
Just before 4 p.m. ET, the White House released text of a compromise on abortion to help clear the way for passage of the health care legislation.
STATEMENT FROM COMMUNICATIONS DIRECTOR DAN PFEIFFER
Today, the President announced that he will be issuing an executive order after the passage of the health insurance reform law that will reaffirm its consistency with longstanding restrictions on the use of federal funds for abortion.
While the legislation as written maintains current law, the executive order provides additional safeguards to ensure that the status quo is upheld and enforced, and that the health care legislation's restrictions against the public funding of abortions cannot be circumvented.
The President has said from the start that this health insurance reform should not be the forum to upset longstanding precedent. The health care legislation and this executive order are consistent with this principle.
The President is grateful for the tireless efforts of leaders on both sides of this issue to craft a consensus approach that allows the bill to move forward.
A text of the pending executive order follows:
EXECUTIVE ORDER
- - - - - - -
ENSURING ENFORCEMENT AND IMPLEMENTATION OF ABORTION RESTRICTIONS IN THE PATIENT PROTECTION AND AFFORDABLE CARE ACT
By the authority vested in me as President by the Constitution and the laws of the United States of America, including the "Patient Protection and Affordable Care Act" (approved March __, 2010), I hereby order as follows:
Section 1. Policy.
Following the recent passage of the Patient Protection and Affordable Care Act ("the Act"), it is necessary to establish an adequate enforcement mechanism to ensure that Federal funds are not used for abortion services (except in cases of rape or incest, or when the life of the woman would be endangered), consistent with a longstanding Federal statutory restriction that is commonly known as the Hyde Amendment. The purpose of this Executive Order is to establish a comprehensive, government-wide set of policies and procedures to achieve this goal and to make certain that all relevant actors--Federal officials, state officials (including insurance regulators) and health care providers--are aware of their responsibilities, new and old.
The Act maintains current Hyde Amendment restrictions governing abortion policy and extends those restrictions to the newly-created health insurance exchanges. Under the Act, longstanding Federal laws to protect conscience (such as the Church Amendment, 42 U.S.C. §300a-7, and the Weldon Amendment, Pub. L. No. 111-8, §508(d)(1) (2009)) remain intact and new protections prohibit discrimination against health care facilities and health care providers because of an unwillingness to provide, pay for, provide coverage of, or refer for abortions.
Numerous executive agencies have a role in ensuring that these restrictions are enforced, including the Department of Health and Human Services (HHS), the Office of Management and Budget (OMB), and the Office of Personnel Management (OPM).
Section 2. Strict Compliance with Prohibitions on Abortion Funding in Health Insurance Exchanges. The Act specifically prohibits the use of tax credits and cost-sharing reduction payments to pay for abortion services (except in cases of rape or incest, or when the life of the woman would be endangered) in the health insurance exchanges that will be operational in 2014. The Act also imposes strict payment and accounting requirements to ensure that Federal funds are not used for abortion services in exchange plans (except in cases of rape or incest, or when the life of the woman would be endangered) and requires state health insurance commissioners to ensure that exchange plan funds are segregated by insurance companies in accordance with generally accepted accounting principles, OMB funds management circulars, and accounting guidance provided by the Government Accountability Office.
I hereby direct the Director of OMB and the Secretary of HHS to develop, within 180 days of the date of this Executive Order, a model set of segregation guidelines for state health insurance commissioners to use when determining whether exchange plans are complying with the Act's segregation requirements, established in Section 1303 of the Act, for enrollees receiving Federal financial assistance. The guidelines shall also offer technical information that states should follow to conduct independent regular audits of insurance companies that participate in the health insurance exchanges. In developing these model guidelines, the Director of OMB and the Secretary of HHS shall consult with executive agencies and offices that have relevant expertise in accounting principles, including, but not limited to, the Department of the Treasury, and with the Government Accountability Office. Upon completion of those model guidelines, the Secretary of HHS should promptly initiate a rulemaking to issue regulations, which will have the force of law, to interpret the Act's segregation requirements, and shall provide guidance to state health insurance commissioners on how to comply with the model guidelines.
Section 3. Community Health Center Program.
