WASHINGTON – The debate surrounding abortion access is about to spill over from the campaign trail to Capitol Hill as lawmakers begin debating must-pass appropriations bills.

Starting Wednesday, the House will take up a nearly $1 trillion spending package written by Democrats that would roll back Trump administration anti-abortion policies, including restrictions barring health clinics from recommending abortion services and preventing U.S. foreign assistance to aid groups that perform or promote abortions.

But the massive spending bill keeps in place the four-decades-old Hyde amendment, which prevents federal health care funding, including Medicaid, the insurance program for low-income beneficiaries, from covering abortions except in cases of rape, incest or to save the woman’s life. The amendment is named for the late Illinois Republican Rep. Henry J. Hyde, who sponsored the original language.

That’s an increasingly difficult position for Democrats to defend these days, given the outcry on the campaign trail even among presidential candidates who’ve voted for Hyde in the past. Former Vice President Joe Biden, a self-described “practicing Catholic,” became the latest high-profile Democrat to publicly disavow the Hyde amendment Thursday after taking fire from fellow candidates and interest groups.

A group of liberal House Democrats, including Barbara Lee of California, Pramila Jayapal of Washington and Ayanna S. Pressley of Massachusetts, filed an amendment with the Rules Committee on Friday that would strike the Hyde amendment from the 667-page bill. It would also go further, requiring the federal government to “ensure coverage for abortion care in public health insurance programs” and prevent the federal government, as well as state and local governments, from restricting abortion coverage by private health plans.

If the proposal creating new coverage requirements were allowed, it would be in violation of House rules and subject to a point of order against its consideration, since it would constitute legislating on an appropriations bill. The Rules Committee will meet Monday and Tuesday to determine what amendments are in order for the floor debate on the five-bill package.

House Labor-HHS-Education Appropriations Chairwoman Rosa DeLauro said in late April when her subcommittee marked up its draft bill that a continuation of the Hyde amendment is a recognition of political reality. The Connecticut Democrat said she opposes the “discriminatory policy that makes access to basic reproductive health care based on your income,” but acknowledged that in order to get a bill signed into law Democrats needed to maintain the language.

Brendan Buck, who was a top aide to former Speaker Paul D. Ryan, predicted an ugly government shutdown showdown if that changes.

“Allow me to be alarmist for a moment: If House Dems stake out a position that they won’t include the Hyde amendment in this year’s spending bills, just watch out,” he tweeted Friday. “If you think a long shutdown over immigration was bad, wait until we have one over abortion funding.”

But other abortion access riders House Democrats included seem destined for a showdown this fall with Senate Republicans and the Trump administration anyway. Senate Labor-HHS-Education Appropriations Subcommittee Chairman Roy Blunt said last week it’s unlikely any of the new abortion-related provisions in the House bill actually become law.

“I believe what will happen in the final bill is that all the language that has traditionally been in these Labor-H bills will still be there, and it’s highly unlikely that there’s any new language added on either side of those issues,” the Missouri Republican said. Senate appropriators haven’t yet released their fiscal 2020 spending bills.

The debate is re-emerging as abortion access surges to the forefront of voters’ minds after several states passed laws that ban virtually all abortions. Federal lawmakers are unlikely to have much influence on those efforts, but they can use the “power of the purse” strategically to make their voices heard.

“There is this lack of trust, respect for women, and it’s going to be an issue that we are going to continue to fight,” DeLauro said last week.

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