To placate pro-life Democrat Ben Nelson of Nebraska, the Senate worked out this compromise in the Health Care Reform bill:
Under the new abortion provisions, states can opt out of allowing plans to cover abortion in the insurance exchanges the bill would set up. The exchanges are designed to serve individuals who lack coverage through their jobs, with most receiving federal subsidies to buy insurance. Enrollees in plans that cover abortion procedures would pay with separate checks — one for abortion, one for any other health-care services.
This was an effort to comport with the 32-year prohibition against federal funding for abortions, but the Nelson compromise is a softening of the House language, which was written by Rep. Bart Stupak (D-Mich.). The Stupak amendment forbid any insurer in the exchange "to pay for any abortion or to cover any part of the costs of any health plan that includes coverage of abortion" — a position that abortion rights advocates suggested would have led to many insurance providers dropping abortion coverage.
Neither pro-lifers nor pro-deathers are happy.