USA: Healthcare bill passes with abortion restrictions

The US House of Representatives on 22 March narrowly voted to pass a landmark healthcare reform bill at the heart of President Barack Obama’s agenda.

The bill was passed by 219 votes to 212, with no Republican backing, after hours of fierce argument and debate, BBC News Online reports. It extends coverage to 32 million more Americans, and marks the biggest change to the US healthcare system in decades.

‘We proved that we are still a people capable of doing big things,’ Mr Obama said in remarks after the vote. ‘This legislation will not fix everything that ails our healthcare system, but it moves us decisively in the right direction’.

President Obama signed the healthcare bill into law without delay after the House vote. But a new challenge is expected in the Senate, where Democrats hope amendments to the bill will be enacted by a simple majority. Republicans say the move is unconstitutional and plan to stop it.

Under the legislation, health insurance will be extended to nearly all Americans, new taxes will be imposed on the wealthy, and restrictive insurance practices such as refusing to cover people with pre-existing medical conditions will be outlawed, BBC News Online reports. Republicans say the measures are unaffordable and represent a government takeover of the health industry.

In a last-minute move designed to win the support of a bloc of anti-abortion lawmakers, Mr Obama on 21 March announced plans to issue an executive order assuring that healthcare reform will not change the restrictions barring federal money for abortion.

In doing so, reported Fox News, President Obama ‘created a perfect political storm over the issue of abortion’: he ‘upset both the pro-choice proponents who supported his rise to the White House and the anti-abortion activists vehemently opposed to portions of the health care bill’.

In a statement, the National Organization of Women (NOW) said it was ‘incensed’ that ‘President Barack Obama agreed to issue an executive order designed to appease a handful of anti-choice Democrats who have held up health care reform in an effort to restrict women’s access to abortion’.

In a public letter to pro-choice activists, Nancy Keenan, president of NARAL Pro-Choice America, condemned the ‘insulting, unworkable Nelson restriction on abortion coverage’. The requirement requires Americans to write two separate cheques if the health plan they choose includes abortion coverage.

Keenan wrote: ‘This unacceptable bureaucratic stigmatization could cause insurance carriers to stop covering abortion care. This would represent a major setback, given that more than 85 percent of private plans cover this care for women today’.

However, Keenan also noted that ‘[d]espite this totally unacceptable anti-choice provision, reform will bring more than 30 million Americans into a system that includes affordable family-planning services and maternity care for women’, and that therefore NARAL Pro-Choice America had ‘struggled with the dilemma of how to respond to a bill that included both positive and disappointing provisions for reproductive health’. Keenan concluded:

‘Ultimately, we determined that we could not endorse this bill due to the abortion-coverage restrictions. But, we also could not, in good conscience, call for the bill’s outright defeat and deny millions of American women the promise of better--although imperfect--health-care services that are an important part of our pro-choice values.

The Nation carries a useful interview here with the noted sociologist Carole Joffe, author of Abortion Wars: The Costs of Fanaticism to Doctors, Patients, and the Rest of Us.

US House passes key healthcare reform bill. BBC News Online, 22 March 2010

Abortion Foes and Pro-Choicers Unite Against Obama Decision. Fox News, 22 March 2010

Abortion rights groups not happy with Obama executive order on abortion. Sun-Times media, 22 March 2010

Q&A: US healthcare reform bill. Guardian, 22 March 2010

Abortion takes center stage in US health care debate. AFP, 22 March 2010

US health bill sent back for new House vote. BBC News Online, 25 March 2010