Pelosi tries to stamp out abortion fight on Medicare fix She stressed the need to finally come up with a solution for Medicare physician payments.

Abortion politics, meet the “doc fix.”

House Democratic Leader Nancy Pelosi is trying to head off an abortion dispute so it doesn’t derail a bipartisan permanent solution to the flawed Medicare pay formula for doctors, which Congress for years has been trying to repeal and repair. But she faced sharp words Friday from abortion rights groups who have been her traditional allies.


The policy piece of the doctor payment fix is bipartisan. It’s been tougher for negotiators to agree on the financing and on what other health care programs should tag along on the legislation. Included in the tentative deal outlined Friday is $7.2 billion for community health centers — but it’s tied it to language banning the federal funding of abortions at the clinics, the so-called Hyde Amendment.

The backdrop is the intense abortion fight that brought a bipartisan human trafficking bill to a halt in the Senate, which has, in turn, delayed a confirmation vote on attorney general nominee Loretta Lynch.

“Nothing happens in a vacuum,” one Democratic lobbyist said.

Pelosi circulated a “Dear Colleague” letter Friday, saying that the abortion language regarding the community health clinics is basically how the centers operate now and that it’s important to get them the funds. The National Association of Community Health Centers in a statement said that the clinics have been subject to the Hyde Amendment ban on using taxpayer funds for abortion since 1979 and that failure to secure the billions in new funding for the clinics “endangers care for millions of low-income underserved patients.”

The abortion language, the group wrote, “represents no change in current policy for health centers, and would not change anything about how health centers operate today.”

Pelosi also stressed the need to finally come up with a real solution for Medicare physician payments after years of short-term patches to the Sustainable Growth Rate formula. She argued that the bill “includes important victories for low-income seniors, children and families.”

But some traditional Democratic allies on abortion were angry about language, particularly given the intensity of the stalemate in the Senate.

”It is outrageous that for the second time in two weeks, some politicians are using important legislation to advance their anti-abortion agenda on the backs of the most vulnerable,” Cecile Richards, president of Planned Parenthood Action Fund, said in a statement.

“Congress should be expanding women’s access to basic, preventive health care. Instead, women’s health care access is being ignored while some politicians instead continue their fixation on blocking the most vulnerable women’s access to abortion,” she added.

NARAL, which also backs abortion rights, Friday afternoon said, “We urge all congressional House members, including Leader Pelosi, who say they stand for women to reject any anti-choice legislation, including Hyde.” Referring to the battle in the Senate, NARAL added,”We hold up champions in the Senate who are relentlessly standing firm to protect women against politicians who are obsessed with banning abortion access in America, including those of trafficked women.”

Pelosi’s letter came on the heels of a statement from top Senate Finance Committee Democrat Ron Wyden that an abortion rider as part of a permanent doc fix would be a “complete nonstarter.” Wyden played a significant role in drafting the policy for the Medicare pay formula replacement, yet he left his name off the bill that was introduced. Two other senior Democrats joined three key Republicans in the introduction of the bipartisan, bicameral bill, which is strongly backed by physician groups across the country.

The legislation faces other opposition in the Senate, where Democrats are pushing hard to extend the Children’s Health Insurance Program for four years. The House would limit it to two years. The House position got a boost, however, when the health care advocacy group Families USA praised the deal, saying it would prefer four years but two years was still an achievement.

Pelosi is now working hard to distinguish the clinic funding from the volatile Senate fight over the human trafficking bill. She’s been working on a doc fix deal with House Speaker John Boehner since at least mid-January, and it’s been an unusually bipartisan, leadership-driven initiative that contains lots of bipartisan compromises. Boehner has been building support among conservatives, even though it’s only partly offset.

“In contrast to the effort by Republicans on the Senate trafficking bill, this is not a codification of Hyde because the language expires when the funds do,” Pelosi spokesman Drew Hammill said in a statement. “If this funding does not move in this vehicle, it is very likely that funding for community health centers will significantly decline.”

Adam Jentleson, a spokesman for Senate Minority Leader Harry Reid, said, “There is a slight difference of opinion on this issue because in the Senate we are watching Republicans try to expand Hyde on a completely unrelated trafficking bill. Republicans’ efforts to pick an abortion fight on the trafficking bill in addition to their efforts to add unnecessary Hyde language to the emerging doc fix compromise has Senator Reid concerned that Republicans are trying to slowly but systematically expand the scope of Hyde.”

He added, “Senator Reid hopes House leaders will resolve these and other issues.”

The Hyde Amendment routinely gets attached to annual appropriations bills, and abortion rights advocates say it’s a problem that the language that’s included in the House’s SGR deal would be extended for longer. The change is a “big deal,” one women’s health source said. “It changes the way it’s done.”

But a Republican aide criticized Wyden’s statement on Thursday as an attempt to “blow up the process” on getting rid of the hated SGR, which has been on the books since 1997 and has been patched 17 times in order to avert steep cuts to physicians’ Medicare reimbursements.

“You’ve decided at that point that you’re picking a bigger fight,” the aide said. “That’s shouting fire.”

Rep. Gene Green (D-Texas), a member of the House Energy and Commerce Committee who co-sponsored the SGR repeal bill, said in an interview Friday that he would prefer the abortion language not be in the package, “but for all practical purposes, we already live under the Hyde Amendment because of the appropriations process.”

“I just want to make sure we get the whole package,” he said of the Medicare pay formula. The current patch expires on March 31, and physicians are facing a 21 percent cut to their Medicare payments.

This article tagged under: Abortion

Nancy Pelosi