A last-minute agreement between the White House and anti-abortion Democrats sealed support for the health-care bill, with an executive order that would clarify but not change the underlying legislation.
Abortion opponents were divided about whether it went far enough. The agreement falls short of stricter language included in a previous bill.
At issue is whether the overhaul would allow tax dollars to help fund abortion coverage. Under the new measure, women who receive federal aid to help pay for health insurance could choose a plan that covers abortion, but would have to pay for that additional coverage with a separate check, to ensure the funds are not mingled.
Anti-abortion lawmakers wanted a total ban, but the two-check system will remain. An executive order, which President Barack Obama promised to sign after the bill became law, reiterates that no federal money would go to abortion coverage. It directs federal agencies to set up guidelines for states to determine whether insurers are in compliance.
In addition, anti-abortion lawmakers worried that Community Health Centers might use new funds for abortions, though these centers don’t perform the procedure. Health centers are banned from using their regular federal funding for abortion, based on a provision first enacted in 1976 called the Hyde amendment. In addition, existing federal regulation bans centers from using funds for abortion.
But the health measure provides $9.5 billion to which the Hyde language does not apply. The executive order applies the Hyde language to those funds.
“There was a principle that meant more to us than anything, and that is the sanctity of life,” said Rep. Bart Stupak (D., Mich.), who led a group of about a half-dozen House Democrats.
Their support for the bill Sunday made clear Democrats would have the backing they needed.
Mr. Stupak said Sunday he couldn’t win a total ban, partly because of opposition in the Senate. In a press conference, he suggested the House could have passed a bill without his bloc, cutting into his leverage.
He said he was pleased with the extension of funding restrictions and a reference to protections for health facilities that decline to perform abortions.
For other abortion opponents, the executive order wasn’t enough. The original House bill had an outright ban on abortion offered by any health-insurance plan purchased through government-run exchanges. Sister Mary Ann Walsh, a spokeswoman for the U.S. Conference of Catholic Bishops, said the executive order didn’t change the bishops’ opposition to the bill.
House Minority Leader John Boehner (R., Ohio) said any executive order could be reversed by this or a future president, and could not override legislative language that, he argued, allowed for taxpayer funding of abortion.
An executive order doesn’t carry the force of law but represents the president’s directive to agencies he controls. This order is aimed at the Department of Health and Human Services and other agencies.
The abortion issue has dogged the health-care fight for months. The original House bill passed only after lawmakers adopted tough antiabortion language supported by Mr. Stupak.
Abortion-rights groups have long opposed moves to restrict abortion coverage. Some were vociferous in their comments. But Planned Parenthood said Sunday it was grateful the bill didn’t include a total ban.
