Abortion provisions in GOP health plan in danger

Anti-abortion groups and conservative lawmakers are worried that several provisions aimed at cutting abortions won't survive in the House Republicans' plan to repeal Obamacare.

The lawmakers are worried that a plan to cut Medicaid spending to Planned Parenthood for one year, a long-standing goal among conservatives, nor a provision that would restrict abortions could make it to final passage in the American Health Care Act, which would repeal Obamacare.

Some lawmakers are worried that the defunding provision won't survive as GOP leadership aims to shore up support in the Senate.

"I am concerned that [stripping defunding] will be a condition for passage on the other side. I want to make sure that it doesn't happen," Rep. Andy Biggs, R-Ariz., told the Washington Examiner.

Two Republican senators, Lisa Murkowski of Alaska and Susan Collins of Maine, oppose defunding Planned Parenthood. Both senators successfully quashed a similar defunding provision in a 2015 repeal bill.

The Senate can only afford only three defections, as Democrats are expected to be united in opposition to the healthcare legislation.

Collins said Monday that she remains opposed to cutting Medicaid funding for Planned Parenthood. She said that doing so would "discriminate" against Planned Parenthood as opposed to other Medicaid providers.

But Collins isn't open yet to offering an amendment in the chamber to strip the defunding provision. She said she first wants to see what will happen in the House.

The nonpartisan Congressional Budget Office estimated that defunding Planned Parenthood would save $178 million this year and $234 million over the next decade. The CBO found in its estimate released Monday that defunding the provider would lead to a spike in Medicaid spending because of more unplanned pregnancies. Medicaid covers 45 percent of all live births in the U.S.

Lawmakers aren't concerned only about whether Planned Parenthood defunding gets dropped. They also wonder if other anti-abortion provisions will pass the Senate's rules.

The American Health Care Act would put new restrictions on eligibility for tax credits to help lower the cost of insurance.

Under the Hyde amendment, which prohibits any federal funding for abortions, no federal subsidies can be spent on abortions.

Under Obamacare, a person can use the tax credit to pay for a plan, and that plan can offer abortions. However, the person cannot use the tax credit to pay for an abortion.

The GOP plan goes further than Obamacare. It says tax credits cannot be used on any plan that offers abortion.

There are exceptions in both Obamacare and the American Health Care Act for cases of rape and incest or to save the life of the mother.

But some experts believe the Hyde amendment protection could doom the rest of the bill.

Republicans are using an arcane Senate tool called reconciliation that lets them pass the bill via a 51-vote majority in the chamber as opposed to getting 60 votes to stop a filibuster.

But reconciliation can be used only for budgetary and spending provisions, and the Senate parliamentarian could reject parts of the bill that don't meet that threshold.

One expert doubts the Hyde amendment can make the cut.

"Over multiple decades, and numerous parliamentarians, Republican efforts to enact Hyde amendment protections through budget reconciliation have all failed," said policy expert Chris Jacobs in a recent blog post.

Republican senators are aware that not all abortion provisions could make it through reconciliation.

"I strongly support putting the language in. We will have to see," Sen. Steve Daines, R-Mont., told the Washington Examiner.

Daines said if the provisions fail to make the cut, Republicans can look for "other avenues," but he declined to elaborate.

One anti-abortion group is watching the proceedings with trepidation.

"At this point and time, between parliamentary parlays and Senate deals, anything can happen," said Tom McClusky, vice president of government affairs for March for Life Action. "Our biggest concern right now is that the underlying healthcare provisions have pro-life protections connected to them."

If those provisions don't make it into the final bill, March for Life will oppose it "regardless if it defunds specific abortion providers or not."

"If pro-life protections remain in the bill and the defunding does not, we will address that when the time comes," McClusky said.