The New York Times , July 20, 2009
By ROBERT PEAR and ADAM LIPTAK
WASHINGTON An Obama administration official refused Sunday to rule out the possibility that federal tax money might be used to pay for abortions under proposed health care legislation.
Peter R. Orszag, the White House budget director, asked whether he was prepared to say that no taxpayer money will go to pay for abortions, answered: I am not prepared to say explicitly that right now. Its obviously a controversial issue, and its one of the questions that is playing out in this debate.
Senator Judd Gregg, Republican of New Hampshire, who along with Mr. Orszag was asked about the issue on Fox News Sunday, said it had the potential to complicate the legislative battle over health care. I would hate to see the health care debate go down over that issue, Mr. Gregg said.
Abortion has been simmering behind the scenes as an issue in legislation to guarantee access to health insurance for all Americans. The debate affects not only the public health insurance plan that Democrats want to create, but also private insurers, who would receive tens of billions of dollars of federal subsidies to cover people with low and moderate incomes.
Under the House bill, for example, most insurers would have to provide an essential benefits package specified by the health and human services secretary, who would receive recommendations from a federal advisory committee. Opponents of abortion want Congress to prohibit inclusion of abortion in that benefits package, while advocates of abortion rights say the package should be left to medical professionals to determine.
In an analysis of the House bill, the National Right to Life Committee said that ordinary principles of administrative law could allow the Obama administration to determine what would be included in the benefits package. There is no doubt, the group said, that coverage of abortion will be mandated, unless Congress explicitly excludes abortion from the scope of federal authority to define essential benefits.
Even if the health secretary did not require coverage of abortion, the group said, federal courts would interpret the broadly worded mandatory categories of coverage to include abortion.
Susan M. Pisano, a spokeswoman for Americas Health Insurance Plans, a trade group, said that most insurance companies offered benefit packages that included abortion coverage but that many employers decided not to buy such packages.
Douglas D. Johnson, legislative director of the National Right to Life Committee, said the House bill, like one approved last week by the Senate health committee, would result in the greatest expansion of abortion since Roe v. Wade, the 1973 Supreme Court decision that established a constitutional right to abortion.
In the three House committees that approved comprehensive health care bills last week, Republicans tried unsuccessfully to restrict coverage of abortion.
Since 1976, Congress has imposed sweeping restrictions on the use of federal money for abortions. The Hyde Amendment, for instance, prohibits the Medicaid program from spending federal money on most abortions.
But opponents of abortion said the proposed federal subsidies to be provided for coverage of the uninsured would not be subject to these restrictions.
Kathleen Sebelius, the health and human services secretary, was asked about the issue in April when her nomination was being considered by the Senate Finance Committee.
Most private plans do not cover abortion services except in limited instances, but do cover family planning, Ms. Sebelius said. And Congress has limited the Federal Employee Health Benefit plan to covering abortion services only in cases of rape or incest, or when the life of the mother is in danger.
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