Another Blow to House GOP Health Care Bill

The American Health Care Act lost another vote Wednesday night when Rep. Chris Smith of New Jersey, an ardent pro-lifer and fiscal moderate, announced his opposition to the bill. "The overriding concern I have is the Medicaid expansion being significantly altered," Smith told the Asbury Park Press. "It affects so many of our disabled individuals and families, and the working poor."

Smith's opposition is surprising because he's one of the most committed pro-life members of Congress, and pro-life groups back the bill. The House bill would defund Planned Parenthood and cut off taxpayer-funding of insurance that covers elective abortion. As Marjorie Dannenfelser of the pro-life Susan B. Anthony List wrote to members of Congress: "SBA List's position on the American Health Care Act is that preventing taxpayer funding of abortion in the bill is a non-negotiable. We are supportive of the current House draft that meets this standard. SBA List would oppose any future version that does not. These protections must be included in the law—executive action as a substitute would be insufficient."

Some who oppose the AHCA have suggested that it's a near certainty that the prohibition on taxpayer-funding of abortion, known as the Hyde amendment, would be stripped out of the bill in the Senate under rules that govern budget reconciliation, legislation that cannot be filibustered by the Senate minority. But it's not always easy to see what will or won't pass muster under reconciliation rules. In 2015, for example, the Heritage Foundation said that Planned Parenthood could not be defunded under reconciliation, but that analysis turned out to be wrong.

According to one Senate rules expert, it's a "close call" on whether or not the Senate parliamentarian would allow Hyde amendment protections in the health care bill. "I think it is a very close call, and I could see it being ruled out as primarily affecting the private market," a former senior Senate staffer tells THE WEEKLY STANDARD. "However, the funding restriction may be analogized to the one permitted in 2015 on Planned Parenthood. If that analogy holds, then this would be okay."

Even if the Hyde amendment is stripped out, pro-life activists say there are other ways their goals could be achieved. For example, AHCA funding could be funneled through appropriations bills or programs that already include the Hyde amendment.