NOVEMBER 3, 2009

Flash Points Linger in Health Bill
Democrats Trying to Reach Final Deals on Handling of Abortions, Illegal Immigrants

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By JANET ADAMY

WASHINGTON -- House Democrats are wrestling with how their health-care bill will deal with abortion and immigration issues as they prepare to bring the bill to the floor as soon as Friday.

Democratic leaders in the House warned members that debate on the floor may stretch through the weekend and into next week so the House can vote on the bill before the Nov. 11 Veterans Day holiday. After critics attacked an earlier draft of the health bill during the August recess, Democrats are wary of letting it languish during a break.

House leaders unveiled their revised 1,990-page bill last week after months of negotiations. The $1.055 trillion measure would expand health insurance to 36 million Americans and create a new government health-insurance plan to compete with private insurers, among other things.

But Democrats are still trying to reach a final agreement on how the bill addresses funding for abortions and insurance coverage for immigrants.

Although the issues are small parts of the legislation, they have become flash points for Republicans and Democrats that could determine whether key lawmakers support the bill.

Some Democrats are concerned that the House bill would allow illegal immigrants to participate in new exchanges designed to help individuals and smaller employers buy insurance.

While those immigrants wouldn't have access to government subsidies to buy insurance, the bill leaves open the possibility that they could participate in the public health-insurance plan if they paid the premiums out of their own pockets.

It is one area where the House bill contrasts with what the White House is seeking in the health-care overhaul. President Barack Obama has pledged that the health overhaul won't apply to people who are in the U.S. illegally.

While the Senate has yet to unveil its most recent bill, the measure that passed through its Finance Committee last month prohibited illegal immigrants from participating in the insurance exchanges.

On abortion, the House bill prevents federal money from being used to pay for abortions through the insurance exchange, except in the case of rape, incest or when the mother's life is endangered. The bill says that, in each market, the insurance exchange should offer at least one insurance plan that covers abortion and one that doesn't.

But some House Democrats argue that such a structure effectively allows federal dollars to underwrite abortions, because the government would be subsidizing the insurance premiums for plans that cover the procedure. They are trying to tighten the language so the funding is more restricted and ban abortion services from the public option.

Supporters of the current proposal say it is consistent with how other laws treat abortion funding, and that it includes protections to separate out the federal subsidies so no premium subsidies go toward abortions.

Republicans are preparing to unveil their own health bill in the next few days. Minority Leader John Boehner (R., Ohio) said Monday that the plan wouldn't seek to prevent health-insurance companies from denying sick people insurance -- a key plank of the Democrats' legislation.

Instead, the bill would allow insurance firms to sell policies across state lines, permit small businesses to pool their risks to bring down costs, change medical-malpractice laws and give state governments more flexibility to pursue rule changes.

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