The Act establishes a new Community Health Center (CHC) Fund within HHS, which provides additional Federal funds for the community health center program. Existing law prohibits these centers from using federal funds to provide abortion services (except in cases of rape or incest, or when the life of the woman would be endangered), as a result of both the Hyde Amendment and longstanding regulations containing the Hyde language. Under the Act, the Hyde language shall apply to the authorization and appropriations of funds for Community Health Centers under section 10503 and all other relevant provisions. I hereby direct the Secretary of HHS to ensure that program administrators and recipients of Federal funds are aware of and comply with the limitations on abortion services imposed on CHCs by existing law. Such actions should include, but are not limited to, updating Grant Policy Statements that accompany CHC grants and issuing new interpretive rules.
Section 4. General Provisions.
(a) Nothing in this Executive Order shall be construed to impair or otherwise affect: (i) authority granted by law or presidential directive to an agency, or the head thereof; or (ii) functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.
(b) This Executive Order shall be implemented consistent with applicable law and subject to the availability of appropriations.
(c) This Executive Order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity against the United States, its departments, agencies, entities, officers, employees or agents, or any other person.
THE WHITE HOUSE,
mcc
March 21, 2010 4:06 PM
*Squints* Near as I can tell this doesn't even really say anything. It basically just says "we'll enforce the bill as written."
Stupak lost.
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Ethan
March 21, 2010 4:07 PM in reply to mcc
Shh, don't let him hear that.
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theCleverBulldog
March 21, 2010 4:12 PM in reply to mcc
No, America lost.
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Ethan
March 21, 2010 4:13 PM in reply to theCleverBulldog
If by America, you mean Hamsher and the teapartiers, then yes.
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mans_best_friend
March 21, 2010 4:13 PM in reply to mcc
Stupak didn't really lose. I said last week that his three outcomes, in order of preference are:
1. Bill passes, but he votes against it, burnishing his pro-life credentials.
2. Bill passes with him voting in favor, but he gets some kind of fig leaf so he can claim some kind of victory. Not as good as #1, but close.
3. Bill fails. He does NOT want this.
He got door #2.
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mcc
March 21, 2010 4:16 PM in reply to mans_best_friend
Well... really if you think about it, whether Stupak won or lost comes down to the answer to one question.
"Will Connie Saltonstall withdraw her candidacy on Monday?"
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averb
March 21, 2010 4:29 PM in reply to mcc
I hope she doesn't. Mr. Stupak has been the cause of way too much drama on this one. Good riddance, if it comes to that.
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Measure for Measure
March 21, 2010 8:20 PM in reply to mcc
And will this move take the wind out of Connie's sails? For the moment, I hope it does: I think the left should direct its fire towards those who vote no from the least red districts.
But I hope some disagree with me: Stupak should feel a little heat.
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hewhohasnoname
March 21, 2010 4:16 PM in reply to mcc
Yep. It's just a reaffirmation of the law that exists under the Hyde Amendment.
This was a way for the Stupak crew to save face.
But, ultimately, this agreement is probably a boon to the Dems, because it's a high-profile confirmation that there will be no federal funding of abortion. People intimately following the process already knew that was the case. But, the general public was confused (largely by the impressions that Stupak et al. was giving). So, seeing the Stupak crew come along reinforces the notion that the abortion issue has finally been resolved.
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midnight rambler
March 21, 2010 4:19 PM in reply to mcc
That was my reaction too. The only thing that's even an "order" is in setting up regulations for segregating money in the exchanges.
So the question is, were Stupak et al. just looking for cover so they could vote yes all along, or are they so stupid that they think this does something? Given how Washington usually works the former is the default, but I don't rule out the latter.
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Richardxx
March 21, 2010 5:03 PM in reply to midnight rambler
I think that the Stupak crew were primarily set on raising the issue and making a big deal of it. It was a PR effort to raise awareness of the (fake) morality they are championing.
Have they left a lot of the public questioning the abortion issue from their point of view who did not do so before they got this issue so much publicity? Without any doubt, yes. They got what they wanted. Increased public awareness of their position.
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ema
March 21, 2010 5:03 PM in reply to mcc
Near as I can tell this doesn't even really say anything.
I disagree. Here are the two things that jumped out at me after a quick read:
First, it makes the Hyde Amendment--a temporary rider that has to be voted on and negotiated every year--a permanent feature of the newly-created health insurance exchanges.
Second, it also tells us that there are new protections in the Act, on top of Church and Weldon, for institutions and individuals who practice substandard medicine. [Not that I'm complaining, mind you. It's good to know that you have a patient population you can blow off and debase at will without having to worry about malpractice.]
