Health Care Reform: How Democrats Might Deal With Abortion Language Through Reconciliation

The New York Times is reporting that the White House is preparing to use reconciliation to advance health care reform. Reconciliation will be used to make changes to the Senate bill to make it an acceptable compromise between the House and the Senate. As always, the elephant in the room is abortion.
Democrats said it was still unclear how the president would deal with other disagreements, including the issue of insurance coverage for abortions.

Abortion remains “a wild card,” said a Democrat on Capitol Hill.

The House passed the very restrictive Stupak anti-choice amendment. The Senate bill included Ben Nelson's abortion language, which, while very restrictive, is not quite restrictive enough for some anti-choice Democrats in the House, and some powerful pro-life lobbying groups. Stupak has previously claimed to have enough votes to bring down health care if the abortion language is not to his standards.

Changing the abortion language through reconciliation can be difficult because of the Byrd rule. Any provision that does not impact the budget can be stripped from the bill by a senator raising a point of order. It is widely believed that changing the abortion language would be found in violation of the Byrd rule.

So, does that make changing the abortion language impossible through reconciliation? The answer is, not really. If a senator were to raise a point of order to remove the abortion language, and the presiding officer of the Senate was to uphold the point of order, it could still be waived by a vote of 60 senators. If 60 senators voted to keep the abortion language in the reconciliation measure it could stay in.

This means a united Republican Senate caucus could have the compromise abortion language removed from the reconciliation measure. They might consider doing this if they thought removing the abortion language would ruin the compromise and could cause all of health care reform to fail. Of course, this is a move that could really backfire. Pro-life voters might get furious with Republican senators for effectively voting against a standalone provision to restrict abortion coverage. It would also allow conservative Democratic House members to blame Republicans for removing the more restrictive abortion language, and that could create the political cover to vote for the Nelson language in Senate bill, which is still a big step backwards for women's reproductive rights. Bit that would enable Democrats to pass reform anyway.

I suspect that not all 41 members of the Republican Senate caucus will be able to be whipped into taking what would effectively be a standalone vote on simply restricting abortion coverage. Too many of Republicans depend on pro-life voters, and the vote could end up a killer in a presidential primary for any Republican senator who has their eye on 2012 or 2016. It would seem Democrats could probably peel off at least a few Republicans for just this one vote on waiving the Byrd rule. If a few Republicans voted for it, they would probably vote en mass for it.

It is possible that Democrats could deal with an abortion compromise through the reconciliation sidecar strategy if they could get 60 votes to waive the Byrd rule. It seems like a possibility, and one of the only routes for Democrats to deal with the issue. And, it has the plus side of possibly putting Republicans in an awkward place.

The big issue for Democrats will be their base. Reports indicate that the changes in the reconciliation measure will probably be a new tax on the wealthy, a deal with the unions to raise the limit and protect their members from the excise tax, and some other minor changes. Nothing that will really fire-up a demoralized base, or win over swing voters. If those changes are combined with even more restrictions on a woman's reproductive rights in a single bill, I picture it being impossible to rally enough supporters to pass the reconciliation measure. If they don't add popular provisions favored by progressives--like public option, Medicare buy-in, or drug re-importation--I don't see how they get the grassroots energy to get anything across the finish line.

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