Health insurers have argued that the individual mandate helps make a ban on medical underwriting sustainable.

(Bloomberg) — Republican leaders in Congress are considering a pledge to hold a separate vote on defunding Planned Parenthood as a way to keep the issue from derailing legislation to keep the government running, said congressional aides with knowledge of the discussions.

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In private discussions, the leaders are looking at using reconciliation procedures to let a Planned Parenthood bill come up for a filibuster-proof Senate vote, the aides said.

Handling the issue that way would postpone the fight over federal funding for the medical services that Planned Parenthood provides to the poor, and deprive Democrats of being able to accuse the majority party of threatening to shut down the government to make a stand against an abortion provider.

Some Republican presidential candidates, including Sens. Marco Rubio and Ted Cruz, have demanded that legislation to fund federal agencies after Sept. 30 include a provision barring abortion providers such as Planned Parenthood from receiving federal money.

Time considerations

Lawmakers return Sept. 8 from their summer recess. They already face a time crunch and a broader battle over the annual appropriations bills.

Democrats have blocked Senate action on those, arguing that spending shouldn’t be capped at the levels mandated in the Budget Control Act, Public Law 112-25.

Using reconciliation as the vehicle would force a Senate vote on the Planned Parenthood issue, which so far Democrats have blocked. The leaders could combine Planned Parenthood provisions with language repealing parts of the Affordable Care Act into a package that, under reconciliation procedures, would require only a simple majority of members.

The combination of the Obamacare and Planned Parenthood provisions would be attractive to many rank-and-file Republicans. Passage would be all but guaranteed — as would a veto by President Obama.

Videos outcry

The clamor for defunding Planned Parenthood grew after the release of videos purporting to show the organization’s doctors discussing harvesting fetal tissue for research, with activists posing as representatives of a medical research company.

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The House and Senate aides, who spoke on condition of anonymity, stressed that using reconciliation to deal with Planned Parenthood was still an option being studied. No decision is likely until after members discuss it next month, they said.

Since there’s not enough time to deal with both reconciliation and the stopgap spending bill in September, leaders might offer a public statement committing to using reconciliation to defund Planned Parenthood this year, one aide said. If rank-and-file Republicans accept such an assurance, the leaders would be able to focus on other aspects of their negotiations with the White House.

Medicaid reimbursements

Planned Parenthood denies that the organization is illegally selling fetal tissue for a profit, saying it provides such tissue at the cost of harvesting and delivering it. The group has said the majority of its funding — $528 million in 2013 — comes from Medicaid reimbursements.

Supporters of Planned Parenthood argue that abortions constitute only a small percentage of its activities and that the organization and its affiliates are a major provider of women’s health services, including contraception and breast cancer screening, for indigent women.

One possible option would be to repeal the Patient Protection and Affordable Care Act (PPACA) mandates that individuals purchase health insurance, either with government-subsidized exchanges, or on the private market. Some of the savings could be used to increase government assistance to community health centers, public hospitals and other certified providers to replace Planned Parenthood’s role as a provider of women’s health services, one aide said.

The Congressional Budget Office (CBO) estimated that repealing the individual mandate would produce net savings of $282 billion between 2012 and 2021, according to a 2012 presentation to the Rand Corp.

America’s Health Insurance Plans (AHIP) and others have argued that the only way to make the PPACA ban on use of personal health information other than location, age and tobacco use in underwriting feasible is to use a mandate to get healthy people to pay for coverage. 

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