House Democratic leaders are growing increasingly confident that they can avoid an impasse on abortion when they vote later this week on health care legislation.
That confidence has been buoyed as a trickle of Democrats opposed to abortion rights, such as Rep. Dale Kildee (D-Mich.), have said they are satisfied that the Senate bill's language effectively prohibits federal funding of abortions, while other Democrats who oppose abortion rights, including Transportation and Infrastructure Chairman James Oberstar (D-Minn.), have left open wiggle room to vote for the Senate bill despite earlier comments to the contrary.
Majority Leader Steny Hoyer (D-Md.) said Friday that the House plans to forge ahead without adding strict language to appease Rep. Bart Stupak (D-Mich.) and other opponents of abortion rights. Hoyer said the Senate approach, which Stupak has assailed as too weak, cannot be tweaked "per se" in the reconciliation package.
"We'll have to deal with it pretty much as it is at this point in time," Hoyer told reporters.
House leaders continue to make the case to Members like Kildee that the Senate language would continue the prohibition on federal funding of abortions. Under the bill, women getting federal insurance subsidies would be able to purchase plans that cover abortion, but they would have to pay out of their own pocket for the abortion coverage with a separate check.
Leaders have not yet given up on picking up some votes from Stupak's backers or getting a side agreement involving a future vote on the issue.
Hoyer signaled optimism that Stupak will vote for the package without his fix. "Mr. Stupak has made it very, very clear that he's very strongly in favor of achieving health care reform in this Congress, and I think that a lot of his colleagues feel the same way," Hoyer said.
The sales pitch may have been helped by a stance taken by Republican Senators that they will block any abortion or other amendments that require 60 votes to overcome a point of order under reconciliation. That position appears to offer no sure way for leaders to change the legislation.
Politics also may have a role. Stupak is facing a primary challenge, and outside supporters of the health care bill are looking to find primary opponents for other Democrats who vote against it.
One key vote will be that of Rep. Brad Ellsworth (D), who is seeking retiring Democrat Evan Bayh's Indiana Senate seat. Ellsworth has supported Stupak's language in the past but said this week that he remains unsure about whether he would vote for the Senate bill without changes.
Ellsworth is caught between groups like the Catholic bishops, who have condemned the Senate language, and the Democratic activists and fundraisers, who he needs on his side to mount a Senate campaign.
House leadership aides cautioned, meanwhile, that until they have the votes for the bill, no decision on abortion or any other issue is final. But the surging momentum for passing a bill — now expected within a week — and the strict confines under reconciliation rules are making the idea of any changes increasingly unlikely.
Asked whether she considered the abortion and immigration language in the bill settled, Speaker Nancy Pelosi (D-Calif.) reiterated that only budget-related items can be included.
"Reconciliation is just about the budget," she said.
Still, some anti-abortion Members continued to hold firm. Rep. Dan Lipinski (D-Ill.) reiterated a hard-line position, vowing to oppose any bill unless Stupak-like language is added. "There has to be a realization among leadership that they need to pick up votes and abortion is a stumbling block," he said. "Nothing yet has moved forward."
There has been some talk, initiated by Rep. Henry Waxman (D-Calif.), of pushing off the abortion debate and offering both sides of the issue a future vote, but to date, both supporters and opponents of abortion rights have rejected that idea.
Members who support abortion rights, including Rep. Jan Schakowsky (D-Ill.), said last week that they would not accept any side deals that would give Stupak the chance to put his amendment on a future appropriations bill or any other bill.
Abortion isn't the only headache for Democratic leaders.
The other long-simmering social debate — over the treatment of illegal immigrants under the bills — reared up late last week when Rep. Luis Gutierrez (D-Ill.), the Congressional Hispanic Caucus' point man on immigration reform, said he planned to vote against the package on account of Senate language that he called too restrictive.
"At this time, I am a no' vote on health care," he said in a statement Friday. "I will fight to change proposals that would exclude our nation's hardworking immigrants from the health care exchange, and I would find it extremely difficult if not impossible to vote for any measure that denies undocumented workers health care purchased with their own dollars."
Democratic leadership sources said they hoped the bundling of a student-loan measure with the health care package would compel other CHC members to swallow their reservations about the immigration language.
But there were other problem spots, as well. Rep. Ron Kind (D-Wis.), who worked for months to help craft language addressing regional iniquities in the Medicare reimbursement formula, has been raising objections to how the Senate measure handled that issue and is working on reconciliation-compliant language that he hopes will be included in the bill.
Other Democrats said they wanted to make sure their states did not get treated unfairly under Medicaid reimbursement rules in the Senate package.