The Senate healthcare bill unveiled Wednesday night by Majority Leader Harry Reid, D-Nevada, is not exactly the cure for all of what ails America.
But the 2,074-page document significantly expands access to medical care for Americans who currently lack coverage, contains a modest public option, bars discrimination by insurers against Americans with pre-existing medical conditions and gets remarkably good marks from the Congressional Budget Office.
In many respects, Reid’s “Patient Protection and Affordable Care Act” is a better bill than the House measure.
And it one respect, it is dramatically better.
The Senate plan does not contain the draconian “Stupak” language, which was written into the House bill with the intent of establishing radical new limits on access to reproductive health services.
As part of negotiations to secure passage of the House healthcare reform bill, House Speaker Nancy Pelosi, D-California, agreed to a vote on an amendment by Congressman Bart Stupak, D-Michigan, that did not merely forbid a government-run “public option” from covering abortion services. It also barred private insurance plans that might participate in the exchange set up by the new program from doing so.
Republicans in the House aligned with 64 Democrats to attach the radical anti-abortion language to the bill, which was then passed by a narrow 220-215 margin.
Reid rejects the Stupak language.
That does not mean that his measure is a pro-choice bonanza.
It preserves existing limits on public-funding of abortions. But, as part of the exchange set up by the bill, families and individuals who participate in the new program could purchase insurance plans that provide abortion coverage.
“We’re basically going to keep current law, which is what we ought to do,” says Massachusetts Senator John Kerry, a pro-choice Democrat who participated in the session where Reid unveiled the Senate measure.
The current law is defined by the Hyde amendment, a measure named for former Illinois Congressman Henry Hyde that was approved in 1976. The Hyde amendment prohibits federal money from paying for abortions except in cases or rape or incest or instances where a woman’s life is endangered.
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The National Organization for Women has described the Stupak Amendment as “Hyde on Steroids.”
Several Democratic senators whose support will be essential if this bill is to have a chance of being enacted in its current form, including opponents of abortion rights such as Pennsylvania Democrat Bob Casey, have indicated that they would be willing to vote for a measure that maintains the constraints established by Hyde — even if the Stupak provisions are removed. That’s good news for Reid, who is still struggling to wrangle up 60 votes in order to get the debate started.
If the Senate passes the bill as written by the majority leader — and that remains a big “if” — the Senate and House measures will then have to be reconciled in a conference committee involving key leaders from both chambers.
The final compromise would likely maintain the Hyde amendment but not go as far as Stupak proposed.
That would be a win for pro-choice forces, which have made elimination of the Stupak language a high priority.
The fight over abortion rights would continue in the House, however, as Pelosi built her majority there by drawing in a number of anti-choice representatives who said they backed the House bill because it included the Stupak language. Stupak bluntly declares that, if the legislation that comes back to the House does not include his amendment, “healthcare will not move forward.”
Pelosi will have her work cut out for her. And she will, unquestionably, need an assist from the White House.
In other words, while the Senate may clean up some of the mess, it will take a major intervention by President Obama to wrangle the votes needed to pass a healthcare reform bill that maintains existing rules with regard to abortion.
Of course, the right health care reform bill would go much further and say that women have a right to all safe and legal medical services — be they provided as part of a public plan or by a private insurer.
Not even the most ardent backers of abortion rights are hoping to achieve that ideal, however.
For good reason, they will be pleased to get rid of the Stupak language — as Reid’s action represents a win for those who have been campaigning to keep it out of the Senate proposal.
That’s a compromise position for those who would prefer that healthcare reform be done right. But its hardly the only compromise that will be asked of real reformers as they approach a Senate bill that, like its House counterpart, falls far short of the change that is needed but could end up being the change that is possible — and acceptable.
