The debate surrounding abortion access is about to spill over from the campaign trail to Capitol Hill as lawmakers begin debating must-pass appropriations bills.
Starting Wednesday, the House will take up a nearly $1 trillion spending package written by Democrats that would roll back Trump administration anti-abortion policies, including restrictions barring health clinics from recommending abortion services and preventing U.S. foreign assistance to aid groups that perform or promote abortions.
But the massive spending bill keeps in place the four-decades-old Hyde amendment, which prevents federal health care funding, including Medicaid, the insurance program for low-income beneficiaries, from covering abortions except in cases of rape, incest or to save the woman’s life. The amendment is named for the late Illinois Republican Rep. Henry J. Hyde, who sponsored the original language.
That’s an increasingly difficult position for Democrats to defend these days, given the outcry on the campaign trail even among presidential candidates who’ve voted for Hyde in the past. Former Vice President Joe Biden, a self-described “practicing Catholic,” became the latest high-profile Democrat to publicly disavow the Hyde amendment Thursday after taking fire from fellow candidates and interest groups.
A group of liberal House Democrats, including Barbara Lee of California, Pramila Jayapal of Washington and Ayanna S. Pressley of Massachusetts, filed an amendment with the Rules Committee on Friday that would strike the Hyde amendment from the 667-page bill. It would also go further, requiring the federal government to “ensure coverage for abortion care in public health insurance programs” and prevent the federal government, as well as state and local governments, from restricting abortion coverage by private health plans.
If the proposal creating new coverage requirements were allowed, it would be in violation of House rules and subject to a point of order against its consideration, since it would constitute legislating on an appropriations bill. The Rules Committee will meet Monday and Tuesday to determine what amendments are in order for the floor debate on the five-bill package.
House Labor-HHS-Education Appropriations Chairwoman Rosa DeLauro said in late April when her subcommittee marked up its draft bill that a continuation of the Hyde amendment is a recognition of political reality. The Connecticut Democrat said she opposes the “discriminatory policy that makes access to basic reproductive health care based on your income,” but acknowledged that in order to get a bill signed into law Democrats needed to maintain the language.
Brendan Buck, who was a top aide to former Speaker Paul D. Ryan, predicted an ugly government shutdown showdown if that changes.
“Allow me to be alarmist for a moment: If House Dems stake out a position that they won’t include the Hyde amendment in this year’s spending bills, just watch out,” he tweeted Friday. “If you think a long shutdown over immigration was bad, wait until we have one over abortion funding.”
But other abortion access riders House Democrats included seem destined for a showdown this fall with Senate Republicans and the Trump administration anyway. Senate Labor-HHS-Education Appropriations Subcommittee Chairman Roy Blunt said last week it’s unlikely any of the new abortion-related provisions in the House bill actually become law.
“I believe what will happen in the final bill is that all the language that has traditionally been in these Labor-H bills will still be there, and it’s highly unlikely that there’s any new language added on either side of those issues,” the Missouri Republican said. Senate appropriators haven’t yet released their fiscal 2020 spending bills.
The debate is re-emerging as abortion access surges to the forefront of voters’ minds after several states passed laws that ban virtually all abortions. Federal lawmakers are unlikely to have much influence on those efforts, but they can use the “power of the purse” strategically to make their voices heard.
“There is this lack of trust, respect for women, and it’s going to be an issue that we are going to continue to fight,” DeLauro said last week.
Going after ‘gag rules’
The Labor-HHS-Education title of the spending package would bar new HHS regulations that prevent Title X family planning grants from going to Planned Parenthood and other health care providers that offer abortion services, unless the services are offered at a separate facility. Providers aren’t allowed to promote abortion services or refer patients to clinics where abortions are carried out.
Abortion rights advocates refer to the new regulations, finalized in February, collectively as the “domestic gag rule.”
The measure would provide a nearly 40 percent increase in Title X funding, which serves mainly low-income patients, above the current fiscal year and Trump request for next year. The bill would also prevent the administration from enforcing a “conscience clause” rule that allows a broad array of workers to opt out of providing health care services to which they object on religious grounds, including abortion and prescribing birth control.
And the State-Foreign Operationstitle of the package would eliminate the Mexico City policy, which prevents federal funding from going to any nongovernmental organization that uses any funding, including private money, to discuss, provide referrals or perform abortions outside of the country. Abortion rights advocates refer to the Mexico City policy as the “global gag rule.”
The Trump administration reinstated and expanded the policy — which has mainly been in existence under GOP presidents since the Reagan administration instituted it, and dropped by Democratic presidents — in January 2017.
Trump expanded the scope of the restrictions to encompass federal funding for programs like global HIV/AIDS, malaria and tuberculosis and maternal and child health programs. Prior to Trump, Mexico City had mainly applied to overseas family planning accounts.
A report from the International Women’s Health Coalition released this month argues the policy is harming a variety of health care services for women around the world and leading to an increase in deaths. “Efforts to restrict access to abortion do not decrease incidence of abortion,” the report says. “Instead, they often force women to resort to unsafe abortion methods.”
The House bill would also provide $55 million for the United Nations Population Fund, which supports reproductive health care programs in developing countries. The Trump State Department had cut off funding over the group’s alleged support for coerced abortions and involuntary sterilization in China, and the White House and Hill Republicans oppose giving the U.N. agency any money. The organization disputes the charge, but Democrats included a provision in the State-Foreign Operations bill that would bar any program funds from being used in China.
‘Testing the waters’
Republicans generally argue the inclusion of provisions that ease access to abortions will incur a Trump veto, and the Office of Management and Budget has already sent letters to appropriators expressing opposition to provisions in the House bill. For House Democrats, it’s an opening bid in a monthslong negotiation.
“I am always cautiously optimistic that common sense will prevail and that we will be able to work together on preserving the language, which I think is essential,” House Appropriations Chairwoman Nita M. Lowey of New York said.
Jacqueline Ayers, vice president of public policy and government relations at Planned Parenthood, said the group is preparing to run a “wide campaign” with its 13 million supporters to talk with lawmakers in their districts as well as in Washington.
Planned Parenthood’s focus will be on how the spending bills would affect a “vast array of reproductive health care” options for women, not solely abortion access, she said.
Steven Aden, chief legal officer and general counsel at Americans United for Life, believes Democrats are trying to find out how having control of the House will affect various policies laid out in the spending bills.
“They are testing the waters,” Aden said.
For now, he isn’t particularly worried about the provisions included in the House bills, saying he expects Senate Republicans and the Trump administration to hold the line.
“We’ve made our concerns known to folks on the Hill, especially on the Senate side. I think the pro-life Senate majority is determined to stand fast on every single one of these,” Aden said.
Sandhya Raman and Andrew Siddons contributed to this report.