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Bull Schmitt
March 21, 2010 5:12 PM in reply to ema
It's an executive order, not a signing statement. That means it's in force through the Obama administration. It's up to the voters in 2016 to elect a President that will rescind the order. (If you believe there is any practical effect from saying "Hyde Rule applies to this legislation, as it does to any Federal program.)
If there's a practical objection from the pro-choice side on this language, I haven't heard it yet.
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Publishermike
March 21, 2010 4:10 PM
Nothing to see here...move along...get your ass to the floor and vote yes, Bart and co....
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jdb316
March 21, 2010 4:11 PM
So I guess Stupak really was just trying to make the most of his 15 minutes of fame. I see nothing here that is different from the Hyde Amendment that has already been on the books for decades.
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ShoelessJoeMcCarthy
March 21, 2010 4:12 PM
OK--how does this ultimately affect the potential funding for Planned Parenthood that was part of what Sanders got put into the Senate bill?
If we got this deal without throwing PP under the bus, then yeah, a victory of sorts in terms of the Stupak negotiations. And ultimately a huge victory overall.
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mcc
March 21, 2010 4:20 PM in reply to ShoelessJoeMcCarthy
If I am reading the EO correctly, the community health centers were an existing program, and the bill institutes a new funding mechanism for them. It would already be the case that these health centers could be built by an organization that does abortions (such as Planned Parenthood) but that said organization would not be allowed to provide abortion services at a location which had received federal funds (Planned Parenthood offers many services besides abortion and as I remember in some states they don't do abortions at all). Under this EO this would continue, Planned Parenthood could continue to receive "community health center" money, they will continue to be banned from using that money on locations with abortion services, it's just now there will be more money.
Did I get that right?
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Severus
March 21, 2010 4:29 PM in reply to mcc
I don't know, but this makes me want to donate to Planned Parenthood. I assume private donations CAN be used for all reproductive services.
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mcc
March 21, 2010 4:45 PM in reply to Severus
Yeah, I'm sure. Planned Parenthood just has to segregate funds. Federal funds often come with restrictions like this so it's not a difficult thing.
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EnnuiDivine
March 21, 2010 4:13 PM
Stupak wanted his 15 minutes of fame.
He got it.
And an executive order reaffirming the Hyde Amendment.
Had Stupak succeeded in killing the bill, he would've lost his seat in November.
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JohnW1141
March 21, 2010 4:24 PM
I think Stupak was scared shitless of being the one who lead the charge to destroy health care reform, so he had to find a way to save face and vote for the bill. This empty executive order was his way out.
Whenever you put someone through the wringer before you acceed to their wishes you build a tsunami of resentment from the people you twisted. I think this resentment is what Stupak and his cohort will be facing from many Democrats.
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JohnW1141
March 21, 2010 4:27 PM in reply to JohnW1141
By the way, Stupak opened his presser by thanking Obama, Hoyer and one or two others, I didn't hear Pelosi's name.
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theWalrus
March 21, 2010 4:30 PM
Personally, I find any restrictions on what a woman wants to do with her own body reproductively extremely distasteful, especially when they come from an extreme moral or religious viewpoint. In my view, abortion should be free, safe and legal.
How ironic, then, that the final issue of the health care reform bill is abortion - an issue that the Republicans would like to think they solely own. Well, Stupak just destroyed that image.
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Jeronimo Dan
March 21, 2010 4:49 PM
Old Stu folded like a two dollars suitcase and we all knew he would... he just needed that fifteen!
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seccotine
March 21, 2010 4:50 PM
I used to think abortion should be allowed. Stupak just convinced me that in some cases it should be compulsory.
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mjae
March 21, 2010 4:55 PM
The Walrus:
Bringing in ancient and outdated arguments on your interpretation of what a women should do with her own body is too late. As someone outside of America watching America destroy itself through this ridiculous legislation is both a sad day for America and for the rest of the planet. I would know, having talked to Americans about this very issue, as well, being outside of America and living in the health system your lawmakers are about to pass into law.
You will find that passing laws does not change the the reality of how a country operates; and if I am wrong and it does change the country, then you are truly destroyed. Why? Because a $1 trillion+ deficit along with new taxes will BANKRUPT you. Companies like mine find it hard to invest in America because of the high taxes and red-tape. Without those people, America's financial position will continue to slide because it will not have the taxes to finance the way it wants to operate. World powers, like the USA is today, in whatever form always destroy themselves from the inside out; this is the best path to do that.
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psyberian
March 21, 2010 5:19 PM in reply to mjae
"I would know, [...] being outside of America and living in the health system your lawmakers are about to pass into law."
