The House on Thursday returned to an abortion issue that nearly sank President Barack Obama's health care law last year with legislation that bars an insurance plan regulated under the new law from covering abortion if any of its customers receive federal subsidies.
Providers that offer abortion coverage would have to set up identical plans without abortion coverage to participate in the health insurance exchanges to be set up under the new law.
The legislation, which passed 251-172, is unlikely to be considered by the Democratic-led Senate and faces a veto threat from President Barack Obama. But it gives House Republicans, focused this year on cutting spending and reducing the size of the federal government, a chance to reaffirm their credentials on social conservative issues. Democrats chided Republicans for wasting time better spent on promoting job growth.
Supporters of the bill, including author Rep. Joe Pitts, R-Pa., say they are trying to close loopholes in the health care act that could lead to violations of the longstanding prohibition of the federal funding of abortion.
Opponents warn that millions of middle- and low-income women who receive partial subsidies to buy insurance would be denied abortion coverage. They said most providers were unlikely to set up two separate plans, one with abortion coverage.
The legislation also strengthens conscience protections for anti-abortion health care providers. Again there is divergence between bill supporters saying they are merely clarifying existing law and opponents saying it will lead to hospitals denying emergency care to pregnant women.
The legislation revives the debate that almost scuttled the health care act. Former Rep. Bart Stupak, D-Mich., leading a rebellion of anti-abortion Democrats, joined Pitts in pushing through an amendment that imposed tight restrictions on abortions in the proposed government-run insurance plan. When the Senate wouldn't go along, Stupak got Obama to sign an executive order reaffirming the Hyde Amendment, a 1976 provision named after the late Rep. Henry Hyde, R-Ill., that bans all federal funds for abortion except in cases of rape, incest and when the life of the mother is at risk.
Pitts argued that the executive order can be rescinded at any time and the new health care act is not bound to follow the Hyde Amendment. As a result, said Rep. Chris Smith, R-N.J., the law, "when phased in fully in 2014 will open up the floodgates of public funding for abortion in a myriad of programs."
But the White House, in issuing its veto threat, said the health care law preserves the ban on federal funding and the legislation "intrudes on women's reproductive freedom and access to health care and unnecessarily restricts the private insurance choices that women and their families have today."
Under the law, federally subsidized health care plans can offer abortion coverage but they have to set up separate accounts to segregate federal funds from funds that can be used for abortion coverage.
Pitts said these are nothing more than "accounting gimmicks" that won't stop taxpayer money from being used to fund abortions.
Democratic opponents were particularly upset about the conscience clause, saying it would lead to pregnant women being denied emergency treatment. "When the Republicans vote for this bill today they will be voting to say women can die on the floor and health care providers don't have to intervene," said Democratic leader Nancy Pelosi of California.
"This bill is putting the religious leaders' views right there in the surgery room," said Jon O'Brien, president of Catholics for Choice.
They said it would override the Emergency Medical Treatment and Labor Act, which requires that all people have access to emergency services.
Pitts' office said they were codifying a 2004 amendment to a spending bill that protects doctors who object to performing abortions. It said that there has never been a case where a doctor cited these protections to refuse necessary care and that Catholic hospitals, even with their strict standards, allow doctors to perform necessary procedures that could result in the death of a fetus.
NARAL Pro-Choice America, in a statement by its president Nancy Keenan opposing the bill, said it was the House's seventh anti-abortion vote this year. Others have included attempts to eliminate funding for Planned Parenthood and funding for the Title X family planning program, a ban on Washington D.C. using its own funds to cover abortion services and a ban on teaching health centers using federal money to teach abortion procedures.