From the Albany Herald — The debate over health care reform, at least what has been proposed so far, may boil down to another question — abortion.

The U.S. House passed health care reform legislation by the skin of its teeth late Saturday, 220-215. Only four of Georgia’s 13-member House delegation — Reps. Sanford Bishop, Hank Johnson, John Lewis and David Scott — supported the bill, while nine — all seven Republicans and Democratic Reps. Jim Marshall and John Barrow — opposed it.

Now the Senate has to come up its own proposal, which would go to a conference committee with the House bill to iron out differences. The way Senate Majority Leader Harry Reid is talking, it doesn’t sound like there’s much chance of that happening by year’s end.

Thomas Voting Reports described the House bill as one that is designed to provide “affordable medical coverage to about 36 million U.S. residents who are now uncovered while overhauling insurance-industry practices in ways that benefit sick as well as healthy policyholders. The bill, which awaits Senate action, seeks to extend coverage to about 96 percent of the population by 2017 while not adding to the national debt.

“The bill expands Medicaid to cover an additional 15 million persons, requires employers with payrolls above $500,000 to provide insurance for their workers, and establishes an exchange for delivering coverage to individuals who do not receive insurance at work or through Medicaid or Medicare. The exchange, or marketplace, would offer private policies alongside a government-run ‘public option,’ and would provide subsidies to help low- and middle-income individuals obtain coverage. The public option, a Medicare-style plan in which the government would negotiate rates with doctors and hospitals, would serve an estimated 6 million persons.

“Roughly half of the bill’s projected net cost of $894 billion over 10 years would be financed through measures that slow the growth rate of Medicare and Medicaid. Additionally, the bill would raise about $460 billion through a 5.4 percent surtax on individuals with adjusted gross incomes over $500,000 and couples earning over $1 million. (Surtaxes are figured on taxes owed, not adjusted gross incomes.) The bill also would levy a 2.5 percent excise tax on medical devices, among other revenue-raisers.”

While there are a number potential stumbling blocks in the bill, such as the public option and how accurate the cost numbers really are, the poison pill for the health bill may be an issue that has stayed on Americans’ minds since the 1970s — abortion.

Senate Democrats are facing an intraparty fight over whether the legislation will cover abortion services. The House bill restricts public plans from covering abortions except in cases of incest, rape of endangerment to the life of the woman who is pregnant. The House bill also would prohibit plans in a new federally subsidized marketplace from offering abortion coverage. If individuals want abortion coverage, they would have to pay for it with their own funds.

Republican senators are standing together solidly in opposition to the bill, so Reid cannot lose even one member of the Democratic caucus if he wants to move the legislation forward. He would need the full 60-member caucus to stand firm to overcome a GOP filibuster.

But some Democratic senators who opposed abortion are saying they won’t vote for a bill that doesn’t include tough restrictions.

That means that the Senate bill, which does not have as restrictive language as the House bill on abortion coverage, would have to tighten up on that language to have a chance of passing the chamber. And that, in turn, may mean the end for the legislation back in the House, where liberals are threatening to vote against it if the restrictions the House imposed are not loosened, evaporating that five-vote margin.

And while few issues are as galvanizing as abortion, there still the other issues to contend with, issues that could cause enough support defections to scuttle the bill. That’s especially true in an election year, which looking more and more like the time when this reform will be decided.