WASHINGTON — As if it were not complicated enough, the debate over health care in Congress is becoming a battlefield in the fight over abortion.
Abortion opponents in both the House and the Senate are seeking to block the millions of middle- and lower-income people who might receive federal insurance subsidies to help them buy health coverage from using the money on plans that cover abortion. And the abortion opponents are getting enough support from moderate Democrats that both sides say the outcome is too close to call. Opponents of abortion cite as precedent a 30-year-old ban on the use of taxpayer money to pay for elective abortions.
Abortion-rights supporters say such a restriction would all but eliminate from the marketplace private plans that cover the procedure, pushing women who have such coverage to give it up. Nearly half of those with employer-sponsored health plans now have policies that cover abortion, according to a recent study by the Kaiser Family Foundation. The question looms as a test of President Barack Obama's campaign pledge to support abortion rights but seek middle ground with those who do not. Obama has promised for months that the health care overhaul would not provide federal money to pay for elective abortions, but White House officials have declined to spell out what he means.
Democratic congressional leaders say the latest House and Senate health care bills preserve the spirit of the current ban on federal abortion financing by requiring insurers to segregate their public subsidies into separate accounts from individual premiums and co-payments. Insurers could use money only from private sources to pay for abortions.
But opponents say that is not good enough, because the subsidies would still help people afford health coverage that included abortion.
Lawmakers pushing the abortion restrictions say they think the momentum is on their side, especially because the restlessness of other Democratic moderates is making every vote count.
At least 31 House Democrats have signed various recent letters to the House speaker, Nancy Pelosi, D-Calif., urging her to allow a vote on a measure to restrict use of the subsidies to pay for abortion, including 25 who joined more than 100 Republicans on a letter delivered Monday.
Rep. Bart Stupak of Michigan, a leading Democratic abortion opponent, said he had commitments from 40 Democrats to block the health care bill unless they have a chance to include the restrictions.
