By Mary E. O'Leary
NEW HAVEN -- House Speaker Nancy Pelosi vowed Saturday that a final health care bill will be passed by Congress and delivered to President Barack Obama's desk.
Speaking at the Graduate Club during a Northeast trip promoting health care reform, Pelosi predicted the differences on abortion between the House and Senate versions will not stop the bill.
After a year of discussion, Obama wants an up-or-down vote on health care this month, with the House adopting the Senate version, before resolving other issues in both chambers through reconciliation, a parliamentary tactic that only requires a simple majority vote.
The House, when it passed health care reform in November, adopted by a 240-194 vote an amendment by Rep. Bart Stupak, D-Mich., that had more stringent language preventing federal funds from going toward abortion services than is currently the law.
“We believe that the Senate language more than satisfies the needs of some of our members who are pro-life,” Pelosi said after an hour-long meeting with more than 100 supporters of health care reform at the Graduate Club, mainly local and state women leaders. The Senate version prohibits the use of federal funds for abortion services. It allows private insurance plans that would be part of an insurance exchange to cover abortions, but they would be paid for with premiums paid directly by beneficiaries. States can also ban such coverage, in the exchanges, if they want.
The Stupak amendment limits access to abortions for anyone who receives a federal subsidy and does not allow insurers in an exchange from offering abortion services.
“The facts are there are no federal funds for abortion in this (Senate) bill and there is no reduction or increase in access to abortion,” the speaker said. “Federal funding for abortions is prohibited. Don't let anyone tell you anything different.”
There are a number of hurdles that Pelosi has to overcome as she works to reach consensus in the House, including differences between the House and the Senate versions on how the reforms are paid for. It also comes as representatives face re-election in eight months.
Republicans have opposed the health care bill as too expensive and far-reaching in a time of economic distress.
But on the abortion controversy, Pelosi's Connecticut colleagues in the House, U.S. Rep. Rosa DeLauro, D-3, and U.S. Rep. John Larson, D-1, who accompanied her to the meeting, did not see it as a problem.
Larson, chairman of the Democratic House Caucus, said there were Democrats who voted for the Stupak amendment, but promised that as long as the Hyde Amendment was still the law of the land, they could support the Senate bill if necessary.
“I believe that that's where the votes are and that's why this bill will go forward,” Larson said. The Hyde amendment has prevented the use of any federal funds for abortion coverage since 1976.
DeLauro said pro-life and pro-choice colleagues who want health care “are not going to be pressured by outside influences to move off the dime of passing health care in this country ... they are not going to hold health care hostage. This is not a bill about abortion. Those who want to defeat the bill want to make it a bill about that.”
Pelosi said the language on the final bill should be out this week, but she would not commit to a timetable on a vote. “I don't set any deadlines. It's when my members come to their conclusion, we will take our vote,” she said.
The discussion at the Graduate Club, before a very supportive crowd, was about the bill itself and particularly the benefits for women. Pelosi traced the impetus for reform back to Dr. Carolyn Mazure, director of Women's Health Research at Yale University, and her research on gender-specific treatments.
Mazure said women are the biggest consumers of health care services in the country and make the majority of health care decisions for their families, so it is important to have reforms that recognize that.
Women suffer from chronic disease and disability at higher rates than men, with higher rates of autoimmune disease, depression, osteoporosis and die at higher rates from heart attacks. She said even so, the country has yet to develop optimal gender-based treatments to maximize care and reduce costs for women.
The health care bill emphasizes prevention and would expand coverage to 31 million uninsured through income-based subsidies and an expansion of Medicaid at a cost of nearly a trillion dollars. There is no cap on annual or lifetime benefits.
Pelosi said the bill will not allow insurance companies to deny coverage for pre-existing conditions, which now includes such things as pregnancy, Cesarean sections and being a victim of domestic violence. In the individual insurance market, women are charged 48 percent more than men, while more than three-quarters of women in this market do not have maternity coverage.
“I'm surprised ... that women haven't already taken to the ramparts,” said Larson. “We need your support. We need to push back against the forces that just want to say no.”
Melissa Marottoli, 28, of Branford, said she was misdiagnosed with walking pneumonia in 2006. Two years later, the nonsmoker found she had stage four cancer with tumors in her brain and lung and told she had six months to live.
“I fear for my life. I fear for my job,” said Marottoli, who has gone through nine rounds of chemotherapy. She said she alternates between worrying she will lose her job and being resentful that she can't switch careers because of her pre-existing condition. Pelosi said health care reform will cover medical care, but also allow people who are “job-locked” to move on. “We compete with countries who don't have these issues,” she told the crowd.
In answer to a concern that the bill does not contain a public option, Pelosi said the reform bill is a good start that shouldn't be rejected for what it does not contain. She said there were similar concerns with Social Security and Medicare when they were initially passed.
“You have to start -- you have to kick open the door,” Pelosi said.
She said she tells her members: “I understand sometimes you want to go against a bill for what it isn't, but we want you to vote for this for what it is and what it can lead to,” she said.
Asked about the state of bipartisanship after a year of debate, Pelosi said representatives are elected to work together to arrive at solutions. “If we don't find it though, we must stand our ground. What you are hearing from the other side is an excuse for not wanting to free themselves from being handmaidens of the insurance companies,” she said.