Where do you live? I wasn't aware that there are any countries with such a Frankenstein's Monster of a health care system as we are about to enjoy.
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Bull Schmitt
March 21, 2010 5:21 PM in reply to mjae
Actually, it's the deficit combined with tax CUTS that is threatening to bankrupt the country. $1.7 trillion dollars over 10 years, that's the added debt for the two Bush tax cuts as determined by the non-partisan CBO.
In the end, Democrats will need cover for cuts to entitlement programs, and Republicans will need cover for tax hikes. And that's where the deal to get the national debt under control will be made. But you can't do it strictly on entitlement cuts, or strictly on tax hikes.
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Richardxx
March 21, 2010 5:25 PM in reply to mjae
The primary financial problems that will bankrupt America are:
1. Excessive military spending.
2. Encouraging banking and financial operations while abandoning real production and outsourcing it to other nations.
3. Excessive Executive pay and the failure to pay workers for their productivity.
4. Training lawyers and MBA's instead of engineers and technicians.
5. Inadequate spending on research. As you read reports of new basic discoveries out of the European proton collider, remember that America had an even bigger on over half built in Texas until Congress cut the budget to supposedly save $2 billion back in the 90's.
The new structure of American health care financing has great promise to slow the excessive increases in medical costs. More important is that it will remove a major factor of financial uncertainty for the middle class and for labor in general. That is going to be reflected in improved labor productivity and improved small business starts.
I won't even try to convince you that the CBO has probably gotten the deficit reduction factors of this bill right or even understated them.
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expat46
March 21, 2010 6:41 PM in reply to mjae
You must be a member of the British Nationalist Party?
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AJM
March 21, 2010 9:35 PM in reply to mjae
We have repeatedly found that we can change the conduct of our government by changing our laws. The civil rights legislation is a good example. Social Security is another example.
This is certainly not the best health care system possible -- Europe has a lot which are better -- but it should save us money.
Take your concern trolling where it is appreciated,
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mjae
March 21, 2010 7:40 PM
No I am not a member of the BNP. And I live in New Zealand. DO not criticise me as uninformed. I have family living in America, so I am just as informed as anyone else is about the debate. Better informed then you are when it comes to healthcare in New Zealand, that's for sure.
Excessive military spending. Therein lies the fundamental problem with your knowledge of how America was founded. Hopefully, given your supposedly superior knowledge to mine of what has made America fundamentlaly different to every other nation on earth so far will lead you to know why you think military spending is not the problem. Furthermore, you seem to think that the world can govern itself. Look at all the failed states and you say that the world can govern itself?
America simply has no experience with the healthcare you laud today.
You talk about your financial problems:
1. Outsourcing factories to other nations was America's choice, you didn't have to. That outsourcing will remain IN PLACE after this vote. China is not going to give up its new found economic power, just because you are trying to destroy your country.
2. Excessive executive pay. Can you substantiate that with real figures, vs the size of America's GDP?
3. You may well be right that training lawyers and MBAs does not increase productivity, however that will continue long after today is finished.
4. You may also be correct when it comes to the Tevatron and related research too. But again that [lack of spending] will continue long after today.
That is the problem, your supposed healthcare fix will add, get this, a further $1 trillion+ to the deficit, where are the tax hikes for that? America WILL begin its long decline (yes it will take time, maybe a century, but who cares, at least your healthcare will be looked after). Yes Bush II made a mistake in increasing the deficit and he needs to take the blame for that. But you need to know that America has been a net debtor to the rest of the World since the early 1970s. Why should we continue to lend money to you if you are becoming more and more focused in on yourself; which is what healthcare is all about? There comes a point when the debt is so big, and the rantionale so ridiculous to pay it back, that countries will stop buying the Treasury Bills. In fact already I see the rating agencies threatening to decrease the US's credit rating. That impacts interest rates and we all know what happens from there. Whether the noncongressional CBO is right or wrong is irrelevant, when outside institutions start to question America's ability to pay back debt, you need to take notice.
Why should the rest of the world continue to pour in billions of investment money to a country that is a NET DEBTOR to the world. Without that money, it doesn't matter how good your healthcare system is, the country will be gutted at some point in the future, because it can't pay its debt back. Check out Japan if you want to see what happens to a country where debt is 200% of GPD. That's where you're heading.
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Measure for Measure
March 21, 2010 8:27 PM in reply to mjae
You appear to be misinformed. According the the Congressional Budger Office (CBO), this bill runs a surplus over a 10 year period, as well as a surplus during the 10-20 year horizon.
