KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Issues Over Abortion, Reconciliation Rules Remain In The Path Of Health Reform Vote

A host of political challenges and possible pitfalls awaits lawmakers as they push toward a final vote on health reform -- among them, abortion, reconciliation rules and immigration.

Politico outlines the top issues and includes House-Senate distrust and the Senate parliamentarian among the potential roadblocks to passing a health overhaul bill. But on abortion, the "result will come down to a handful of senior Democrats, such as Illinois Rep. Jerry Costello and Minnesota Rep. James Oberstar, and some younger members, such as first-term Reps. Kathleen Dahlkemper of Pennsylvania and Steve Driehaus of Ohio." The anti-abortion Democrats are led by Rep. Bart Stupak, D-Mich. Democrats are also preparing to "bend" the House rules to "deem" the Senate legislation on health reform passed when House members pass the reconciliation bill, which has its own battle (O'Connor, 3/15).

Roll Call: House Majority Whip Jim Clyburn, D-S.C., predicted Sunday that Stupak will vote for the reform bill. "Along with other House Democratic leaders, Clyburn worked furiously in recent weeks to assuage the concerns of Stupak, an abortion-rights foe who successfully led the charge last year to strike federal abortion-related funding provisions from the House's health care package. With threats of a GOP filibuster forcing House Democrats to take up the already-passed Senate bill, which includes less stringent abortion language, the votes of 41 House Democrats who do not support abortion rights continue to hang in the balance. But on Sunday, Clyburn said the recent endorsement by the Catholic Health Association is an indication that the concerns of Stupak and other fence-sitting Democrats have been met" (Murray, 3/14).

See related Daily Report coverage of the Catholic Health Association's endorsement

Roll Call, in a separate story: Abortion language in the current legislation is unlikely to change because Democratic leaders' "confidence has been buoyed as a trickle of Democrats opposed to abortion rights, such as Rep. Dale Kildee (D-Mich.), have said they are satisfied that the Senate bill's language effectively prohibits federal funding of abortions, while other Democrats who oppose abortion rights, including Transportation and Infrastructure Chairman James Oberstar (D-Minn.) have left open wiggle room to vote for the Senate bill despite earlier comments to the contrary" (Dennis and Newmyer, 3/15).

The Wall Street Journal: Democrats are trying to win over at least three more distinct sets of lawmakers in addition to the abortion opponents: Hispanic lawmakers fighting to allow illegal immigrants to use their own money to purchase coverage in proposed insurance marketplaces, centrist Blue Dog Democrats concerned over the cost of the legislation and a smaller, more liberal group who say "the bill should provide for a bigger government role. Rep. Dennis Kucinich, the liberal Ohio lawmaker who voted no in November, blasted the latest version as a giveaway to insurance companies and said he was still opposed to the bill." Obama administration officials and House Democrat leaders will spend the next few days gathering those votes "in a push to persuade several of last year's no votes to switch to yes, while retaining at least a dozen yes votes who are wavering. No Republicans are expected to vote for the measure" (Adamy and Hitt, 3/15).

USA Today: "In November, the House passed an early version of the health care plan 220-215, and 39 Democrats voted against it. Since then, one supporter, Rep. John Murtha, D-Pa., died and two others left Congress. The bill needs 216 votes to pass, making virtually every Democratic lawmaker important." USA Today also has mini-profiles of six of the lawmakers on whose votes reform hinges, including one who doesn't back using reconciliation (Fritze, 3/15). 

Chicago Sun-Times: Rep. Luis Gutierrez, D-Ill., is threatening to vote against the legislation because of his concerns that illegal immigrants will not be allowed to use their own money to buy insurance in proposed health care insurance marketplaces. "Am I going to vote for the proposal as it is currently formulated? No," Gutierrez said. "Gutierrez's pledge of a no vote is linked to his pressure - with other immigrant rights groups - on the Obama team to try to pass a comprehensive immigration reform package this year" (Sweet, 3/14).

The Hill: "For most members, the indecision is genuine. For others, it's a leverage game to parlay their votes into getting something they want. … Speaker Nancy Pelosi (D-Calif.) has expressed confidence that the votes will be there when the roll is called. Healthcare sources on and off Capitol Hill have different opinions on whether she is right, but they do agree that if she does get the votes, there won't be many to spare" (Hooper and Cusack, 3/14).

CBS News: White House Press Secretary Robert Gibbs told CBS' "Face the Nation" Sunday that House members will have a chance to make up their minds after the Congressional Budget Office scores the reconciliation bill. Gibbs expressed optimism reform would pass and "added that he thought Members of the House would see that small businesses would be helped in buying insurance for their employees, and that families with worries of discrimination because of pre-existing conditions would no longer have to worry about those conditions" (Riedel, 3/14).

The Associated Press/The Boston Globe: In the meantime, political strategist David Axelrod said the White House "was backing down on an attempt to get senators to rid the legislation of a number of lawmakers' special deals. Taking a new position, he said the White House only objects to state-specific arrangements, such as an increase in Medicaid funding for Nebraska, ridiculed as the 'Cornhusker Kickback.' That's being cut, but provisions that could affect more than one state are OK, Axelrod said. ... That means deals sought by senators from Montana and Connecticut would be fine, even though Gibbs last week singled them out as items Obama wanted removed. There was resistance, however, from two powerful committee chairmen, Democratic senators Max Baucus of Montana and Chris Dodd of Connecticut, and the White House has apparently backed down." Dodd is seeking a provision for $100 million for a hospital in Connecticut, although he says it would be up to the health secretary to decide where to locate the hospital, and Baucus' measure would allow asbestos-sickened Libby, Mont. residents to get Medicare benefits (Quaid, 3/15).


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