A front page story in today’s edition of the New York Times highlights access to abortion as a potential roadblock to acheiving health insurance reform.  Abortion access opponents are fighting for a provision that would ensure no federal health insurance subsidy money is used to purchase private insurance policies that cover abortion care.  There seems to be enough support from moderate Democrats to make the debate too close to call at this point:

Abortion opponents in both the House and the Senate are seeking to
block the millions of middle- and lower-income people who might receive
federal insurance subsidies to help them buy health coverage from using
the money on plans that cover abortion. And the abortion opponents are
getting enough support from moderate Democrats that both sides say the
outcome is too close to call.

If federal subsidies to middle- and lower-income Americans exclude insurance plans that cover abortion it could "eliminate from the marketplace private plans that cover the procedure, pushing women who have such coverage to give it up."

At the center of the claim from those opposing access to abortion care is a 30-year-old ban on the use of taxpayer money to pay for elective abortions but abortion access supporters in Congress have attempted to address this concern:

Democratic Congressional leaders say the latest House and Senate
health care bills preserve the spirit of the current ban on federal
abortion financing by requiring insurers to segregate their public
subsidies into separate accounts from individual premiums and
co-payments. Insurers could use money only from private sources to pay
for abortions.

But opponents say that is not good enough,
because only a line on an insurers’ accounting ledger would divide the
federal money from the payments for abortions. The subsidies would
still help people afford health coverage that included abortion.

The Senate Finance committee, which is today debating a public insurance option amendment, is scheduled to take up debate on an amendment from Senator Hatch to restrict the use of federal subsidies later this week:

Advocates on both sides said that if the committee does not adopt
the amendment they expect a very close contest over the issue when the
bill reaches the floor. Two Democratic abortion-rights opponents,
Senator Bob Casey Jr. of Pennsylvania and Senator Ben Nelson of Nebraska, are pushing the issue.

Mr.
Casey voted in the Senate health committee for a proposal to restrict
the use of the subsidies; it was defeated by one vote. Mr. Nelson is
considered a pivotal vote needed to pass the overall bill. “Senator
Nelson does not believe that taxpayer dollars should be used in any way
to fund abortion,” his spokesman said.

Jim Manley, a spokesman for the Democratic leader, Senator Harry Reid, said that Mr. Reid believes that the latest drafts of legislation already accomplish that goal.

Supporters of the current segregated-money model argue that 17 state Medicaid
programs that cover elective abortions use a similar system, dividing
their federal financing from state revenues they use to pay for
procedures.

“The language of the compromise is very clear,”
said Representative Rosa DeLauro, Democrat of Connecticut, “it
prohibits the use of federal funds to pay for abortions.” (The bills
would also mandate the availability in each state of at least one plan
that covers abortion and at least one that does not.)