5 Unresolved Questions on Abortion in Healthcare Debate

With the Senate rejecting ban on federal abortion funding, issue is an obstacle in healthcare debate.

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By Dan Gilgoff, God & Country

With the Senate tabling Democrat Ben Nelson's strict ban on federal funds for abortion in a government-managed healthcare plan, there are lots of unresolved questions about how abortion will figure into the ongoing healthcare debate. Here are the ones I see as the five biggest:

1. Will Pennsylvania Sen. Bob Casey, Nebraska's Nelson, or another antiabortion Democrat withhold a cloture vote on the Senate healthcare bill because it lacks a strict ban on federal dollars for abortions? Nelson has left the door open to the possibility. The antiabortion group Susan B. Anthony List plans to launch an ad pressuring Casey to withhold his vote and enable a Republican filibuster this week.

The Family Research Council has just launched a campaign to press other Senate Dems, including South Dakota's Tim Johnson, Louisiana's Mary Landrieu, and Arkansas's two senators, to withhold cloture votes over abortion. For every Senate Democrat that antiabortion advocates can convince to withhold a cloture vote—and it's not certain they'll win over any—the Dems need a Republican vote to counter.

2. Can a healthcare bill pass the House without a sweeping Stupak-Pitts ban on federal dollars available to healthcare plans that offer abortion coverage? Sixty-three House Democrats supported that ban, and 41 have signed onto Michigan Rep. Bart Stupak's letter vowing opposition to any healthcare bill that lacks something like it. It will be nearly impossible for the healthcare bill to pass without at least one in that group changing his or her tune.

3. Can Catholic bishops stop healthcare reform that lacks a Stupak-style ban on federal abortion funding? The bishops have an influential role in the healthcare debate because they're the one powerful constituency that's both strongly in favor of Democratic-style healthcare reform yet dead set against any bill lacking a Stupak-style ban on federal funding for abortion coverage.

Can the bishops pressure Casey, Nelson, and other Democratic moderates to withhold cloture on the Senate bill? Can they keep Stupak's antiabortion Democrats from softening their line?

4. In a government-managed health insurance system, does segregating federal money from personal premiums in funding abortion coverage constitute a ban on federally funded abortion? Abortion rights activists say yes, but antiabortion activists scoff at the idea.

This question will resurface if Democrats shed the Stupak language in negotiations between House and Senate versions of the healthcare bill and revert to the "separation of funds" position, which they say maintains the status quo on federal abortion policy. Abortion foes say that approach is an accounting trick. If it passes, they say they will work hard to make the legislation a big issue in next year's midterms, presenting the possibility of a culture war election the likes of which we haven't seen since 2004.

5. Will an abortion compromise emerge that goes further than the Democrats "segregation of funds" approach in walling off federal funds from abortion coverage (encapsulated in the House's Capps amendment) but stops short of preventing government-subsidized plans from covering the procedure, as Stupak would. This might be the most likely outcome, though the attempt of antiabortion Rep. Brad Ellsworth, an Indiana Democrat, to forge such a compromise last month went up in smoke.

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