Editor’s note: The full text of President Obama’s executive order, along with a statement from the White House Communications Office, is reprinted at the end of this report.
The biggest overhaul of the nation’s health care system in more than four decades appeared certain for passage Sunday as House Democrats picked up the last crucial votes they needed to pass it.
The White House announced that President Barack Obama would issue an executive order later Sunday ensuring that the administration would enforce longstanding restrictions on the use of federal funds for abortion.
U.S. Rep. Bart Stupak, D-Mich., the main holdout on the health care bill, immediately went before a nationally televised news conference to say he would vote for the bill.
“I’m pleased to announce that we have an agreement,” Stupak said. “We wanted to see helath care reform, but there was a pricnicpal we wanted to see — the sanctity of life. Today the president has announced that he will sign an executive order to reinforce that principal.”
Stupak called the American people the winner of the agreement, noting that 31 million people will have coverage under the bill.
House leaders were aiming for a final vote by 9 p.m. on the $940 billion package that could change the way most Americans deal with their insurers, doctors and other health care providers.
Other key Democrats announced they would vote for the bill Sunday. Rep. Brian Baird, D-Wash., who had voted “no” on a House health care bill in November, said he would vote yes. “This legislation before us in not perfect, but it does make substantial improvements on what exists today,” he said.
And Rep. Marcy Kaptur, D-Ohio, one of the anti-abortion Democrats on the fence, told Toledo, Ohio, television station WTVG she got assurances from administration officials that current federal law on abortion would be preserved.
The debate Sunday began as the Capitol buzzed with an electric atmosphere. Outside in the mid-70s weather, crowds gathered to both protest and support the health care bill.
“Things are colliding today,” said Maria Robalino, 35, of Washington D.C., carrying a purple “Catholics for Healthcare Reform” sign.
Inside the Capitol, the mood was tense. A protester in the House visitors’ gallery jumped up during the debate and shouted “Kill the bill.” Police quickly pounced and escorted him out of the chamber. …
The House plans three major votes Sunday. After voting on the rules of debate _ a vote expected by 5 p.m. _ the House is to consider legislation the Senate passed Dec.24, legislation many House Democrats dislike.
Liberals are upset that the bill contains no government-run health insurance program, or public option, while fiscal conservatives see the bill as too laden with special giveaways like extra Medicaid money for Nebraska.
If that bill passes, it is expected to be quickly changed by the second vote on a package called reconciliation.
Among the changes: A Medicare payroll tax increase of 0.9 percentage points for earnings of more than $200,000 for single filers and $250,000 for joint filers. In addition, they would pay 3.8 percent on dividend, interest and other unearned income, starting in 2013.
The bill also provides more help with insurance premiums for lower and middle income consumers and expands Medicaid aid to states. The debate on the House floor was a rerun of sorts, as Republicans and Democrats took turns offering well-rehearsed talking points.
“We know a nation is truly health when all of its itizens can have health care,” said Rep. Jay Inslee, D-Wash.
“These bills are not the answer. They compound current problems and make health care even more expensive for small businesses,’ argued Rep. Joe Wilson, R-S.C. Rep. Paul Ryan, top Republican on the House Budget Committee, labeled it a “fiscal Frankenstein.”
Erika Bolstad and Les Blumenthal contributed to this story
STATEMENT FROM COMMUNICATIONS DIRECTOR DAN PFEIFFER
Today, the President announced that he will be issuing an executive order after the passage of the health insurance reform law that will reaffirm its consistency with longstanding restrictions on the use of federal funds for abortion.
While the legislation as written maintains current law, the executive order provides additional safeguards to ensure that the status quo is upheld and enforced, and that the health care legislation’s restrictions against the public funding of abortions cannot be circumvented.
The President has said from the start that this health insurance reform should not be the forum to upset longstanding precedent. The health care legislation and this executive order are consistent with this principle.
The President is grateful for the tireless efforts of leaders on both sides of this issue to craft a consensus approach that allows the bill to move forward.
A text of the pending executive order follows:
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ensuring enforcement and implementation of abortion restrictions in the patient protection and affordable care act
By the authority vested in me as President by the Constitution and the laws of the United States of America, including the “Patient Protection and Affordable Care Act” (approved March __, 2010), I hereby order as follows:
Section 1. Policy.
