Healthcare repeal effort will bring abortion debate to the forefront

An intense debate on federal funding for abortions is expected to begin shortly as Congress resumes debate on repealing the healthcare law.

The House is scheduled to vote on a repeal bill next week, after a one-week hiatus following last weekend's shooting in Tucson that left six people dead and gravely injured Rep. Gabrielle Giffords (D-Ariz.). Lawmakers on both sides of the aisle have since called for the political rhetoric to be toned down, but a looming showdown over abortion may make that especially difficult.

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If anything, the issue may have become even more divisive over the past week after the pro-abortion rights Guttmacher Institute released a report saying a steady decline in U.S. abortions between 1990 and 2005 appears to have stalled while incidents of harassment against providers are on the rise. Anti-abortion rights groups immediately blamed the growing use of abortion drugs such as RU-486, while Planned Parenthood argued for improved access to contraception.

The abortion issue is almost certain to come up as the House takes up the repeal bill because lawmakers will also vote to adopt a resolution instructing congressional committees to draft replacement legislation. That resolution specifies that the effort should include "provisions that ... prohibit taxpayer funding of abortions and provide conscience protections for health care providers."

Democrats say the healthcare bill signed into law last year already prohibits taxpayer funds from being used to pay for abortions, but Republicans and anti-abortion advocates say the bill's restrictions aren’t strong enough.

Next week’s resolution is seen by pro-abortion rights groups as an invitation for lawmakers to craft anti-abortion rights bills.

“It seems clear to us that the new House leadership is threatening a whole series of attacks on reproductive rights, to begin next week,” NARAL Pro-Choice Policy Director Donna Crane told The Hill.

She said Republicans are going beyond any mandate they won from voters in the midterm elections.

“The American public thought they were voting for an agenda that included a better economy and more jobs, and apparently what they're going to get is two abortion votes a week,” she said.

Rep. Fred Upton (R-Mich.), the new chairman of the Energy and Commerce Committee, promised quick action on the abortion front during a recent appearance on "Fox News Sunday."

“We are going to take up early ... language [that says] ‘no funds shall be spent on abortion’ as a separate bill early on,” Upton said. 

Anti-abortion rights advocates are counting on it.

“We made abortion funding the defining issue in the elections,” said Marjorie Dannenfelser, president of the Susan B. Anthony List. She said abortion provisions are the “most egregious issue” with the new law.

After repeal, the anti-abortion rights group has two top priorities related to the healthcare law.

One is a prohibition on taxpayer support for abortion providers under Title X family planning grants. The legislation, introduced Jan. 7 by Rep. Mike Pence (R-Ind.), targets Planned Parenthood; defeating it is a top priority for NARAL. The bill would “cripple family planning services - not necessarily abortion services but contraceptive services in this country,” Crane said.

SBA's other priority is a multi-pronged abortion funding ban sponsored by Reps. Chris Smith (R-N.J.) and Dan Lipinski (D-Ill.). The legislation was introduced last year but has not been introduced so far this year.

The bill incorporates an amendment, sponsored by Reps. Joe Pitts (R-Penn.) and Bart Stupak (D-Mich.) during the reform debate, prohibiting federal funds from being used “to pay for any abortion or to cover any part of the costs of any health plan that includes coverage of abortion.”

Anti-abortion advocates, she said, will make a determined push for the legislation when they descend on the capital on Jan. 24 for their annual March for Life marking the anniversary of the Supreme Court's 1973 Roe vs. Wade decision.

Dannenfelser said the Smith-Lipinski bill would “absolutely resolve” the SBA's concerns with the healthcare reform bill. But that doesn't leave off the hook lawmakers, such as Lipinski, who say they’ll vote against repeal.

“Anybody who votes against repeal is saying there's no problem regarding abortion in the bill,” Dannenfelser told The Hill. “When you know you've got a chance to do the right thing, you don't put it off.”

The bill goes further than the Pitts-Stupak amendment, earning it the nickname “Stupak on steroids.” One of its provisions would codify a rider, reauthorized every year, that protects healthcare entities from having to perform medical procedures - such as abortions - that they don't morally agree with.

The issue could be a tough one for centrist Democrats facing tough re-election races in 2012. Sens. Ben Nelson (D-Neb.) and Bob Casey (D-Pa.), for example, wrote to President Obama soon after his inauguration to protest his administration’s plans to revisit a Bush-era regulation on the issue.

“We believe it is very important that federally funded health care providers and entities not be discriminated against because the refuse to participate in procedures or activities which are a violation of their consciences,” the senators’ letter says.

Crane said NARAL doesn’t object to conscience protections that are “narrowly crafted” and “apply to individuals who have legitimate conscience issues.” However, she said the annual rider goes too far by exempting entire health plans and healthcare systems that get federal Medicare and Medicaid funding from having to provide abortion services, contraception or even referrals and counseling.

“It's not our belief that people should be forced to provide medical services that they oppose,” Crane said. “It is our belief that women deserve the services that are appropriate and legal in this country, and that medical corporations have an obligation to provide them.”