As Senate health care vote nears, will pro-life provisions be included?

Washington D.C., Jul 24, 2017 / 23:08 pm

As the Senate prepares to vote later today to begin the process of repealing and replacing the Affordable Care Act, pro-life leaders are working to ensure pro-life language is included in the final version of the bill voted on.

"There is no reason for private non-governmental organizations, like Planned Parenthood, to receive millions of dollars every year in taxpayer money. I will keep working with my colleagues to include pro-life provisions in the healthcare bill because abortion is not healthcare," Senator James Lankford (R-Okla.) said.

The Senate is set to vote Tuesday on whether to proceed with repealing and replacing the Affordable Care Act, although it has not been announced which replacement bill will ultimately be voted on.

However, there are concerns that the final legislation voted on in the Senate will not include pro-life provisions.

On Friday, the Senate Parliamentarian sent out a guidance stating the pro-life provisions in the bill – stripping Planned Parenthood of Medicaid reimbursements for one year and prohibiting any tax credits from paying for insurance that includes abortion coverage – could be removed short of 60 votes.

Senate Republicans do not have the 60 votes usually required to move a bill to the floor for a vote, but they had planned to pass a bill under the process of reconciliation, where legislation pertaining to the budget can be passed with a simple majority of votes.

The Parliamentarian, however, advised on Friday that the pro-life provisions violated the "Byrd Rule," which prevents language not pertaining to the budget from being included in a bill passed through the reconciliation process.

However, the language stripping Planned Parenthood of federal funds reportedly can be adjusted and re-inserted into the legislation voted on Tuesday. The language preventing federal funding of plans covering abortions, however, may still be blocked from a vote.

The 2016 Republican Party platform states that "we will not fund or subsidize healthcare that includes abortion coverage."

"The news from the parliamentarian was another dip in the roller coaster ride," Marjorie Dannenfelser, president of the Susan B. Anthony List, told the Washington Post on Sunday. "We have been reassured the problem can be fixed, so are in a tentative support mode still."

The most recent Senate health care proposal, the Better Care Reconciliation Act, would reduce spending on Medicaid and put a cap on Medicaid payments to states based on their population. Federal subsidies for coverage would also be reduced, and the penalties imposed on people who are without health insurance, along with the employer insurance mandate, would be done away with.

Scored by the Congressional Budget Office, it was determined to reduce the deficit by $420 billion over a decade, but would increase the number of uninsured by 22 million.

However, some have cautioned that the CBO scores are "flawed" as they consider only government actions while ignoring the private sector. Thus, if a government requirement for persons to have health insurance – the individual mandate – were to be repealed, that would be considered by the CBO for scoring, but not the effect of incentives for persons to buy insurance like tax credits and health savings accounts.

Critics have pointed to the nearly identical scoring of both a simple repeal of the ACA, which judged by the CBO to result in 22 million more uninsured persons, and the House-passed American Health Care Act, a repeal-and-replace bill, which was also determined to result in 23 million more uninsured.

Bishop Frank Dewane of Venice, chair of the U.S. bishops' domestic justice and human development committee, meanwhile said that the first version of the Senate bill was "unacceptable" and that the revised version did not contain enough improvements to change that determination.

Regarding the first version of the bill, he said in June that "it is precisely the detrimental impact on the poor and vulnerable that makes the Senate draft unacceptable as written."

"At a time when tax cuts that would seem to benefit the wealthy and increases in other areas of federal spending, such as defense, are being contemplated, placing a 'per capita cap' on medical coverage for the poor is unconscionable," he said of the proposed per capita caps in Medicaid funding to states.

Regarding the repeal of the individual mandate, and its replacement with a penalty for going more than 63 days without coverage, he said that "many people are forced to use their resources to address immediate needs," and that the penalty "will leave these individuals and families without coverage when they need it most."

And the bill would also result in higher premiums and less relief for some of those who need it most, he said. "In many places, older and lower-income people will pay more than under current law because of decreased levels of tax credit support and higher premiums."

When the revised plan was released, Bishop Dewane said in a July 13 statement that it was still unacceptable and that "more is needed to honor our moral obligation to our brothers and sisters living in poverty and to ensure that essential protections for the unborn remain in the bill."

Last week, short of the needed votes to pass the bill through the Senate, Majority Leader Mitch McConnell ultimately announced that a vote would occur to repeal and replace the ACA.

However, the Senate on Tuesday will reportedly vote on a "motion to proceed" on the House bill, the AHCA, and then would attach amendments to repeal and replace the ACA.

These amendments would include language from the 2015 repeal bill and a version of the Senate's recent health care proposal. That language would reportedly not include the protections against taxpayer funding of insurance plans with abortions.

On July 21, Bishop Dewane said that the Senate would need an acceptable health care plan to replace the Affordable Care Act if they voted to repeal the ACA.

(Story continues below)

He said that "in the face of difficulties passing these proposals, the appropriate response is not to create greater uncertainty, especially for those who can bear it least, by repealing the ACA without a replacement."

"Yet," he said, "reform is still needed to address the ACA's moral deficiencies and challenges with long-term sustainability." The bishops had previously said that funding of abortion coverage in plans offered on the exchanges, as well as lack of coverage for immigrants, were among their concerns with the Affordable Care Act and their reasons for ultimately not supporting its passage.