An unusual public split between U.S. Roman Catholic bishops, nuns and hospitals over abortion in the health care overhaul could undermine the church hierarchy's influence on the debate and give anti-abortion Democrats the political cover they need to vote for the bill.
The president of the U.S. Conference of Catholic Bishops, which opposes the Senate bill up for a House vote this weekend, warned that some forces are trying to use the rift to push the legislation through Congress.
"I think what is going on here is kind of a political tactic that has been used elsewhere, where you divide the potential enemies in such a way that people who can't be brought over to your way of thinking are isolated," said Chicago Cardinal Francis George told The Associated Press.
The disagreement among Catholics has to do with whether the bill would allow federal funding of abortion.
The U.S. bishops believe it does and said they "regretfully" opposes the bill even though they have been pushing for health care reform for more than four decades.
But the Catholic Health Association, which represents 600 hospitals, and about 60 Catholic nuns from various orders and groups disagree and urged Congress to pass the bill.
That unusual break with the hierarchy is influencing at least one anti-abortion House Democrat.
"You've had Catholic hospitals ... a group of Catholic nuns ... I am almost there" on supporting the Senate bill's provision on abortion, Rep. Henry Cuellar of Texas said Friday. Cuellar is a Catholic who voted for an earlier House bill with tougher abortion funding prohibitions the bishops backed.
Rep. Tim Ryan, an anti-abortion Democrat from Ohio, said through a spokesman that he, too, is siding with the nuns and hospitals and will vote for the bill.
On the House floor Friday, Ryan took issue with several arguments Republicans have used against the bill. He said the GOP argues that "seniors are against it, but then AARP endorses it. Our friends on the other side say doctors are against it, but the American Medical Association endorses it."
"You say that this is pro-abortion," he continued, and yet "you have 59,000 Catholic nuns from across the country endorsing this bill, 600 Catholic hospitals, 1,400 Catholic nursing homes endorsing this bill."
(The bishops say the nuns supporting the bill speak only for themselves and are "grossly overstating" their claim of representing 59,000 women -- essentially every nun in the country.)
Other anti-abortion Democrats, though, appear to be standing firm against the bill.
Rep. Bart Stupak, a Michigan Democrat who has led a dozen House Democrats in opposing the bill because of the abortion issue, reiterated Friday that his group may vote no.
The language in the Senate bill that the bishops, hospitals and nuns disagree on was written by Sens. Bob Casey, D-Pa., and Ben Nelson, D-Neb., two abortion foes.
The rift has escalated a debate over who speaks for the Catholic faith on matters of public policy.
"Bishops no longer have a monopoly in public issue discussions in Catholicism," said John Allen Jr., a columnist with the National Catholic Reporter, an independent weekly. "There are a lot more points of reference to bring a Catholic perspective and it's impossible for anyone, including bishops, to control."
George made it clear where the bishops stand on the issue: "The bishops speak for the Catholic faith as such. Others will speak for themselves."
Allen said the letter from the nuns will be viewed as predictable in official Catholic circles because the Catholic social justice group that organized it, Network, is considered liberal. The health association's stance is more unusual because the group strives to work in tandem with the bishops, he said.
Yet the Rev. James Martin, a Jesuit priest and culture editor of America magazine, said it is significant that nuns are opposing the bishops.
"Sisters have vast amounts of experience in dealing with the sick and the poor in hospitals they continue to run," Martin said. "In the United States, the voice of Catholic sisters is almost unimpeachable."
Denver Archbishop Charles Chaput complained that Network and the Catholic Health Association "have done a grave disservice to the American Catholic community by undermining the leadership of the nation's Catholic bishops, sowing confusion among faithful Catholics, and misleading legislators through their support of the Senate bill."
Sister Simone Campbell, executive director of Network, defended the organization, saying: "We are not pretending to speak for the church. We're speaking from our lived experience of caring for people who do not have access to health care and have their human dignity undermined because of that."
Divisions exist among nuns, too. A smaller, more conservative organization, the Council of Major Superiors of Women Religious, which represents over 103 communities and 10,000 members, issued a statement siding with the bishops against the health care bill.
"I feel badly that others who are responsible for this faith ... have not taken the leadership of the bishops as seriously as they should," council president Mother Mary Quentin Sheridan said in an interview.
Under the health care bill, no health plan would be required to offer coverage for abortion. In plans that do cover abortion, policyholders would have to pay for it separately, and that money would have to be kept in a separate account from taxpayer money.
States could ban abortion coverage in plans offered through the exchange. Exceptions would be made for cases of rape, incest and danger to the life of the mother.