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Senate to confront abortion in health debate

House And Senate Legislators Discuss The Stimulus Package
A prominent anti-abortion Democratic senator, Ben Nelson of Nebraska, plans to urge the Senate to include restrictions in health care legislation on the use of taxpayer funds to pay for abortions.Chip Somodevilla / Getty Images
/ Source: NBC News and news services

Prominent anti-abortion lawmaker Sen. Ben Nelson, D-Neb., on Monday filed an amendment to pending health care legislation that would place strict restrictions on federal funds going toward abortion services.

The amendment is co-sponsored by fellow Democrat Sen. Bob Casey, D-Penn., and eight Republicans.

"As written, the Senate health-care bill allows taxpayer dollars, directly and indirectly, to pay for insurance plans that cover abortion. Most Nebraskans, and Americans, do not favor using public funds to cover abortion and as a result this bill shouldn't open the door to do so," Nelson said in a written statement.

Nelson said his amendment mirrors the provision in a House-passed version of the bill offered by Rep. Bart Stupak, D-Mich. Both measures expand the current government prohibition of federal funds for abortions.

Nelson says his measure ensures "that no federal funds are used to pay for abortion in the health care reform legislation currently being considered."

It would bar private plans operating with government subsidies in a new insurance marketplace from covering abortion, except in cases of rape, incest, or to save the life of the mother.

The Republican Senate co-sponsors of the amendment are Orrin Hatch of Utah, Sam Brownback of Kansas, John Thune of South Dakota, Mike Enzi and John Barrasso of Wyoming, Tom Coburn of Oklahoma, Mike Johanns of Nebraska, and David Vitter of Louisiana.

Abortion-rights supporters in the Senate say they are confident they have the votes to defeat Nelson amendment. Thune appeared to agree with that assessment at a news conference earlier Monday.

The top Senate Democrat said Monday lawmakers are approaching the end game on the far-reaching health care legislation and fully expect to prevail on President Barack Obama's signature issue.

"We've tried to get to this point with health care legislation for almost 70 years, and we're there," said Majority Leader Harry Reid, D-Nev., after a weekend of work capped by a presidential pep talk Sunday. The rare weekend session saw intense negotiations among liberal and moderate Democrats — along with Republican Sen. Olympia Snowe of Maine, who may yet vote for the bill.

Moderates and liberals are working to find a compromise on a government-sponsored health insurance plan to compete with private companies. The latest version under discussion — nonprofit private plans overseen by the Office of Personnel Management, the same agency that oversees health insurance for federal employees — doesn't approach the muscular government-run program that liberals wanted — and the insurance industry feared.

Nonetheless some liberals were sounding open to it. Supporters note it could be explained simply to voters as offering them much the same coverage members of Congress get.

"The critical issue is not what we call something, it's the end result," Sen. Debbie Stabenow, D-Mich., said Monday. "I think it has a lot of possibilities,"

"We are I think rapidly coming to a conclusion," Stabenow said.

Compromise seems much less likely on the issue of abortion coverage. Anti-abortion lawmakers in both parties have insisted that taxpayer funds not be used to pay for abortions in government-run health programs.

Abortion rights supporters say that goes too far because it would bar coverage of a legal medical procedure even if paid for entirely from the patient's own share of insurance premiums.

Stabenow said Monday she wouldn't be able to accept the Nelson language. It appeared unlikely that it would gain the necessary 60 votes in the 100-member Senate, according to numerous lawmakers.

"I believe it goes too far ... It crosses a line," Stabenow said, by making it difficult for patients to use their own money for abortion coverage. "The Nelson amendment takes us back, it takes away options on health care coverage."

Debate is expected to begin Monday on Nelson's measure. A vote on the amendment is likely Tuesday, according to Democratic aides.

In a rare visit to the Capitol on Sunday, President Barack Obama urged Senate Democrats to overcome their differences and make history by overhauling the nation's health care system — even if some of them might face angry voters. He stuck to general themes in his 45-minute closed-door speech and did not dwell on specific topics such as abortion.

By a vote of 43-56, the Senate rejected a Republican amendment on Monday that would have prevented the government from implementing the bill by using savings from Medicare. The measure needed 60 votes to pass.

The Senate bill would cover more than 30 million additional Americans over the next decade with a new requirement for nearly everyone to buy insurance. The federal-state Medicaid program for the poor would be expanded, and there would be a ban on unpopular insurance company practices such as denying coverage based on medical history.

It would create marketplaces where people could shop for and compare insurance plans. Lower-income people would get subsidies to help them buy coverage.

A government-run insurance program, or "public option," is one of the bill's most contentious issues. At the urging of Reid, a group of moderate and liberal Democrats will keep meeting to seek a compromise. After their Sunday evening meeting, senators said it could be days — or a week_ before they know if they can reach a deal.

The latest idea calls for national nonprofit insurance plans to be administered by the Office of Personnel Management, which oversees the popular Federal Employees Health Benefits Program.

The proposal seems to appeal to a key Republican, Snowe of Maine, who met with Obama at the White House on Saturday.

On Sunday, Snowe called the possible compromise "a positive development" because it would give consumers more options for buying insurance.

Snowe's potential support for the Democratic-crafted bill is crucial. Supporters need 60 votes to overcome filibusters, and the chamber's 40 Republicans hope to draw at least one Democrat to their side.

It could be Nelson, who says he will not support final passage of a health care bill unless it includes the tight abortion restrictions he wants. If so, Democrats would have to woo moderate Republicans such as Snowe.

NBC's Ken Strickland contributed to this report.