Changing landscape

WASHINGTON-For conservatives fearing a government takeover of the nation's healthcare system, this past weekend brought some good news sprinkled in with the bad. After a daylong debate, the House passed a trillion-dollar, nearly 2,000-page healthcare overhaul bill late Saturday night while many Americans were probably watching the day's last few college football games or out on the town.

While this marks a milestone moment for liberal reformers, one vote earlier in the day led to liberal hand-wringing and a significant victory for social conservatives: Pro-life Democrats succeeded in securing a vote on an amendment barring the public funding of abortion services through the bill's new government-run insurance option. The amendment, championed by Rep. Bart Stupak, D-Mich., passed by a 240 to 194 majority, including about 25 percent of House Democrats. It also overcame an alternative amendment backed by House leadership, who hoped to siphon off enough pro-life Democrats to allow healthcare to move forward. That alternative would have made cosmetic changes but would have still allowed the government insurance option to pay for abortions.

This insertion of abortion restrictions with bipartisan support is a blow to abortion advocates and will put added pressure on senators to include such protections in their version of healthcare reform. The overall bill likely would not have passed without the pro-life amendment-a fact that could begin to change the abortion debate landscape.

While both parties supported the abortion amendment, the 220-215 vote on the overall healthcare bill broke along party lines: 39 Democrats opposed the measure while just one Republican, freshman lawmaker Anh Joseph Cao of Louisiana's Democratic-leaning New Orleans district, backed the bill. (See "One-term wonder?" May 23, 2009.)

Democrats spent the rest of the weekend heralding Saturday's vote. But it is just one step in what will continue to be a long process. Attention now shifts to the Senate where significant changes to the legislation are expected. Sen. Lindsey Graham, R-S.C., has already announced that the "House bill is dead on arrival. It was a bill written by liberals for liberals." Indeed, moderate Democrats, who succeeded in leveraging their votes for pro-life concessions in the House, hold an even greater sway in the Senate, where margins are thinner.

Already numerous Democrats there have said they will not back a government-run insurance plan-something that forms a key part of the House bill. As the Senate debate plays out, expect abortion to continue to command a central role. If healthcare passes the Senate, this issue will again dominate Congress, as the House and Senate will have to reconcile their two bills. Liberal Democrats in the House have already said they will fight to strike the abortion restrictions from the final bill.

"We know that the White House and pro-abortion congressional Democratic leaders will keep trying to enact government funding of abortion," said National Right to Life Committee's legislative director Douglas Johnson. "So there is a long battle ahead."

Lawmakers are notorious for skirting hot-button issues when it comes to formal debate on the actual legislation, but now, thanks to the resistance of pro-life Democrats, the fulcrum of the healthcare debate is turning on one of the country's most controversial issues.