Abortion rights groups, outflanked and outnumbered in the health debate, are scrambling to regain lost ground after the House passed a health bill with strict abortion limits.
They're blanketing Capitol Hill with lobbyists, petitions, letters and phone calls in efforts to defeat the restrictions in the Senate, where debate could begin in a few days. They also have a larger goal: to prove that with their Democratic allies in control of the White House and both congressional chambers _ but increasingly appealing to conservative voters who back abortion limits _ they still have clout.
It's an uphill battle after the House approved health legislation that bars a new government-run insurance plan from covering abortions, except in cases or rape, incest or peril to the life of the mother, and prohibits any health plan that receives federal subsidies in a new insurance marketplace from offering abortion coverage.
Lawmakers who back abortion rights watched helplessly, lacking the votes to prevail, as fellow Democrats who oppose abortion joined with Republicans to put the curbs in place, prodded to action by Catholic bishops and anti-abortion rights groups. Then they voted en masse for the final health bill, in a move quickly hailed by President Barack Obama as "historic."
"Our phones were ringing off the hook," said Cecile Richards of Planned Parenthood Federation of America, who hosted a hastily called strategy meeting last week where abortion rights and women's groups scrambled to regroup. "We're not going to have health care reform off the backs of women _ this isn't what we've all spent our lives for."
By the time prominent abortion rights supporters were summoned to the White House's West Wing on Wednesday to meet with top aides, they were livid _ although the president's team was quick to point out that their ire shouldn't be directed toward Obama.
We're your friends and the president is pro-choice, chief of staff Rahm Emanuel reminded the group of 15 or so women. There's no need for anger here, senior adviser and Obama confidante Valerie Jarrett offered, according to people knowledgeable about the session, who spoke on condition of anonymity because the discussion was confidential.
Still, the episode exposed a rift the health debate has opened between a president and Democratic congressional leaders and a key interest group struggling to maintain its influence.
Like other such special interests, abortion rights groups rely on pitched policy battles on high-profile issues to raise money and energize supporters, and the health debate offers an opportunity to do just that.
It wasn't supposed to be this way. Early on, the organizations had opted to stay quiet on the abortion funding issue for fear of making a politically tricky negotiation over a health care overhaul even harder.
"We were trying to diffuse the situation, knowing that the time to fight on the notion of federal funding for abortion was not this political moment _ the health care reform bill is hard enough. Now I'm thinking we might have recognized that we were going to have this fight, and we should have stood firm a year ago and we might not have found ourselves here," said Laura MacCleery, director of government affairs at the Center for Reproductive Rights.
The organizations gave tacit but grudging approval earlier this year to a proposal by Rep. Lois Capps, D-Calif., that would have allowed the new government-run insurance plan or private plans offered in the new exchange to cover abortion but without using federal funds, only private dollars. It was an attempt to apply an existing law known as the Hyde amendment _ it bars federal funding for abortion in Medicaid, the health program for the poor _ to the new health care regime.
The House-passed measure goes much further, effectively requiring women buying health insurance with their own money to purchase abortion coverage through a separate supplemental plan, as a so-called rider on the policy.
Obama has said he wants to find a middle ground that preserves the status quo of denying federal funding for abortions but doesn't restrict women's insurance choices.
In the meantime, though, some abortion rights champions are threatening to take down the president's top priority over the issue.
"These are our friends _ I don't think that anybody wants us to be on opposing sides," said Terry O'Neill of the National Organization for Women, who attended this week's White House session but declined to comment on the exchange. But her group's position, she said, is that "we would rather have no health care (overhaul) than a vicious abortion law."
Nancy Keenan of NARAL Pro-Choice America, who also went to Wednesday's session but would not comment on it, said Obama's team is well aware that her group is deeply disappointed with the House-passed limits and is counting on the Senate to roll them back.
"We fully expect them to stand with us as this battle continues," Keenan said. "They know the message loud and clear."
NARAL says it has begun a major grass-roots mobilization, including collecting more than 40,000 signatures on a petition addressed to Senate Majority Leader Harry Reid, D-Nev., demanding that he omit the abortion curbs from health legislation he's drafting.
The group is sending out automated calls in 17 states to connect abortion rights supporters at the touch of a button to senators who are seen as potential swing votes on the issue, asking them to oppose the "abortion ban." Phone banks by nine NARAL state affiliates are pitching in, targeting their calls to states including Nevada, home to Reid, who opposes abortion rights and is facing a potentially tough 2010 re-election fight.
"All politics are local. They've got to hear from their constituency at home," Keenan said. "Those are the folks that elect them and re-elect them."