The White House is on a collision course with Catholic bishops in an intractable dispute over abortion that could blow up the fragile political coalition behind President Barack Obama's health care overhaul.
A top Obama administration official on Thursday praised the new Senate health care bill's attempt to find a compromise on abortion coverage — even as an official of the U.S. Conference of Catholic Bishops said Sen. Harry Reid's bill is the worst he's seen so far on the divisive issue.
The bishops were instrumental in getting tough anti-abortion language adopted by the House, forcing Speaker Nancy Pelosi, D-Calif., to accept restrictions that outraged liberals as the price for passing the Democratic health care bill. Reid, D-Nev., now faces a similar choice: Ultimately, he will need the votes of Democratic senators who oppose abortion to get his bill through the Senate.
So far, Reid has steered the Senate bill in a direction that abortion rights supporters can live with: allowing coverage for abortion in federally subsidized health care plans, provided that beneficiaries' own premiums are used to pay for the procedure. But abortion opponents say his compromise would gut current federal restrictions on abortion funding.
Despite criticism, there were growing indications Reid would prevail on an initial Senate showdown set for Saturday night. He needs a 60-vote majority to advance the bill toward full debate, expected to begin after Thanksgiving and last for weeks. It's during that debate that the battle over abortion will be joined in earnest. Reid will need to clear other 60-vote hurdles before senators cast their final vote on the bill.
At the White House on Thursday, health reform director Nancy Ann DeParle praised Reid's effort to find a compromise on abortion.
"It was carefully worked through by the leader, who cares a lot about making sure this maintains the status quo on abortion policy," DeParle told reporters. Obama has said he wants the bill to remain neutral on abortion, and DeParle said Reid struck just the right balance.
But Richard Doerflinger, associate director of the bishops' conference Secretariat of Pro-Life Activities, said Reid's "is actually the worst bill we've seen so far on the life issues."
He called it "completely unacceptable," adding that "to say this reflects current law is ridiculous."
The bill would forbid including abortion coverage as a required medical benefit. However, it would allow a new government insurance plan to cover abortions and let private insurers that receive federal subsidies offer plans that include abortion coverage.
In all cases, the money to pay for abortions would have to come from premiums paid by beneficiaries themselves, kept strictly separate from federal subsidy dollars. Government funds could be used for abortions only in cases of rape, incest or to save the life of the mother — reflecting a current law known as the Hyde amendment.
The Hyde amendment restrictions apply to Medicaid, military health care and the federal employee health plan. Many states provide abortion coverage to low-income Medicaid beneficiaries, but they must do so separately with their own funds.
Abortion opponents say Reid's bill circumvents Hyde. For example, they say that any funds a government insurance plan would use to pay for abortion would be federal funds by definition — even if the money comes from premiums paid by beneficiaries.
"All the money the government has starts out being private money," said Douglas Johnson, legislative director for National Right to Life. "Once the government has them, they're federal funds."
The restrictive language passed by the House would forbid any health plan that receives federal subsidies from paying for abortions, except as allowed by the Hyde amendment. Women would have to purchase separate coverage for abortion services.
Abortion rights supporters say that fencing off government funds from private premiums would achieve the same goal, without forcing women to get special coverage for a legal medical procedure now routinely included in many private health insurance plans.