The White House is on a collision course with Catholic bishops in an intractable dispute over abortion that could blow up the fragile political coalition behind President Barack Obama's health care overhaul.
A top Obama administration official is praising the new Senate health bill's attempt to find a compromise on abortion coverage _ even as an official of the U.S. Conference of Catholic Bishops says Sen. Harry Reid's bill is the worst he's seen so far on the divisive issue.
The bishops were instrumental in getting tough anti-abortion language adopted by the House, forcing Speaker Nancy Pelosi, D-Calif., to accept restrictions that outraged liberals as the price for passing the Democratic health care bill.
Reid, D-Nev., now faces a similar choice: Ultimately, he will need the votes of a handful of Democratic senators who oppose abortion to get his bill through. Republicans hoping to block the health bill in the Senate are relishing the Democrats' predicament.
"Obviously, it's a problem (for Reid)," Sen. Jon Kyl, R-Ariz., the No. 2 Republican, said Friday.
Reid has steered the Senate bill in a direction that abortion-rights supporters can live with: allowing coverage for abortion in federally subsidized health care plans, provided that beneficiaries' own premiums are used to pay for the procedure. But abortion opponents say his compromise would gut current restrictions that bar federal funding of abortion, except in cases of rape, incest, or to save the life of the mother.
Despite criticism, Reid is expected to prevail on an initial Senate showdown set for Saturday night. He needs a 60-vote majority to advance the health bill toward full debate. It's during that debate _ expected to begin after Thanksgiving and last for weeks _ that the battle over abortion will be joined. Reid will need the votes of anti-abortion Democrats to clear other 60-vote hurdles before the Senate can take final action.
At the White House, health reform director Nancy-Ann DeParle praised Reid's effort to find a compromise on abortion.
"It was carefully worked through by the leader, who cares a lot about making sure this maintains the status quo on abortion policy," DeParle told reporters on Thursday. Obama has said he wants the bill to remain neutral on abortion, and DeParle said Reid struck just the right balance.
But Richard Doerflinger, associate director of the bishops' conference Secretariat of Pro-Life Activities, said Reid's "is actually the worst bill" on life issues.
He called it completely unacceptable, adding that "to say this reflects current law is ridiculous."
On Friday, the bishops' conference sent each senator a letter saying the Senate bill violates federal policy on abortion funding and must be changed. "If that fails," the letter said, "the current legislation should be opposed."
Reid's bill would forbid including abortion coverage as a required medical benefit. However, it would allow a new government insurance plan to cover abortions and let private insurers that receive federal subsidies offer plans that include abortion coverage.
In all cases, the money to pay for abortions would have to come from premiums paid by beneficiaries themselves, kept strictly separate from federal subsidy dollars. Supporters say that would keep government funds from being used for abortions, except in cases of rape, incest or to save the life of the mother as allowed under a current law known as the Hyde amendment.
The Hyde amendment restrictions apply to Medicaid, military health care and the federal employee health plan. Many states provide abortion coverage to low-income Medicaid beneficiaries, but they must do so separately with their own funds.
Abortion opponents say Reid's bill circumvents Hyde. For example, they say that any funds a government insurance plan would use to pay for abortion would be federal funds by definition _ even if the money comes from premiums paid by beneficiaries.
"All the money the government has starts out being private money," said Douglas Johnson, legislative director for National Right to Life. "Once the government has them, they're federal funds."
The restrictive language passed by the House would forbid any health plan that receives federal subsidies from paying for abortions, except as allowed by the Hyde amendment. Women would have to purchase separate coverage for abortion services.
Abortion rights supporters say that fencing off government funds from private premiums would achieve the same goal, without forcing women to get special coverage for a legal medical procedure now routinely included in many private health insurance plans.
Associated Press Special Correspondent David Espo contributed to this report.