The U.S. bishops have launched a final effort to persuade lawmakers to correct major moral “deficiencies” — including, but not limited to, mandatory taxpayer support for abortion — in health care reform bills heading toward a final vote in the coming weeks.

Last-minute strong-arm politicking, and confusion over the language in the bills, has made the reform package’s ultimate fate difficult to predict. But, at least on the abortion issue, a leading pro-life lawmaker in the House believes he has sufficient aligned and determined colleagues to prevent abortion funding in the final version of the health care reform bill.

“We have to make sure we do not have abortion as a federal benefit,” Michigan Democratic House Rep. Bart Stupak told Our Sunday Visitor at the end of December. 

‘Bookkeeping gimmick’

The U.S. bishops called the Senate legislation “deficient” in “all the areas of our moral concern,” in a Dec. 22 letter to the Senate. They cited federal funding of abortion, abrogation of individuals’ right not to pay for abortion, failure to protect conscience rights of hospitals and health care workers, and the exclusion of illegal and new legal immigrants from the plan.

The bishops and other national pro-life organizations rejected a much-touted “compromise” on abortion in a final amendment to the Senate bill, which was critical in getting the bill-passing support of Sen. Ben Nelson (D-Neb). Though the amendment claims to create a “firewall” between public and private funds, a National Right to Life Committee analysis called it “merely a bookkeeping gimmick.”

The Senate’s Patient Protection and Affordable Care Act (HR 3590) still would allow the federal government to subsidize private insurance plans that cover abortion on demand, allow the federal government to oversee multistate plans that cover elective abortions, and would empower federal officials to mandate that private health plans cover abortions even if they do not accept subsidized enrollees, according to the National Right to Life Committee.

The abortion language is acceptable in the House’s Affordable Health Care for America Act (HR 3962), passed 220-215 Nov. 7, because it includes the Stupak-Pitts Amendment prohibiting federal funding of abortion, said Richard Doerflinger, associate director of the U.S. Conference of Catholic Bishops’ Secretariat of Pro-Life Activities.

Pro-choice lawmakers and lobbyists have vowed to make sure abortion funding remains in the bill, even though it is opposed by a large majority of Americans. A Quinnipiac University survey Dec. 22 showed 72 percent of Americans oppose public funding of abortion in health care legislation.

The Catholic Medical Association says that abortion funding is only one of the problematic areas in the reform plans.

“The other important issue is that the federal government is seizing the power to determine what services must be included in the plans and what standards for quality, etc., will be required,” said John Brehany, CMA’s executive director and ethicist. He cited the example of the Mikulski Amendment in the Senate bill that gives a federal panel the power to determine what is mandatory preventive care coverage for women, allowing them to classify abortion as “prevention.”

The U.S. bishops have other concerns. “Both bills are deficient in conscience protection beyond abortion,” Doerflinger told OSV, meaning the government could mandate benefits such as sex-change operations and sterilizations. “We have been trying in the House and Senate to get some rights of conscience for religious freedom so Catholic health plans and employers are not required to buy, purchase or sell insurance they have a major objection to.” 

‘Solid people’

Stupak said he is confident he has the votes to keep the Stupak Amendment in the final health care legislation, although he predicts that top Congressional Democratic leaders and the White House will use arm-twisting and pork-barrel tactics to try to win over reluctant House Democrats.

The House health care bill passed 220-215 with all pro-choice votes on board and 41 Democrats who had supported the Stupak Amendment. Stupak says he has 10-12 solid Democrats who won’t be swayed. “I am sure the leadership is trying to figure out the 10 votes. Even if they do, they are solid people, they aren’t going to change,” Stupak said. “If they don’t keep the Stupak language I don’t think they can pass it in the House no matter what they do.”

The 60-40 party-line Senate vote on Dec. 24, with 58 Democrats and two independents comprising the majority, followed a 54-45 defeat on Dec. 8 of an amendment sponsored by Nelson and Sen. Orrin Hatch (R-Utah). The amendment would have continued the federal policy, enshrined in what is known as the Hyde Amendment, barring the use of tax-payer money to pay for abortions.

A final bill, containing elements of the House and Senate bills along with possible new language, will be crafted by a small group of Democratic leaders in conjunction with the White House and likely presented to the House and Senate for an up or down vote without amendment. “It may have some provisions that no one ever saw before in the House or the Senate,” predicted Douglas Johnson, legislative director for the National Right to Life Committee. “The abortion language is yet to be determined. It will be as bad as they think they can get away with.”

The House was set to return to session on Jan. 12 and the Senate on Jan. 20. Congressional leaders and the White House hope to have a law by the State of the Union address at the end of January, or at least by early February, Stupak said. 

Valerie Schmalz is an OSV contributing editor.

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