Over the longer run, the *only* route to fiscal responsibility lies with health care reform. The existing plan contains a number of cost control measures designed to do exactly that.
As you are probably aware, the US spends the largest share of GDP on health care among advanced nations and receives only middling life expectancy (and other outcomes) in return. Fixing this mess will take a while: the existing plan is a useful first step.
----
"Why should the rest of the world continue to pour in billions of investment money to a country that is a NET DEBTOR to the world."
A1: The US became a net debtor under Ronald Reagan, about 25-30 years ago. It hasn't stopped international capital flows.
A2: The US's fiscal problems are sharply reduced as it borrows in domestic currency, not foreign currency.
A3: Appropos nothing, Japan is an interesting case study of a nation caught in a liquidity trap.
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mjae
March 21, 2010 9:28 PM in reply to Measure for Measure
Fair enough about the CBO, and the starting date for being a net debtor.
However, you have to realise that by increasing healthcare you will become bankrupt. No nation in history has managed to spend what it does in the military and health and survive financially. You can't now and you will not be able to in the future.
The point about being a net debtor --> I just love your statement "It hasn't stopped international capital flows." There comes a point when a country's guarantee for itself becomes worthless (which is what happened under Nixon). After that, you cannot guarantee that funds will come in. Even today, the two half-a-trillion dollar funds that I am part of are reducing their exposure to the US and going to developing countries.
Your statement for A2 is another way of saying that we will just print money to avoid being unable to pay off our debt. Obviously you will be aware of the economic impact of printing money, even if you believe that it is right. Once the American dollar loses its preeminent position, then you will have little choice but to go to the rest of the world (that loss of curency value is just as inevitable as you view your progress towards healthcare). Haven't you learned what happened to Britain after the US had finished dealing with her in WW II? the US demanded that it pay back every cent and nearly bankrupted the Britain. That forced Britain to withdraw its armed forces globally (read Lee Kuan Yew's autobiography as an example) and has caused it to become an economic basket case today (with its natioalised health care system). I have lived in Britain and experienced what it has to offer, both healthwise and economically. I can tell you friend, it is not a path you want to follow.
Even your own country is split over this issue. Take note of that.
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fpie
March 22, 2010 6:02 AM in reply to mjae
Yes we know it's a bloody mess. And we lefties have been trying for decades to shove the 'deregulation' and 'bomb everything in sight to prop up oil' crowd out of the way. So now maybe there is a political toehold on that front.
We'll just have to see how that flies. There are a lot of things standing on the cusp and crisis has a way of setting potential into motion. No doubt things will get worse before they get better.
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expat46
March 22, 2010 11:04 AM in reply to mjae
No nation in history has managed to spend what it does in the military and health and survive financially.
So your argument is that we should continue to spend on military rather than health care for our citizens?
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Rick
March 22, 2010 1:32 AM in reply to mjae
"DO not criticise me as uninformed."
Why not?
"You appear to be misinformed."
The nerve!
"Fair enough about the CBO..."
Good thing Measure for Measure ignored your demand.
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Tosh
April 2, 2010 8:37 AM
i was looking at some of his photos and he has really lost weight from when he was elected til now
kamagra l m65
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jim144
July 14, 2010 12:19 PM
This information would provide "early warnings" of serious cybersecurity threats. "Companies are not going to be willing to share that information with each other," so government involvement might be critical to harnessing the data, Barnett said. "We are currently examining the best path forward to obtain this information."Performance Parts
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jim144
July 25, 2010 7:31 AM
If a bus carrying men or women or children, meets accidents then can it be anyone's fault. Like sueing any one for accidents are not fair as I see. So things should be made clear and reasonable.
Link Building Service
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jim144
July 29, 2010 8:25 AM
Well... really if you think about it, whether Stupak won or lost comes down to the answer to one question.Industrial flooring
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jim144
August 1, 2010 11:31 AM
I hereby direct the Secretary of HHS to ensure that program administrators and recipients of Federal funds are aware of and comply with the limitations on abortion services imposed on CHCs by existing law. Such actions should include, but are not limited to, updating Grant Policy Statements that accompany CHC grants and issuing new interpretive rules.Italian Gold Chains
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jim144
August 16, 2010 11:34 AM
I think Stupak was scared shitless of being the one who lead the charge to destroy health care reform, so he had to find a way to save face and vote for the bill. This empty executive order was his way out.Online Shopping
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