It is an age-old issue that has caused many a conflict.
For 36 years, the controversial Roe v. Wade decision set the ground rules for abortion law in the United States, but the issue has continued to simmer beneath the political surface. With the momentum to get a health care bill passed by the end of the year, it is now threatening to boil over and derail the health care legislation, and one senator is leading the helm -- Ben Nelson of Nebraska.
Nelson, 68, is a longtime abortion opponent. His amendment to tighten restrictions on federal funding for abortion was struck down in the Senate on Dec. 8, even though a similar measure passed in the House.
Since then, Nelson has ratcheted up the heat and is threatening to filibuster with Republicans if language similar to what he proposed is not included in the health care bill.
"The compromise adds important new initiatives addressing teen pregnancy and tax credits to help with adoptions," Nelson said Thursday in a written statement, referring to a compromise offered by a fellow anti-abortion Democrat, Sen. Bob Casey of Pennsylvania. "These are valuable improvements that will make a positive difference and promote life. But as it is, without modifications, the language concerning abortion is not sufficient."
Nelson is considered to be one of the most conservative Democrats in the Senate and his staunch stance is making some wonder whether he is the lone Democrat standing in the way of health care victory.
Senate Democratic leaders are in a tough spot. They need 60 votes to avoid a Republican filibuster of their health care bill, but there is little political capital left to spare between courting Sen. Joe Lieberman, I-Conn., who objects to a government-run insurance option and liberal Democrats, who want the opposite.
Nelson, however, is not a definite "no." In fact, he says, he "is open to looking at additional attempts to maintain the federal restriction on public funding of abortion."
But the question of whether his fellow party members will take the language as far as he wants is another issue. The current law restricts federal funding for abortion, but opponents argue that the new health care system contains loopholes that won't be able to stop federal dollars from going toward abortion services.
And it's not just abortion that the Nebraska native is taking issue with. In an interview with KLIN in Lincoln, Nebraska Thursday, Nelson said he has additional concerns about other proposals in the health care bill -- namely Medicare costs and new taxes and fees -- and that Senate Majority Leader Harry Reid's deadline of Christmas was unattainable.
Nelson Widely Courted
Lawmakers and the White House both have tried to woo Nelson, who has famously declared his vote is not for sale. He has met with President Obama three times in eight days, and has been scoffed at by some liberal groups for not siding with his caucus. Nelson, for his part, is standing by his arguments.
"I am not feeling any pressure from the party," he said. "I know what they would like me to do."
Sen. Casey's compromise included an increase in a tax credit for people who adopt a child, funding to help pregnant teens and others with alternatives to abortion and stronger language to protect health care providers who don't want to perform abortions. But it is unclear whether it went as far as the Stupak-Pitts amendment in the House bill, which would not only cut federal funding for abortion-related services, but would also limit access to abortions for people who receive federal subsidies and those who purchase insurance through a health insurance exchange, a marketplace where people would be able to shop for and compare insurance plans.
Rep. Bart Stupak, D-Mich., rejected the Casey proposal as a "non-starter," and expressed confidence that his language will be included in the final bill. Stupak told ABC News he has been in touch with Sen. Nelson.
"They are holding tough and they are asking me, 'Is the House holding tough?'" Stupak said, referring to his Senate counterparts like Nelson and Sen. Orrin Hatch, R-Utah, who crafted the abortion amendment in the Senate health care bill. "Our members are holding, so we will not pass if they are putting anything but a version of our language."
Ben Nelson Opposes Abortion Language in Senate Health Care Bill
Nelson, a former insurance industry executive, has been something of a star in Nebraska's Democratic party. Hailing from a relatively conservative state, he has enjoyed a long public service career and is currently the only Democratic candidate from the state in Congress.
But while he enjoys local success, he has butted heads with fellow Democrats in Nebraska several times, especially on the issue of abortion.
As governor, Nelson signed a ban on so-called partial-birth abortion that was overturned by Nebraska's Supreme Court in 2000.
He also backed the nomination of Supreme Court nominee Samuel A. Alito Jr. despite Democrats' objections to the judge's anti-abortion position.
Nelson, who was born in Nebraska and has lived all his life there, is also a member of anti-abortion organizations and, during his campaign, was endorsed by several of them.
Nelson sees a tough battle in 2012, when his term expires. The Nebraska senate race is expected to be a competitive one as Republicans step up efforts to reclaim Nelson's seat, which has been occupied by a Democrat for more than two decades.
It is no surprise then that Nelson has been so steadfastly fixed on the idea of introducing firmer language on abortion in the Senate health care bill.
"Federal taxpayer money ought not to be used to fund abortions," Nelson told ABC News' Jonathan Karl in November. "So whether it is subsidies on premiums or whether it is tax credits or whatever it is... it should not be used to fund abortions."
Bob Kerrey, who held the senate seat before Nelson and is now president of the New School in New York, said the anti-abortion group is a formidable force in Nebraska politics, and their pressure on lawmakers is enormous.
"It certainly accounted for a significant part of my opposition because I held the opposite view," Kerry told ABC News. However, Kerrey differs with Nelson on the issue, arguing that one should make a "decision on what you believe the law should be, not what you believe about the action."
Nebraskan Democrats have raised little ruckus over the deadlock on the abortion issue.
In a statement to ABC News, the Lancaster County Democratic Party in Nebraska said, "While most of the Democratic constituents in Lancaster County do not agree with Senator Nelson's views regarding women's reproductive rights, the Lancaster County Democratic Party understands that our party is a big tent. Our elected officials are not held to a litmus test, but are asked to wisely serve the citizens of our state."
Americans' view of abortion remains split. In a November Washington Post poll, 54 percent of Americans said abortion should be legal in all or most cases. Opinions range widely in states across the country.
Nelson, a former state insurance director of Nebraska and industry executive, has also opposed other measures in the health care bill. He is against a new long-term care insurance program and proposed cuts in payments to nursing homes and home health care providers.
Nelson's top source of campaign contributions is the insurance industry, with names such as Aetna and MetLife gracing the list of his donors. Nelson's contributions from the insurance industry amounted to $636,209, according to maplight.org.
Abortion Debate on the Forefront in Health Care Debate
In recent weeks, the White House has ratcheted up pressure on Democratic leaders to pass a health care overhaul bill. President Obama has repeatedly urged his party members to reach a compromise, saying that this is a health care bill, not an abortion bill.
But the controversial issue is unlikely to fade away any time soon, and some liberal Democrats say that the party needs to reframe the debate to reach out to Americans.
Kerrey, who supports what he calls freedom of choice, said that when one argues that they are right and the other is wrong, "you're not going to persuade anybody that some logic exists behind the argument."
"Abortion is so controversial that it becomes a litmus test vote," he said.
At the same time, the issue -- and the division within Democrats on abortion -- is not foreign. According to Kerrey, had the health care plan that the Clinton administration was proposing moved forward, the same scenario would likely have played out.
"I think in 1993, the issue was very much alive and well, it would've produced very similar faultlines within Democrats," the former senator said. "Maybe there are more today but the Democratic party has always had very large number of active participants in state and national level both as supporters and as candidates who are pro-life."
The abortion debate is likely to take center stage as Senate Democratic leaders clamor to gain full support for the health care bill by Christmas.
Nelson's office did not return calls seeking comment, but his counterparts say they will not back down anytime soon.
"This isn't an argument on merit. This is more an argument on their pride," Rep. Stupak said of his Democratic colleagues who opposed his amendment. "They chose this fight and lost."