Obamacare and Abortion

Health overhaul could lead to federal subsidy of abortion, critic says

July 3, 2012

The Supreme Court’s controversial decision last week to uphold the constitutionality of Obamacare is re-igniting the debate over the president’s health care overhaul and public funding of abortions.

Douglas Johnson, legislative director of the National Right to Life Committee, told the Free Beacon recently that "there are a number of different components in Obamacare that would expand abortion" as well as several provisions to fund abortion.

Johnson explained that abortion funding "is always included unless it’s explicitly excluded."

He provided Medicaid as an example: "Medicaid law doesn’t say anything about abortion, so Medicaid began to pay for abortion on demand." According to federal law, "abortions are medical services," he said.

The Hyde Amendment forbids federal funding of abortion, but does not cover the new provisions in the Affordable Care Act.

"Direct appropriations," Johnson explained, fall outside the "regular funding pipeline" of the Department of Health and Human Services (HHS), which the Hyde Amendment covers.

In sworn testimony of October 2010, Johnson recorded the failure of two amendments—Stupak-Pitts and Nelson-Hatch—to the House and Senate versions of the Affordable Care Act.

Each would have ensured that the law could neither directly fund abortion nor subsidize insurance plans including it.

President Barack Obama and then-House Speaker Nancy Pelosi (D., Calif.,) opposed these amendments, and Senate Majority Leader Harry Reid (D., Nev.) wrote a new version of the bill in order to avoid the Stupak-Pitts Amendment.

The Nelson-Hatch Amendment failed in the Senate.

Since these amendments failed, the law became "riddled with provisions that predictably will result in federal subsidies for private insurance plans that cover abortion … direct federal funding of abortion through Community Health Centers, and pro-abortion federal administrative mandates," said Johnson.

He cited four examples.

The Pre-existing Condition Insurance Plan enables the HHS to authorize funding for abortion, Johnson said. Federal subsidies also support private health plans that cover abortion, while the law sends $7 billion into Community Health Centers, which "are not touched by any restriction on their use for abortion in the bill itself or in existing law."

The law also establishes "multi-state" plans to be administered by the Office of Personnel Management, which may cover abortion.

Johnson cited "federal subsidies for private health plans" also covering abortion. The "premium subsidy program," connected with state insurance exchanges, would become effective in 2014.

Under this program, he said, abortion would be "subsidized directly through government funds to insurance companies."

The Congressional Budget Office (CBO) originally estimated that 19 million Americans would receive insurance through the subsidies, but former CBO director Douglas Holtz-Eakin has argued that the number will be closer to 57 million.

This number may increase even further, Johnson explained, because the Supreme Court decided that states do not have to accept expanded eligibility for Medicaid. An estimated 17 million people would receive insurance through Medicaid in the expanded program.

If states choose not to participate, however, they would "push more people into this federal subsidy program."

Johnson said that while a state can stipulate, "no abortion will be subsidized in this state," they "still have to pay federal taxes, which subsidize abortion coverage in every state that doesn’t have an opt-out law."

For example, Virginians may keep the federal money from going to abortion in their state, but their federal taxes would still pay for the practice in Maryland.

"There is no way you can escape it," Johnson said.

The legal authority behind the controversial HHS mandates requiring contraception coverage "could apply to surgical abortion as well," he said.

The Affordable Care Act "gives the Secretary of Health and Human Services the authority to mandate coverage of anything on the list of preventive services."

Johnson speculated that contraceptives, abuse counseling, even medical marijuana could be added to the list of preventive services.

"Surgical abortion," he added, "has been considered a preventive service before."