After 13 hours of negotiations, Nebraska Sen. Ben Nelson signed on to health-care reform as the pivotal 60th vote. He did so with stronger prohibitions on abortion than those floated by Sen. Robert Casey of Pennsylvania, contained within Majority Leader Harry Reid's manager's amendment. Under the latest set of provisions, not only would federal funds be prohibited from being used for abortion coverage, but states could also prohibit abortion coverage on their exchange.
If this provision passes, how many states would we expect to prohibit abortion coverage on their public exchange? We can get a pretty good guess by looking at the current situation for Medicaid funding of abortion. Since the 1976 passage of the Hyde amendment, barring federal funds from covering abortion, Medicaid has been prohibited from covering the procedure except in cases of rape or incest or if the life of the woman is at risk. However, states are free to use their own funds to cover elective abortions under Medicaid, and at the National Abortion Federation's last count, 17 do so. My guess is, under Reid's proposal, we'd see a few more states, perhaps 20 or so, allowing a plan on their exchange to cover abortion, since this program requires states to opt out of abortion coverage, whereas with Medicaid they must opt in.
Perhaps the most bizarre part of this amendment is the noticeable silence from both abortion-rights supporters and opponents. I've been monitoring my BlackBerry since it was introduced hours ago, yet I have not heard a peep from any of the major groups, including Planned Parenthood, NARAL, and the National Right to Life Committee. I'm sure they are coming—I know of a few groups that have statements planned for early afternoon—and most groups on both sides are not going to be happy, particularly those on the abortion-rights side.
Still, it feels odd that nothing has been said yet, espeically after the deluge of press releases circulated by both sides when the Stupak amendment passed and when Nelson introduced his version in the Senate. We did know yesterday that this amendment was coming and that it would likely need to do something to address Nelson's abortion concerns—so why no immediate statements? Can we blame it on the bad weather? Or the fact that it was introduced very early on a Saturday morning?
Possibly, but my guess is it's a combination of two things. The first is that no one quite knows if they won or lost with Reid's language. As I wrote earlier this week, groups on both side of the issue never really know what to make of supposed compromises and are incredibly leery of getting gamed. This isn't Stupak, but it still allows Stupak to live on in the states that want it. I think there may also be some battle fatigue: Democrats have labored incredibly hard to get this bill out the door by Christmas. Are abortion-rights groups willing to make a stand that it should be thrown out over this position, which does retreat from Stupak?