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The Garden Island: Overall Health Care Bill Trumps Anti-Abortion Amendment

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Location: Washington, D.C.

U.S. Rep. Mazie Hirono was not among 40 progressives who sent a letter last month to House Speaker Nancy Pelosi threatening to vote against health care reform if a controversial anti-abortion amendment is not stripped from it if and when it comes back from conference with the U.S. Senate.

"When you're dealing with a bill with so many provisions, I think you do have to look at it in totality," Hirono said Monday, pointing to the bill's coverage of 30 million to 40 million additional Americans as the most important benefit. "It's not that easy to say I'm going to vote against the whole thing because of an amendment I don't like."

Hirono, a Democrat representing Hawai"i's second congressional district, was one of 194 reps -- all Democrats -- to vote against the Stupak amendment on Nov. 7 but was among the 220 reps -- 219 Democrats and one Republican -- to vote for passage of the underlying bill, a narrow victory over 215 noes.

The amendment, sponsored primarily by moderate Michigan Democrat Bart Stupak, states that no funding from the Affordable Health Care for America Act "may be used to pay for any abortion or to cover any part of the costs of any health plan that includes coverage of abortion."

In the days following the vote, as the country turned its eyes toward the Senate for the next action on health care reform, 41 House Democrats, led by Rep. Diana DeGette of Colorado, sent a letter to Pelosi promising to vote against the bill should it still contain the Stupak amendment, according to reports in The Washington Post.

Those 41 signatories, if joined by the House's 177 Republicans, would comprise 218 "no" votes -- the exact amount needed to kill the bill.

"We'd be much happier if the Stupak amendment was not there, but we did not have the votes to defeat it," Hirono said. "We're going to need every vote we can to pass the overall bill."

Hirono said she is in conversations with DeGette and that the final decision will be a hard one.

"Unless the women of this country and others who support choice ask people who run for office, "Where are you on this issue?', my fear is that we are going to have continuing erosion," she said, adding that while the Stupak amendment, if passed into law, "definitely" constitutes erosion, the rest of the bill has "massive ramifications for health care reform in this country."

"It's going to be hard for me to vote against" the underlying bill, she said, a contrast with her decision earlier this year to join with approximately 80 of her House colleagues to sign a letter demanding that any bill have a strong public option in it and warning that a bill without a public option would not get her vote -- even if that meant the bill would fail.

"The public option was very important. The progressives really stuck together and really allowed that idea to even survive," she said. "There was a point at which I did not think we'd be able to get any type of public option out of the House at all."

Hirono said she has not seen DeGette's letter but that it would be "very difficult to say, "If you don't do this ... we're going to withhold our vote on a bill that has a lot of other parts we want to see move forward.'"

An unsigned draft of the letter says the Stupak amendment "represents an unprecedented and unacceptable restriction on women's ability to access the full range of reproductive health services to which they are lawfully entitled," according to the "Who Runs Gov" Web blog run by The Washington Post.

"Health care reform must not be misused as an opportunity to restrict women's access to reproductive health services," the draft letter states. "We will not vote for a conference report that contains language that restricts women's right to choose any further than current law."

The issue could be moot if the bill is not passed by the U.S. Senate or if the bill that comes back from the Senate does not have a similar provision in it. However, various Washington media outlets reported Tuesday that Sen. Ben Nelson, a moderate Democrat representing Nebraska and a key swing vote on the health care bill, intends to craft an amendment similar to Stupak's to be included in the Senate's bill.

"I would like for the Senate to not go along with the Stupak amendment," Hirono said. "The discussions continue. I have not made up my mind where I'm going to go."

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