Can a Pro-Life Dem Bridge the Health-Care Divide?

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Mark Wilson / Getty

Senator Bob Casey arrives for a Senate Foreign Relations Committee hearing

The point of the Oct. 21 press briefing was to highlight Senate Democrats' outreach to faith-based organizations. Illinois's Dick Durbin, the No. 2 Senate Democrat, spoke approvingly about all the policy areas that religious leaders have been working on with Democrats before adding, "And not just on negative issues like abortion." Across the room, Bob Casey of Pennsylvania, a pro-life Catholic, listened in silence. A few minutes later, a reporter asked his opinion on abortion coverage in the Senate version of health reform. "We want to make sure that there is no federal funding of abortion," began Casey, but Michigan Senator Debbie Stabenow quickly cut him off.

"We do not have funding for abortion services in these bills," she said. "Senator Casey doesn't need to worry about it. He can vote for health reform."

Casey smiled patiently but stood his ground. "We need more work done on this," he said.

Shaking her head, Stabenow jumped in again. "This health care debate is not about changing current policy on abortion," she said. "There is no funding for abortion. So there should be no problem." Unfortunately for Stabenow and other Democrats, in the month since that meeting, abortion has become very much a problem — if not the biggest hurdle — in passing health care reform.

The debate must feel familiar to Casey, who watched his father, former Pennsylvania governor Robert P. Casey, battle with President Bill Clinton and Planned Parenthood over his pro-life stance. Governor Casey successfully defended his tightening of Pennsylvania's abortion policies all the way to the Supreme Court, and would likely have challenged Clinton for the 1996 presidential nomination if his health hadn't suddenly deteriorated (he died in 2000 at the age of 68, seven years after receiving heart and lung transplants). And so now, the son of the man often called the father of pro-life Democrats finds himself facing the biggest issue of his three years in the Senate: a debate over federal funding of abortions that threatens to bring down health care reform.

Any hope that pro-life Democrats were going to go quietly into the night was shattered in the final hours before the House passed its version of the health care bill on Nov. 7. Sixty-four pro-life Dems joined most Republicans in voting for an amendment authored by Representative Bart Stupak, a Michigan Democrat, which aims to ensure that no federal dollars can go — directly or indirectly — to funding abortions in the new health-insurance marketplace that is envisioned by the bill. Pro-choice advocates insist that the amendment goes too far, beyond the decades-old Hyde Amendment, the federal law that prohibits funding of abortions through Medicaid and other federal health plans except in the case of rape, incest or to save the woman's life. By restricting abortion coverage through the so-called exchange, critics say, the Stupak amendment will end up limiting the availability of abortions, especially for the low-income women who would qualify for federal subsidies to help purchase policies. Stupak charged that the Dems' compromise proposal, which would have segregated public funds from private funds that could be used to pay for abortions, was tantamount to subsidizing murder.

Stupak's provision passed the House, but with both sides vowing to vote down the final product if the amendment is included (pro-choice) or left out (pro-life). So it's up to the Senate to find a workable compromise. On the face of it, the Senate is more heavily pro-choice than the House, with only 40 solid pro-life votes (38 Republicans plus Casey and Ben Nelson of Nebraska). But with practically no Republicans except for Maine's Olympia Snowe looking even open to the possibility of voting for the Senate bill, majority leader Harry Reid will need every single one of his caucus' votes. What's more, there are seven additional Democrats who have in the past voted to ban federal funding of abortions and another four who have mixed records, having voted in the past to ban so-called partial-birth abortions. Add to that the unknown quantity of some of the freshmen, such as Virginia's Mark Warner, Colorado's Michael Bennet and Alaska's Mark Begich. While the pro-life movement probably doesn't have the 60 votes needed to add a Stupak-like amendment to the Senate bill, abortion is an intensely personal issue for many politicians, one that could make or break their final votes.

All of this has made these 15 Senators — three of whom, including Reid, Bennet and Arkansas's Blanche Lincoln, are facing tough races next November — top lobbying targets of pro-life groups. And the person they expect to be wrangler in chief of this nervous group? Casey. "He's our No. 1 target to influence others," says Joy Yearout, spokeswoman for the Susan B. Anthony List, a national pro-life fundraising group that has seen activity increase 50% in the past two years (the group is already running $130,000 worth of commercials against Reid). "Casey ran as a pro-life Democrat, and it's time he deliver for his constituents. His father had such a legacy on the issue and you'd think he'd want to augment that." Getting something passed in the Senate has taken on extra urgency, says Douglas Johnson, legislative director of National Right to Life, because pro-life groups believe House Speaker Nancy Pelosi is considering simply passing the Senate version rather than trying to merge the two chambers' different bills into one finished product.

Casey is working on an amendment, though it might not be the one Johnson, Yearout and the U.S. Conference of Catholic Bishops — which has also lobbied heavily on the issue — might hope for. Casey's amendment would boost services to pregnant women to help educate them on their choices. "I think it would help a lot of folks on both sides feel more comfortable about the bill," Casey says. That certainly won't go far enough for pro-life advocates who say the current language in the Reid bill — a version of the separation-of-funds idea — is "an enormous disappointment, creating a new and completely unacceptable federal policy that endangers human life and rights of conscience," as the U.S. Conference of Catholic Bishops wrote in a letter to the Senate last week. While Casey is speaking with other Senators on the issue and is considering other amendments, he's "not drawing any lines in the sand," he says. "I just think that there's going to be enough momentum to get a bill passed that one issue — even one very important issue — will not prevent passage." That said, when pressed, Casey, with a faint smile on his face, echoed the same line he told Stabenow in the meeting with faith leaders: "There's still a good bit of work to be done."

With reporting by Amy Sullivan / Washington