Déjà Vu All Over Again: Why Abortion Imperils Health Care One More Time

Rep. Nancy Pelosi (D-CA), Rep. Bart Stupak (D-MI), President Barack Obama
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For the third time in less than six months, the issue of abortion threatens to kill health care reform. The initiative is fragile enough without abortion, yet more and more it’s becoming clear that abortion is the one, final issue that must be resolved if Democrats are to succeed. But this time, there’s much less legislative wiggle room than before and Democrats are scrambling to figure out what, if anything can be done.

The logjam is a familiar one, and comes down to simple political arithmetic. For health care reform to pass, he House must pass the Senate bill word for word, then make minor tweaks to it through the budget reconciliation process. But Rep. Bart Stupak (D-MI)–and, if we take him at his word, about a dozen of his Democratic colleagues–say they won’t vote for health care again unless the Senate’s abortion language is made more restrictive–a demand that seems like a legislative impossibility.

That leaves House Speaker Nancy Pelosi in an extremely tough position. Follow the numbers: All Republicans will vote against health care reform; 219 Democrats voted for the bill the first time around; three of them are no longer in the House. That leaves 216 Democrats in the House who’ve already voted for reform. Because of vacancies, Pelosi needs 217 votes to pass a bill. In other words the most optimistic scenario will require her to flip a single member who voted “no” on the House bill in November.

Which wouldn’t be too hard. A number of “no” votes have said they’re keeping an open mind on the Senate bill, and some sound downright ready to vote for the thing.

Enter Stupak.

If Stupak makes good on his threat, and turns a dozen–or 10 or seven–reform supporters against the bill, then it’s probably game over. It would put Pelosi and President Obama in the position of having to flip more members toward supporting the bill than they conceivably can.

So the abortion language in the bill can’t change, and the Stupak 12 won’t vote for that language. Is that game over?

Not necessarily. Stupak is once again engaged with House leadership. Yesterday, House Majority Leader Steny Hoyer said one possibility is that Stupak could be given a vote on strict abortion language in separate legislation (a heavy, if not impossible lift in the Senate). There are also murmurings on the Hill that there are steps the White House can take–a signing statement, perhaps, or an executive order–that could sway Stupak and his entourage. Stupak met yesterday Rep. Henry Waxman (D-CA)–a progressive, but a seasoned legislator, and a deal-maker well trusted by his colleagues. So real efforts are underway to find a solution. But can they find one?

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