WASHINGTON -- After an intense debate that hinted at the emotional showdown ahead, abortion rights advocates scored an early victory yesterday in their drive to assure coverage in health care legislation.
The Senate Committee on Labor and Human Resources voted 11 to 6 to reject a Republican attempt to limit the abortion services included in the basic benefits package to be offered to all Americans. Under the Republican plan, coverage would be provided only in cases involving rape, incest or where the life of the mother is at risk.
Only one Republican, Sen. James M. Jeffords of Vermont, the lone GOP supporter of President Clinton's health care reform bill, joined with the panel's 10 Democrats in defeating the amendment offered by Daniel R. Coats, a Republican from Indiana.
"I don't think it's right to require people to pay for something that they think is a termination of human life," Mr. Coats told his colleagues. He argued that if abortion services were included in the basic benefits package, all Americans would be indirectly paying for abortions through their premiums.
Mr. Coats suggested that women who want abortion coverage should pay extra to buy a separate policy for it.
"Women do not anticipate having abortions," shot back Sen. Barbara A. Mikulski, a Maryland Democrat who led the drive to protect abortion rights.
Ms. Mikulski noted that two-thirds of private insurance companies now offer abortion coverage to their clients. The Coats amendment, she said, would effectively deny those women the benefits they already have.
"If abortion is not in the bill, we're going to have a standoff on the floor," Ms. Mikulski said. "If abortion is not in the bill, it will be a big fight.
Advocates on both sides of the abortion issue insisted that there will be a big fight on the House and Senate floor either way.
"It would be quicker without it," Senate Majority Leader George J. Mitchell of Maine acknowledged yesterday when asked whether abortion would slow the already sluggish pace of health care reform legislation.
The highly controversial issue of abortion has been eclipsed lately by struggles over more fundamental questions in the health care reform debate, such as whether everyone will be covered and who exactly will pay for it.
Five House and Senate committees are developing separate versions of the original Clinton proposal; they are due to be completed by the end of June.
Congressional leaders plan to stitch these separate proposals into one House bill and one Senate bill, which will be considered in their respective chambers and merged into a final product by a conference committee.
Yesterday's vote in the Senate Labor and Human Resources committee marked the second victory for abortion rights advocates at the committee level. A House Ways and Means subcommittee similarly voted in March to uphold the provision included in the original Clinton bill that guarantees coverage for all reproductive services deemed "medically necessary and appropriate."
The other committees are also expected to leave the Clinton language on abortion more or less intact. But the anti-abortion forces, dominated by Republicans and conservative Democrats, are stronger on the House and Senate floors.
"It's going to be a tough fight, but we think we have a chance to prevail," said Doug Johnson, chief lobbyist for the National Right Life Committee. He noted that solid majorities in both the House and Senate voted last year to restrict Medicaid abortions for poor women along the lines of the Coats amendment. That proposal came from Rep. Henry J. Hyde, an Illinois Republican.
"That means we should win unless there are a lot of flip-flops like Harris Wofford did yesterday," Mr. Johnson added.
Senator Wofford, a Pennsylvania Democrat who helped catapult health care reform into a national issue in his 1990 election campaign, voted against the Coats amendment yesterday even though he supported the Hyde language last year.
A Wofford spokesman argued that the Coats and Hyde amendments represented two separate issues.
"Hyde affects direct public funding for abortions through Medicaid, which Harris opposes," said Mr. Wofford's spokesman, David Stone. "The Coats amendment would put limits on private insurance, which Harris doesn't believe the government should be involved in."
There may be a more important political distinction between the two questions when the abortion issue reaches the House and Senate floors.
The Hyde language affects only poor women, who don't have much clout in Congress, noted Andrea Camp, an aide to Rep. Patricia Schroeder of Colorado.
"The health care bill affects middle-class voting women who are activists," Ms. Camp said. "The senators and congresspeople know them. These women are the backbone of their campaigns. These are people they would be taking something away from."
"We know the fight is going to be on the floor, and we know it's going to be tough," she added. "But it's not like Hyde."
Under the Clinton health plan and the version of it drafted by Sen. Edward M. Kennedy, the Massachusetts Democrat who chairs the Labor and Human Resources Committee, abortion services would be paid as part of "pregnancy-related services." But doctors and hospitals may refuse to perform abortions on moral or religious grounds.
A similar provision is about to take effect in Maryland, where insurance companies are required to offer small businesses a basic health care package that a state commission has determined must include abortion services.
The Senate committee also rejected yesterday an amendment offered by Judd Gregg, a New Hampshire Republican, to explicitly protect states' rights to enforce waiting periods, parental-consent rules and other constitutionally permissible abortion restrictions.
Mr. Kennedy argued that his bill would not affect those state limitations already upheld by the courts and that Mr. Gregg wanted to give the states additional power to limit abortions.