The latest episodes involve Republicans' attempt to apply the long-standing limitation on federal funding for abortion - known in Washington as the "Hyde amendment" after its author, the late Rep. Henry Hyde (R-Ill.) - outside its usual turf. In particular, some Democrats balked when the restriction turned up in bills to create another federal fund for victims of human trafficking and a wide-ranging proposal to amend and renew Medicare and other federal health programs.
The Hyde amendment has been a staple for years in annual appropriations bills, and similar restrictions have shown up on other measures that appropriated federal dollars, such as the 2010 Patient Protection and Affordable Care Act (better known as Obamacare). As much as some pro-choice Democrats rankle at applying the Hyde amendment to the yearly spending bills, they certainly can't win that fight in today's Republican-led Congress. What they don't want to see, though, is the restrictions applied to multi-year authorization bills that would extend into the next Congress and the next administration.
The problem with the two bills in question is that they would simultaneously authorize and spend money. That shift from the norm set up the fight over abortion.
The anti-trafficking measure allows the U.S. attorney general to dole out money from the fund "without further appropriation" for the purposes specified in the bill and three federal laws aimed at trafficking and child abuse. That appears to shield the fund from the annual appropriations process, which would explain why the Republican authors of the bill included the restrictions on spending the money on abortions.
Granted, it's hard to see the logic of applying the Hyde amendment to a fund that's not filled with tax dollars. But pro-life Republicans don't want to put the federal government's imprimatur on any elective abortion. The dollars in the trafficking victims' fund may not be coming from the taxpaying public, but the fund is still the work of Uncle Sam.
The main purpose of the other measure is to prevent a potentially disastrous cut in payments to doctors who treat Medicare patients. The cut is scheduled to take effect on April 1, so if Congress doesn't act by the end of the week, seniors and the disabled may have trouble finding a doctor willing to see them next month.
In a rare show of bipartisanship on a thorny issue, Republican and Democratic leaders of the House and Senate tax-writing committees came up with a plan to replace the automatic cuts in Medicare provider payments with a less draconian method that gives physicians an incentive to control costs. And in an even more rare display, Republican leaders in the House agreed to let the bill move forward without offsetting its cost, which is estimated to be about $140 billion over 10 years.
The Medicare payment reform was packaged, however, with a slew of extensions for expiring programs, including the popular Children's Health Insurance Program and community health centers. The measure not only authorized funding for the latter, it appropriated $3.6 billion for the centers in each of the next two fiscal years.
So again, you have a bill that both authorizes and appropriates. In that context, it's understandable why Republicans applied the same abortion restrictions as have long been applied to the centers.
House Minority Leader Nancy Pelosi (D-San Francisco) and the co-chairwomen of the House Pro-Choice Caucus, Reps. Louise Slaughter (D-N.Y.) and Diana DeGette (D-Colo.), all have endorsed the measure despite the restrictions. Said Slaughter and DeGette in a statement: "The language included in the bipartisan compromise does not further restrict women's access to abortion, and the provisions expire along with funding — just as the current Hyde amendment does. We will be supporting this bipartisan compromise, and we encourage other members of the Pro-Choice Caucus to do the same."
That message hasn't yet resonated with Senate Democrats. According to the National Journal, Senate Minority Leader Harry Reid (D-Nev.) has expressed his opposition to including Hyde amendment-style strictures in the measure. Sen. Ron Wyden (D-Ore.), the top Democrat on the Senate Finance Committee, expressed sharp concerns last week, although an aide said Tuesday that he was still studying the text of the bill.
It would be stunning if the abortion fracas derailed the crucial reforms in the Medicare bill or disrupted funding for either the Children's Health Insurance Program or the health clinics. If the latter don't have their funding renewed after Sept. 30, they would no longer be able to treat an estimated 7 million of the 23 million people they currently serve, said Dan Hawkins of the National Assn. of Community Health Centers. And about 60% of the centers' clientele is female, Hawkins said.
Lawmakers could have avoided this mess had they simply extended the centers' authorization and left the funding to the appropriators, although that's a bit like trusting strangers to watch your luggage at a bus terminal. Similarly, the trafficking bill probably wouldn't have attracted the Hyde amendment had it merely authorized the new fund.
That's not where we are, however. Instead, we're stuck in the land of fights that never end.
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