As I understand it—and this is a serious qualification, because I’m not sure I do—the principal difference between the treatment of abortion in the House and Senate healthcare bills is this: the House Bill would prohibit government funding of health insurance policies that cover abortion, while the Senate Bill would allow the coverage but require anyone who wants the coverage as part of a government-subsidized policy to make separate premium payments for the basic policy and for the abortion coverage. It would be a terrible thing for the government to fund abortions, which argues decisively for the House approach.
But I think it’s worth speculating about the likely effect of the Senate approach, should it become part of the final legislation. In theory, the Senate approach would serve as a referendum on Americans’ views on abortion. Those who hold to the old Mario Cuomo position of claiming to be pro-life personally but in favor of keeping abortion legal would presumably decline the coverage (and the politicians among them might well get asked about this in political debates). Those who are adamantly pro-choice might opt for the coverage even if it is highly unlikely they would ever have an abortion. My guess is that coverage decisions would show that pro-choice enthusiasm is less widespread than its advocates like to suggest.
But unless it’s prohibited, many employers, under relentless pressure from pro choice groups, might make it very easy to choose the abortion coverage. They might well do all the processing for their employees, so that the employee never has to sign the separate check that adds abortion to a government-subsidized health insurance policy.