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Democratic leaders working to win over abortion opponents for health-care reform
"There will not be abortion coverage in the exchanges. There just won't be," said Linda J. Blumberg, a health policy analyst at the Urban Institute.
At the time of the deal with Nelson, Senate Democrats reassured abortion rights supporters by noting that many people would pay for their coverage via automatic bank debits, minimizing the impact of the separate payments. But abortion rights groups argue that the requirement of a separate check is almost tailor-made to spark public opposition to abortion, complete with protests of companies that offer plans covering it.
"It's clearly intended to be stigmatizing," said Laura MacCleery of the Center for Reproductive Rights.
The rules would not affect women with employer-based insurance, which often covers abortion. But the legislation envisions that more people over time would get their insurance through the exchange, giving its rules a potentially broad impact.
In making their case to the Stupak group, Democratic leaders point out that Nelson -- who initially fought for the Stupak provision but was rebuffed -- thinks his language is highly restrictive. That is not so much because it would discourage insurers from offering abortion coverage, his aide said, but because he thinks it preserves the ban on federal financing of abortion by segregating that money.
"He tried to figure out language that would be as close to Stupak as you could be without repeating the language," said Jake Thompson, his spokesman.
Some abortion opponents concede that it is possible that the two-checks rule will dissuade insurers from offering plans covering the procedure. But they say they still oppose the language on principle, because it would allow federal subsidies to help people buy plans with abortion coverage.
"The fact that the pro-abortion groups don't like it either doesn't make me support it," said Richard Doerflinger, a spokesman for the U.S. Conference of Catholic Bishops.
Abortion opponents also decry what they say are other loopholes in the Senate bill, warning, for instance, that a technicality could allow community health clinics to provide abortions, circumventing the federal ban.
Stupak said he rejected a proposal from congressional leaders to revisit the abortion language in the future. He has urged adding stricter language to the revisions of the Senate bill that both chambers are planning to pass. Leaders say rules allow only budget-related issues to be in this package, but Stupak notes that abortion changes could be added if 60 senators agreed.
Short of that, the only way forward will be to convince the Stupak contingent that the Senate language is as restrictive as abortion rights supporters fear it is -- and at the same time try to put those very fears to rest.
"The good news is that the Senate bill does allow" abortion coverage, said Rep. Diana DeGette (D-Colo.), co-chairman of the House's Pro-Choice Caucus. "But the question is: Would [the coverage] really be there?"
Staff writer Lori Montgomery contributed to this report.