Democrats are clashing over whether to include in their sweeping spending plan a decades-old amendment that blocks Medicaid and other federal health programs from being used to cover abortions.
Sen. Joe Manchin (D-W.Va.), already a key stumbling block to Democratic unity on the $3.5 trillion reconciliation bill, has drawn a line in the sand around the issue, but others in the party are split over whether to include the Hyde amendment in a portion of the spending bill that would create a new federal program to provide health care coverage to low-income individuals in GOP-led states that haven’t adopted Medicaid expansions under the Affordable Care Act.
In recent days, Manchin has signaled he would not support the package without the amendment, which bans the use of federal funds for abortions in most cases and has been included in annual government funding bills since it was introduced by then-Rep. Henry Hyde (R-Ill.) in the 1970s.
Manchin, who has long supported the amendment, has called the provision “a red line” and said his party’s spending plan would be “dead on arrival” if it isn’t included.
The declaration by Manchin presents a new challenge for the Democratic party, which has seen a growing push over the years to do away with the amendment as it seeks to make headway on its sprawling social spending plan that leadership has set sights on passing in Congress in the next few weeks.
The party aims to pass the package using reconciliation, a procedure that will let them bypass the GOP filibuster in the Senate. But Democrats continue to face hurdles in trying to unite members on a path forward on the plan, given the party’s slim majorities in the House and Senate.
While Democrats can only afford three defections in the House to pass the package, which is not expected to gain any Republican support, the party would need all members in the evenly split Senate to be on board to do the same, affording Manchin significant influence over the shape of the legislation.
Some Democrats have made clear they disagree with Manchin and say the Hyde amendment has no place in the legislation.
Rep. Alexandria Ocasio-Cortez (D-N.Y.), who previously started a petition to have it repealed, pushed back on Manchin’s comments in remarks to reporters, noting she and many others in the House are against the provision.
“This is one of the first pro-choice Democratic majorities that we’ve elected, and so the majority of the House firmly believes in protecting a woman’s right to choose,” she said.
“We have made too much progress as a society, and the way that we think about human rights to allow the Hyde amendment to remain in the reconciliation bill,” said Rep. Mondaire Jones (D-N.Y.).
Advocates and lawmakers that oppose the amendment say it discriminates particularly against low-income women who depend on Medicaid and other federal funding for health care and places a disproportionate burden on women of color, especially Black and Hispanic women.
“These barriers fall hardest on people working to make ends meet and BIPOC communities,” Kelsey Ryland, federal strategies director for abortion rights group All* Above All, told The Hill.
Proponents of the amendment, which has has exceptions for abortions in cases of rape, incest or when the life of the woman is at risk, say it’s necessary to keep taxpayer dollars from going to abortion.
“I think the main point is just that the principle of the Hyde amendment has been that regardless of what program we’re talking about, we shouldn’t be funding abortion using taxpayer dollars,” Autumn Christensen, policy director of Susan B. Anthony’s List, a conservative anti-abortion group, said.
Sen. James Lankford (R-Okla.) told The Hill he plans to introduce language preserving the Hyde Amendment when the upper chamber takes up the reconciliation plan if the House sends the bill to the Senate without the provision.
Lankford previously introduced an amendment to preserve Hyde, as well as the Weldon amendment, which bars entities that don’t want to provide abortion care from being denied federal dollars, to the budget resolution that kicked off the reconciliation process for Democrats in August.
Manchin was the only Democratic senator to vote with Republicans in backing the amendment, helping it pass by a single vote margin in the 50-50 Senate.
“That should be the floor of any conversation about abortion, is that we’re not going to pay for the taking of life of a child with federal dollars,” Lankford said of the amendment. He added he’ll “partner with Manchin to be able to do that.”
But there’s confusion among other Democrats, including those who support the Hyde Amendment, as to whether the provision would need to be added to the reconciliation plan. And while a number of Democrats oppose the amendment, none have said publicly whether they would withhold support for the bill if it includes the provision as the party tries to maintain a unified front amid spending negotiations.
Sen. Tim Kaine (D-Va.), who supports the Hyde amendment, said he “doesn’t know that it needs to be included” in the bill, noting it’s typically included in Congress’s annual government appropriations bills, which are separate from the reconciliation legislation.
The amendment is traditionally included in the Department of Health and Human Services (HHS) spending bill passed by Congress every year. However, this year marked the first time in decades that the House Appropriations labor and health and human services subcommittee advanced the bill without the provision.
Though Kaine said he’d “probably” vote to back a provision preserving the amendment if it were brought to the floor when the Senate considers the reconciliation bill, he’s uncertain whether the amendment would be necessary.
Sen. Catherine Cortez Masto (D-Nev.) also told reporters she would “have to take a look” at the legislation, but she added shortly after that she “doesn’t normally support the Hyde amendment.”
Christensen argued in an interview that the Hyde amendment would need to be attached to the reconciliation bill to prohibit federal dollars from going to abortion if Democrats move forward with their plans to create the new Medicaid-like program.
“Typically, funds that are made available through reconciliation don’t go through the Labor-HHS bill,” Christensen said.
“And so this program, while it’s being called a Medicaid lookalike, it’s not actually a change to Medicaid as much as it’s a new program to cover that potential Medicaid population,” she said. “And because the funds are directly appropriated in the reconciliation bill, the Hyde language does not attach to them.”
Ryland, whose organization advocates for lifting abortion coverage bans in Medicaid insurance programs, also said the “reconciliation bill is separate and distinct from the federal appropriations process.”
“It contemplates closing the Medicaid coverage gap in the 12 states that haven’t yet expanded and making health care more affordable for people around the country. What happens in appropriations is not directly related to the reconciliation bill,” she said.
But that doesn’t mean progressives would be happy having to vote for the amendment in order to secure funding for party wish-list items like tuition-free community college, Medicare expansion and universal pre-kindergarten — priorities the party hopes to use the bill to unlock funding for.
Rep. Pramila Jayapal (D-Wash.), chairwoman of the Congressional Progressive Caucus, said during a recent appearance on “Pod Save America” that she thinks adding the provision to the bill would be more of “political statement” than substantive.
“This happens a lot here in Congress where people are like, ‘Oh I want to show everybody that I’m anti-abortion and I don’t want federal funds to go to abortions.’ And I’m like, ‘Well, they don’t already, so don’t put it in the bill because you make those of us who actually want to repeal it vote for it again, and we don’t need too,” she said.
President Biden, a former advocate for the Hyde amendment who reversed his position after drawing criticism during his presidential campaign in 2019, noticeably left the amendment out of the multitrillion-dollar budget he unveiled earlier this year.
During a press briefing on Monday, White House press secretary Jen Psaki said at her podium that Biden “opposes the Hyde amendment,” but she didn’t divulge whether the president intends to fight for its exclusion from the reconciliation bill, a key component of his economic agenda.
Biden himself later said he would sign the bill regardless.
“I’d sign it either way,” Biden told reporters.