Does the ACA Fund Abortion?

We have received several inquires about the recent articles purporting the availability of $1 abortions in “Obamacare.”  The contents of the Affordable Care Act (ACA) have been particularly misconstrued, and polls have indicated that a majority of Americans do not know or understand what is actually in the ACA.

The Supreme Court determined the legality of the bill itself.  It is important to look at the facts and not listen to the rhetoric.  One thing is for sure.  As pro-life Democrats, under the leadership of Congressman Bart Stupak, we worked very hard to include clear and concise language that will not allow Federal funds to be used for abortion.

Abortions will not be available for $1 under the new law.  The fact check web site challenged the notion of the $1 abortion and found that the news articles were false.  (The most outrageous suggestion in the recent articles is that the law has made abortions available for $1; Politifact found that “ridiculously inaccurate.”)

Under the law, no private insurer will be required to include abortion coverage except for the common exceptions under the Hyde Amendment. The provision that is under scrutiny only applies to plans within the state exchanges.  It does not apply to private health plans.

Under the law, abortion cannot be included as an essential benefit.[1]

Under the law, no state will be required to provide abortion coverage, and a state can, in fact, pass a law that bars any plan covering abortion coverage from the state-assisted exchange.  Fifteen states have passed such laws.

Under the law, there must be one plan that does not cover abortion and it must be identical to the plan that does cover abortion (if there is a state exchange plan that covers abortion.)  So, if a person does not want abortion coverage, he or she can choose the identical plan within the exchange that does not cover abortion.  So, essentially, only individuals (presumable women) will choose a plan that includes abortion coverage.  And, they will have to pay a separate fee for that coverage.  That’s the funding that a plan must estimate at least $1 per beneficiary—but it only applies in plans covering abortion.[2]

In a September 2011 Op/Ed piece, Attorney Bill Saunders, Senior Vice President of Legal Affairs of Americans United For Life, wrote that while insurance plans within the exchange can include abortion coverage, they are required to collect and separate “two pots of money for premiums.”  More specifically, insurance plans that do cover abortion will be required, under the law, to set up a separate fund and collect an additional fee designated for abortion services.  The provision specifically says that no Federal funds can be used for this purpose and the additional fee must be collected directly from the individual seeking the plan that includes abortion.

No tax subsides (i.e. federal tax dollars) can be used for that purpose; this prevents direct and indirect public funding of abortion.  Saunders accurately assesses that “it is logical” that” some insurance companies may decide to drop insurance coverage for abortion” to “avoid all the mathematic and logistical confusion that the PPACA requires for abortion coverage.”  NARAL’s own analysis agree with Mr. Saunders and concludes that this feature of PPACA “imposes unacceptable new restrictions on abortion that could result in most private health insurers deciding not to offer coverage for abortion.”  Planned Parenthood, too, criticized the language of the new law stating that it is “highly unlikely that insurance companies will be willing to follow such and administratively cumbersome system.”

Mr. Saunders further points out that the PPACA has had an additional effect of pushing private insurance companies outside of the exchange to review policies about forcing individuals to pay for plans that cover abortion.  This has been a serious but often overlooked issue.  In fact, during debate over the legislation, the Republican National Committee (RNC) came under criticism for including abortion coverage in its health care plan.  Mr. Saunders concluded that “between the complications created by the PPACA and individual state decisions to prohibit private abortion coverage, the abortion lobby’s desire for a world where an abortion is viewed and covered no differently than a routine gynecological exam is becoming less and less of a probability.”  That—not the “$1 abortion” claim—is the truth.

Saunders accurately states that “abortion is not healthcare – it hurts women and ends the life of an unborn baby.”  We agree.  Abortion is not health care.  But health care is pro-life.

[1] DFLA does have some strong concerns about the contraception mandate because some forms of birth control are considered abortifiacients – i.e. they prevent a fertilized egg from attaching to the uterine wall and therefore cause a spontaneous abortion.  The Administration issued a compromise, but there are several issues that we still believe need to be addressed with respect to the mandate.  This is a separate issue which we are exploring.

[2] The Stupak/Pitts Amendment, which all but one Republican supported, allowed plans within the Exchange include abortion.  It did not specify the separate fee arrangement, but does allow individuals, to purchase abortion coverage.

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