WASHINGTON -- Advocates and opponents of abortion rights both threatened yesterday to kill health care reform legislation if they don't get their way on abortion coverage, as congressional leaders began to search for a compromise on the issue.
Some leaders were hoping to find a way to postpone a confrontation over the fiercely emotional abortion issue until after the overhaul of the nation's health care system is completed.
But it was unclear that either side would agree to such a deal.
"We believe all Americans, including women, should be treated equally," said Sen. Barbara A. Mikulski, a Maryland Democrat, who urged her male colleagues at a leadership meeting yesterday not to be so quick to yield to pressure from opponents of abortion.
That pressure stepped up sharply yesterday, when the nation's Roman Catholic bishops, who are strong supporters of President Clinton's drive to provide health care services for all Americans, announced that they would work to kill the measure if abortion services were included in the basic benefits package.
In a letter to congressional leaders signed by Archbishop William H. Keeler of Baltimore, president of the National Conference of Catholic Bishops, the clerics argued:
"Abortion mandates are opposed by the American people. They will force millions of employers, churches and individuals to subsidize abortion in violation of their consciences. They will jeopardize the future of Catholic and other religious providers of health care, and they will destroy the chances for real reform."
The bishops, who have been lobbying on this issue since before Mr. Clinton's health care proposal was drafted last year, wrote that they were "greatly disturbed" that the health plans approved by four congressional committees included abortion coverage as a standard benefit.
Without an exclusion, abortion services would have to be offered inall basic health plans financed by individuals and their employers, and in some cases subsidized by the government.
In some versions of the bill, individual doctors or medical facilities would be exempt, on religious or ethical grounds, from having to perform abortions.
The Senate Finance Committee broadened the conscience clause further to allow any employer or health plan to refuse to buy or provide abortion coverage for religious or moral reasons.
Church leaders not satisfied
But church leaders don't consider that exemption enough to meet their concern that abortion rights would be greatly expanded from the current law, which denies federally financed abortions for poor women.
Despite the limited impact of their lobbying so far, Archbishop James T. McHugh of Camden, N.J., said at a news conference here that he believes the Roman Catholic appeal will have greater leverage now as the health care legislation is about to be debated in the full House and Senate.
"Don't underestimate the value of church bulletins," Archbishop McHugh said in outlining a grass-roots lobbying effort that the church hopes will mobilize millions of American Catholics to their cause.
Democratic congressional leaders readily acknowledge that they cannot afford to lose many votes on the health care bill over abortion.
They need 218 votes to get a bill through the House, where all the Republicans and at least 30 Democrats are considered unalterably opposed to heath reform for other reasons.
Many of those 30 are among a larger group of 35 who have also threatened to vote against the bill unless it specifically excludes "elective abortion" from basic benefits.
Letter to Foley
Meanwhile, another 72 Democrats, including the strongest supporters of the Clinton-style health care reform, sent a letter yesterday to House Speaker Thomas S. Foley, D-Wash., warning that any attempt to exclude abortion services could result in the loss of their votes.
"Denial of health-care services should not be determined because a minority objects," said Rep. Peter A. DeFazio, D-Ore., one of the organizers of the signature-gathering drive. "The idea that certain health care benefits should not be covered if some people find them politically, morally or religiously unacceptable defeats the whole idea of comprehensive health care."
Most private insurance plans, including those offered by Blue Cross-Blue Shield of Maryland and many HMOs in the state, now include abortion services.
If abortion services were excluded from the basic benefits package designed under the health care reform bill, many women who now have such coverage could lose it, Mr. DeFazio and other lawmakers say.
"We want to propel people into 21st-century health care, not send them back to 19th-century health care," said Rep. Patricia Schroeder, a Colorado Democrat who is leading the abortion-rights drive.
House leaders believe they could lose at least 30 votes among abortion-rights advocates if they don't satisfy their concerns.
Yet abortion rights advocates failed last year in both the House and the Senate to repeal the restrictions on Medicaid abortions for poor women, which is what the health care reform changes would do.