House.

At this point, it's not clear what that will be, although talks to resolve the issue have already begun and all involved in the intraparty dispute say they want to be able to support a final health care bill.

"We want to see a health care bill passed, and we don't think it's particularly helpful for anyone to draw a line in the sand," said Rep. Diana DeGette, D-Colo., a leader of the House Pro-Choice Caucus.

Abortion threatened to derail both the House and Senate legislation before last-minute compromises satisfied anti-abortion Democrats in both chambers. But those hard-won deals look very different.

The health bill passed by the House in November bars federal funding from going to any insurance plan that includes abortion coverage. That's a significant limitation because Congress' redesigned health care system would give federal subsidies to millions of lower-income people to help them buy insurance at new marketplaces called exchanges. Since the bulk of purchasers in the exchanges would be receiving federal subsidies, most, if not all, insurance plans would be receiving federal money and therefore would be barred from covering abortion.

Stupak's House language does allow insurers to offer separate rider policies covering only abortion, but abortion-rights activists contend such policies would be unlikely to materialize because there'd be little market for them. They note that most women don't plan for abortions ahead of time.

Abortions in the first trimester typically cost between $350 and $900, according to Planned Parenthood.