From NBC's Mark Murray
Once again, it looks like the thorny issue of abortion will decide the fate of health care.
Last November, the House of Representatives narrowly passed its health-care bill, 220-215, only after it included an amendment by Rep. Bart Stupak (D-MI) barring any federal funding in the legislation from being used for abortion coverage (except in cases of rape, incest, or if the mother's life is in danger). A month later, Senate Democrats secured their 60th -- and decisive -- vote after agreeing to Sen. Ben Nelson's (D-NE) similar (though less restrictive) changes on abortion.
And now, with the House poised to vote later this month on the already-passed Senate health-care bill, Stupak is claiming that he and 11 other House Democrats who voted for the legislation in November will vote against the Senate bill, unless it adopts the House's abortion language. (Stupak tells the AP he's "optimistic" he can resolve this abortion dispute with the White House and Democratic leaders.)
Stupak's rationale: The Senate bill -- despite Nelson's changes -- directly subsidizes abortion.
"In the Senate bill," Stupak told MSNBC's Chris Matthews last week, "it says you must offer insurance policies that will be paid for by the federal government that covers abortion. You must do so."
The Michigan congressman later said this to ABC's George Stephanopoulos: "The bill that they're using as the vehicle is the Senate bill, and if you go to page 2,069 through page 2,078, you will find in there the federal government would directly subsidize abortions, plus every enrollee in the Office of Personnel Management enrolled plan, every enrollee has to pay a minimum of $1 per month towards reproductive rights, which includes abortion."
Stupak's Democratic allies have adopted his rationale. As the office of Rep. Dan Lipinski (D-IL) -- ostensibly one of the Stupak Twelve -- has said: "Congressman Lipinski will not vote for a health care bill that provides federal funding for abortion."
But is Stupak right -- that the Senate bill directly subsidizes abortions? The answer appears to be no.
For starters, let's look at the pages that Stupak cited to Stephanopoulos. From pages 2,071-2,072: "If a qualified health plan provides coverage of services described in paragraph (1)(B)(i)" -- i.e., abortion -- "the issuer of the plan shall not use any amount attributable to [health reform's government-funding mechanisms] for purposes of paying for such services.
As Slate's Timothy Noah, who fact-checked Stupak last week, writes, "That seems pretty straightforward. No government funding for abortions."
What's more, the Senate bill explicitly ensures that Americans who receive federal subsidies under the reform plan must pay separately for abortion coverage. Here's pages 2,074-2,075: "In the case of a plan to which sub paragraph (A) applies, the issuer of the plan shall collect from each enrollee in the plan (without regard to the enrollee's age, sex, or family status) a separate payment" that "may not estimate such a cost at less than $1 per enrollee, per month."
Here's the kicker: Under the Senate bill, due to Nelson's changes, states can choose NOT to offer abortion coverage in the health exchange. Page 2,069: "A State may elect to prohibit abortion coverage in qualified health plans offered through an Exchange in such State is such State enacts a law to provide for such prohibition." And those states that do not prohibit abortion coverage must provide a choice of health plans on the exchange that include abortion coverage and don't include abortion.
First Read contacted Stupak's office for comment, but we've yet to hear back.
Will abortions be covered if the House passes the Senate bill. Yes. (As the Republican National Committee embarrassingly discovered, many health plans already provide elective abortion coverage.)
But will the federal government directly subsidize and pay for abortion coverage? Not if you read the fine print.
*** UPDATE *** A Stupak spokeswoman just called First Read, saying that the office is putting together a document laying out all of its arguments why the Senate bill directly subsidizes abortion. When we asked if there was specific language she could immediately point us to, the spokeswoman declined saying she'd wait until the document is released. When it comes out, we'll post on it.