Following the recent passage of the Patient Protection and Affordable Care Act (“the Act”), it is necessary to establish an adequate enforcement mechanism to ensure that Federal funds are not used for abortion services (except in cases of rape or incest, or when the life of the woman would be endangered), consistent with a longstanding Federal statutory restriction that is commonly known as the Hyde Amendment. The purpose of this Executive Order is to establish a comprehensive, government-wide set of policies and procedures to achieve this goal and to make certain that all relevant actors—Federal officials, state officials (including insurance regulators) and health care providers—are aware of their responsibilities, new and old.
The Act maintains current Hyde Amendment restrictions governing abortion policy and extends those restrictions to the newly-created health insurance exchanges. Under the Act, longstanding Federal laws to protect conscience (such as the Church Amendment, 42 U.S.C. §300a-7, and the Weldon Amendment, Pub. L. No. 111-8, §508(d)(1) (2009)) remain intact and new protections prohibit discrimination against health care facilities and health care providers because of an unwillingness to provide, pay for, provide coverage of, or refer for abortions.
Numerous executive agencies have a role in ensuring that these restrictions are enforced, including the Department of Health and Human Services (HHS), the Office of Management and Budget (OMB), and the Office of Personnel Management (OPM).
Section 2. Strict Compliance with Prohibitions on Abortion Funding in Health Insurance Exchanges. The Act specifically prohibits the use of tax credits and cost-sharing reduction payments to pay for abortion services (except in cases of rape or incest, or when the life of the woman would be endangered) in the health insurance exchanges that will be operational in 2014. The Act also imposes strict payment and accounting requirements to ensure that Federal funds are not used for abortion services in exchange plans (except in cases of rape or incest, or when the life of the woman would be endangered) and requires state health insurance commissioners to ensure that exchange plan funds are segregated by insurance companies in accordance with generally accepted accounting principles, OMB funds management circulars, and accounting guidance provided by the Government Accountability Office.
I hereby direct the Director of OMB and the Secretary of HHS to develop, within 180 days of the date of this Executive Order, a model set of segregation guidelines for state health insurance commissioners to use when determining whether exchange plans are complying with the Act’s segregation requirements, established in Section 1303 of the Act, for enrollees receiving Federal financial assistance. The guidelines shall also offer technical information that states should follow to conduct independent regular audits of insurance companies that participate in the health insurance exchanges. In developing these model guidelines, the Director of OMB and the Secretary of HHS shall consult with executive agencies and offices that have relevant expertise in accounting principles, including, but not limited to, the Department of the Treasury, and with the Government Accountability Office. Upon completion of those model guidelines, the Secretary of HHS should promptly initiate a rulemaking to issue regulations, which will have the force of law, to interpret the Act’s segregation requirements, and shall provide guidance to state health insurance commissioners on how to comply with the model guidelines.
Section 3. Community Health Center Program.
The Act establishes a new Community Health Center (CHC) Fund within HHS, which provides additional Federal funds for the community health center program. Existing law prohibits these centers from using federal funds to provide abortion services (except in cases of rape or incest, or when the life of the woman would be endangered), as a result of both the Hyde Amendment and longstanding regulations containing the Hyde language. Under the Act, the Hyde language shall apply to the authorization and appropriations of funds for Community Health Centers under section 10503 and all other relevant provisions. I hereby direct the Secretary of HHS to ensure that program administrators and recipients of Federal funds are aware of and comply with the limitations on abortion services imposed on CHCs by existing law. Such actions should include, but are not limited to, updating Grant Policy Statements that accompany CHC grants and issuing new interpretive rules.
Section 4. General Provisions.
(a) Nothing in this Executive Order shall be construed to impair or otherwise affect: (i) authority granted by law or presidential directive to an agency, or the head thereof; or (ii) functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.
(b) This Executive Order shall be implemented consistent with applicable law and subject to the availability of appropriations.
(c) This Executive Order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity against the United States, its departments, agencies, entities, officers, employees or agents, or any other person.