By Peter J. Smith

WASHINGTON, D.C., November 10, 2009 ( – The leader of the Senate, Harry Reid (D-Nev.), has now found himself in the most unenviable of positions: having to pass a health-care bill that must satisfy both pro-life and pro-abortion legislators who have the power to stall or kill the Senate's legislation.

The successful inclusion of the pro-life Pitts-Stupak amendment to the Affordable Health Care for America Act (H.R. 3962), the House version of health-care reform that passed late Saturday, has suddenly proved a game-changer in the current debate over health-care reform. As essential as the bipartisan pro-life amendment was to getting health-care reform out of the House, it now has ramifications for the Senate; the whole survival of the Democratic version of health-care reform could turn on the issue of abortion.

On Saturday, Rep. Bart Stupak (D-Mich.) proved that he and his pro-life Democrats could successfully make the House leadership – Speaker Nancy Pelosi and Rules Committee Chairwoman Louise Slaughter, both strongly pro-abortion – yield to their pro-life demands. Despite having been summoned for a personal meeting with President Barack Obama and Speaker Pelosi, the resilient Stupak maintained his promise to block the health-care reform bill from coming to a vote until the House was permitted to vote on his amendment. The Pitts-Stupak amendment blocks all streams of federal revenue from subsidizing health-insurance plans that provide abortions, including the public option.

Alternative “compromise” amendments, such as the amendment proposed by Rep. Brad Ellsworth (D-Ind.), which would have removed “federal funding for abortion” in H.R. 3962 by hiring contractors to issue checks for abortion, proved futile in breaking apart Stupak's coalition. The measure was vehemently denounced by the National Right to Life Committee as a pro-abortion “money laundering scheme,” and was flatly rejected by the US Catholic Bishops, which has put enormous pressure on Democrats to pass only the Pitts-Stupak amendment.

With Stupak unwilling to bow to pressure, Pelosi – desperate to pass the bill before House members went on recess starting Veteran's Day – agreed to allow the House to vote on the amendment, which was added into the bill by a comfortable margin of 240-194.

Pro-abortion legislators, however, are now determined that the Senate not pass its own version of the Pitts-Stupak amendment to their version of health-care reform. Since the bills before the House and the Senate differ greatly, the separate bills will have to be coalesced into one final bill in a conference between representatives of both chambers. Pro-abortion legislators are counting on the Pitts-Stupak amendment – if similar language does not exist in the Senate version – being thrown out in the final “compromise” legislation.

This single bill can no longer be amended and would then go before both chambers for a final vote.

Both Planned Parenthood and NARAL Pro-Choice America have vowed to combat the bill if the Pitts-Stupak language remains. The abortion industry, which has struggled with maintaining enough profit to keep its declining number of clinics operating, has a huge financial stake in health-care reform. Statistics from the Alan Guttmacher Institute have shown that government subsidies for abortion would sharply increase the number of abortions among Medicaid-eligible women by as much as 20 – 35 percent. The financial incentive to have an abortion – which has an average cost of $413, but can cost up to $1800 – increases when the procedure amounts to a co-pay, with insurance companies reimbursing abortionists the rest of the cost.

Pro-abortion members of Pelosi's caucus have informed her that they are prepared to vote against the final version of the bill, if it contains the pro-life language. That could jeopardize the ultimate passage of the House bill, where the loss of three votes is the difference between life or death.

Yet the situation for the health-care bill in the Senate is much more precarious, and for the Democratic Majority Leader, failing to placate both sides of the divide over abortion could kill the bill.

Reid identifies himself as a pro-life Democrat in the Senate, who opposes legal abortion except in cases of rape, incest, and the life of the mother. The Senate Democrat, however, leads a largely pro-abortion caucus in the 100 member Senate that has 39 Republicans, two independents, and needs 60 votes in order to invoke cloture on debate and proceed to a vote.

Already the chances of passage in the Senate are complicated by the fact that while the House wants a public health-insurance option, the Senate does not. Connecticut Sen. Joe Lieberman, an independent who caucuses with Democrats, has pledged to filibuster the bill if it includes a public option.

However, Stupak's victory has emboldened pro-life Democrats in the Senate, and Sen. Ben Nelson (D-Neb.) now poses another filibuster threat to Reid. Nelson told Politico that he wants airtight abortion language as well and if language as restrictive as Stupak's amendment were not included in the bill “you could be sure I would vote against it.”

Two other Democratic Senators that may join Nelson are Kent Conrad of North Dakota and Mary Landrieu of Louisiana.

Like the House bill before the Stupak-Pitts amendment, pro-life objections to the Senate version are centered around the creation of new funding channels that fall outside the scope of the Hyde Amendment (which prohibits the Department of Health and Human Services from disbursing funds that would go to pay for abortions).
A spokesman for Reid also told Politico that the Nevada Senator wants to “ensure that no federal funds are used for abortion,” but stopped short of saying how the Senator would accomplish that.

For Reid, offending social conservatives renders his chances of retaining his seat in 2010 much more difficult. On the other hand, Pitts-Stupak language in the Senate version would likely fail to gain enough support to pass among pro-abortion Senate Democrats.

In any event, the pro-life position has emerged as a decisive issue in the passage of the Democratic proposal for health-care reform, perhaps even more decisive and divisive than the battle over the public option. The fate of the bill may ultimately depend on whether the Democratic leadership can successfully buck the adage that “a man cannot serve two masters” and convince one side or the other to forgo core principles for the sake of health-care reform.

See related coverage by

Senior Democrat “Confident” Stupak Amendment Will Perish in Later Bill Version 

“Do we live in a theocracy?”: Pro-Abortion Reaction to Stupak Amendment is Fierce 

Pro-Life Leaders React to Health Bill Outcome: Caution Outweighs Celebration 

Backfire: Pro-Abort HuffPo Writer Rips NARAL and PP for Pro-Life Victory in Health Bill
PP points finger at U.S. Bishops, calls pro-life stance “unconscionable power play”