It was an issue that nearly derailed President Obama’s national health care law: whether the plan would provide any federal funds for abortion. Now, as Republicans have taken up the effort to repeal the law, the issue has returned to the forefront.
Before the law was passed, pro-life advocates argued that nothing would stop taxpayer dollars from being used to finance abortions through insurance subsidies. Obama and his congressional allies struck a compromise with pro-life Democrats to get the law passed. In return for their support, the president signed an executive order restating his promise to use no federal monies for abortion.
But now, activists see a chance to tighten restrictions.
"This is the first opportunity to really correct some wrongs and solve some problems that were really brushed under the rug and not dealt with," said Marjorie Dannenfelser, president of the pro-life Susan B. Anthony List.
Count Dannenfelser among those who believe the executive order that was part of a deal with a group of pro-life Democrats led by then-Rep. Bart Stupak (D-Mich.) is meaningless. That piece of paper gave Democrats the votes they needed, but it didn't convince skeptics.
"One way or another, taxpayer money will help and assist abortions that will occur as a result of Obamacare," said Rep. John Fleming, a Louisiana Republican who is also a physician.
Fleming says he's concerned about $11 billion slated to fund community health centers.
"There's nothing that blocks using some, if not all, of that money for abortions," said Fleming.
And Republicans can count the abortion debate as one reason that they now enjoy the House majority that makes the renewed impossible. Of the 22 pro-life Democrats who signed off on the controversial deal last year, only five have returned to Congress. Many, like Stupak, opted to retire, and many others were defeated by opponents who used the abortion issue against them.
Many within the pro-choice community call the debate a farce that hides a larger effort to roll back rules allowing elective abortions.
"There is no federal funding of abortion in this law, there is no funding," said Nancy Keenan, President of NARAL Pro-Choice America. "The rhetoric running rampant around this debate doesn't match the reality of the law."
Many members on Capitol Hill echo that feeling, including Rep. Sheila Jackson Lee (D-Texas), who calls the argument a "smokescreen."
“This bill is pro-life in that it saves lives, and it certainly does not in any way promote the use of federal funds for abortion," Jackson Lee said.
In the weeks to come, a bi-partisan coalition in the House -- led by Rep. Joe Pitts (R-Pa.) and Rep. Dan Lipinski (D-Ill.) -- will introduce a measure that would codify an all-out ban on federal funding for abortion costs or coverage.
Pro-life advocates say they'll be watching closely.
"This is the first opportunity to make good on the promises that so many new members of Congress made," Dannenfelser said. "80 of 87 new members are strongly pro-life."
Pro-life advocates want to know why pro-choice groups won't agree to codify language specifically banning any federal funding for abortion -- since they argue that is already the case.
"The tipoff is that NARAL and Planned Parenthood are screaming now," Dannenfelser said. “They don't want statutory language in this health care bill prohibiting abortion."
Keenan believes the current effort is actually aimed at broader restrictions on abortion, not Obama’s health care law.
"I think it's an outright attack on a woman's right to choose, and this is a vehicle to do that," Keenan said.