There are at least six key differences that need to be resolved before the House and Senate can cut a deal, in secret, to pass Obamacare. Maybe the most difficult issue to resolve is the issue of using federal tax dollars to fund abortion. It seems clear, from a reading of the House- and Senate-passed health care bills, that their positions on the federal funding of abortion are at odds and will be difficult to reconcile.

During the House debate, an amendment was added by Rep. Bart Stupak (D-MI) (the Stupak Amendment) by a 240-194 vote that states the following: “No funds authorized or appropriated under this Act (or an Amendment made by this Act) may be used to pay for any abortion or to cover any part of the costs of any health plan that includes coverage for abortion.” There are exceptions in this prohibition for the life of the mother, rape and incest. The prohibition specifically allows states to buy abortion coverage if they so choose, provided they do not use federal funds, any funds derived from federal subsidies under Obamacare, or any nonfederal funds needed to access another federal program. This is easy to understand language and reflects the annual funding rider on appropriations bills, commonly referred to as the Hyde Amendment, which prohibits federal tax dollars from funding abortion. This language was supported by pro-life groups and is widely considered very strong language protecting the taxpayers from funding abortions.

In the Senate, Senator Ben Nelson (D-NE) offered an amendment (the Nelson Amendment) similar to the Stupak Amendment in the Senate. That Amendment was tabled (defeated) by a 54-45 vote. A vote in favor of the motion was a vote against the Nelson Amendment, therefore only 45 Senators supported a ban on the use of federal funds in Obamacare for abortion. A deal was struck later in the debate and put in Senate Majority Leader Harry Reid’s (D-NV) “Manager’s Amendment.” The new language adopted in the Senate-passed Obamacare bill allows the creation of “Allocation Accounts” to pay for abortions.

Americans United for Life argues that it’s “the fact that the government will subsidize insurance plans that cover elective abortions. In departure from longstanding federal policy, section 1303(b)(1)(A) allows a ‘qualified health plan’ – one that participates in an Exchange and is available to individuals who receive tax credits to cover part of their insurance premiums – to include abortion coverage. Therefore, insurance plans that cover elective abortions will receive these federal subsidies.”

Here is how it works: the Senate version of Obamacare says that “an exchange shall be a governmental agency or non-profit entity that is set up by a State.” The Exchange “shall make available qualified health plans to qualified individuals and qualified employers.” Now, the federal government will subsidize private insurance plans through tax credits and subsidies to a state’s Exchange or non-profit entity. These health care plans are allowed to cover abortion, but through an accounting gimmick where an individual who wants abortion coverage will pay $12 extra for a plan.

Very simply, the House bill explicitly forbids federal funds from going to any plan that covers abortions, similar to the law governing the Federal Employees Health Benefits Plan. The Stupak Amendment will require insurance companies to omit abortion coverage if they get federal monies. The Senate restrictions explicitly allow for abortion coverage in federally subsidized plans, under the pretext that people will have to pay an extra $12 dollars in non-federal monies for the coverage. Considering all the federal money that will be pouring into the system, $2.5 trillion over the first 10 years of implementation, to argue that no federal money will support or promote abortion under a government-run health care system defies logic. It seems clear that the House and Senate have a long way to go to reconcile their differing positions on abortion.