Spending bill lets hospitals, HMOs refuse to offer abortions

WASHINGTON – In the first sign of post-election power by abortion opponents, Congress Saturday approved a sweeping $388 billion spending bill that would permit hospitals and HMOs to avoid state requirements that they offer abortion services.

Congressional Republican leaders inserted the provision into the massive appropriations legislation that provides money to scores of domestic government agencies. The legislation had to be passed by the end of the week to avoid a government shutdown.

The House approved the bill by 344 to 51, and the Senate voted 65 to 30. But Senate approval was delayed for hours after legislators discovered the bill contained a provision that would have permitted some senior members of Congress and their staffs access to income tax returns and allow them to disclose the information without penalty.

House and Senate leaders agreed to remove the offending language, saying its inclusion had been a mistake. But the Senate only considered the bill after extensive discussion and a series of procedures that would keep the bill officially in the Senate until the House also deletes the language, probably on Wednesday.

“It’s more than a mistake, it’s a terrible disaster,” said Senate Appropriations Chairman Ted Stevens, R-Alaska, who apologized for not detecting the language earlier.

Departing from some of the more freewheeling spending of recent years, lawmakers adhered to budgetary constraints by whittling spending for federal agencies, but still managed to include money for favorite local projects. The bill came just days after Congress increased that nation’s $7.4 trillion debt limit by $800 billion.

Republicans praised the package as a model of fiscal restraint, noting that some federal agencies had their spending cut. But Democrats and some moderate Republicans complained that the bill’s across-the-board cut of .83 percent for non-security programs unfairly hit some programs that needed additional funds.

It was the abortion provision, however, that elicited the most passionate protests, particularly from female lawmakers. Though the House has supported such language and included it in a labor and health spending bill earlier this year, the Senate had never taken action on such a provision.

The real impact of the legislation is hard to determine. Forty-five states already allow health care providers to refuse to provide or pay for abortions and because the legislation is tucked into a one-year spending bill, it would have to be renewed on an annual basis unless it’s made permanent in separate legislation.

But the legislation carries significant political symbolism. It was the first gesture of the Republican-controlled Congress in the wake of elections that strengthened GOP control of the House and Senate and re-elected President Bush, an opponent of abortions.

House Democratic Leader Nancy Pelosi called it “an extraordinary sneak attack on women’s rights and a disgraceful display of ideology over health.”

On Friday, nine of the 14 women in the Senate – eight Democrats and Republican Olympia Snowe of Maine – unsuccessfully urged Stevens to remove the language from the bill.

Supporters, however, said it was simply a logical extension of a “conscience” clause that prohibits doctors from being forced to offer abortions or undergo abortion training. The new provision says no government agency can discriminate against health care providers who refuse to offer abortion-related services.

“This provision is intended to protect the decisions of physicians, nurses, clinics, hospitals, medical centers and even health insurance providers from being forced by the government to provide, refer or pay for abortions,” said Rep. Dave Weldon, a physician and Florida Republican.

Noting that 45 states permit health care providers to decline participation in abortion or abortion services, Weldon said abortion rights forces were trying to overturn such laws in the courts.

Some states and local governments have denied mergers or certificates of need to hospitals or other medical institutions that refuse to provide abortions.

“This simply will put a stop to that,” said Douglas Johnson, legislative director for the National Right to Life Committee. “It has no impact at all on any health care provider who voluntarily wishes to provide these abortion services.”

Supporters of abortion rights said states that offer abortion under their Medicaid coverage might face a loss of federal funds if they demand all Medicaid providers to provide abortion services. They said the law would encourage abortion opponents to pressure hospitals into refusing abortion services.

“It creates the ability for far-right activists to use intimidation tactics against HMOs, hospitals and other health care entities to develop these gag rule policies,” said David Seldin, a spokesman for NARAL Pro-Choice America, the nation’s leading abortion rights group.