The Patient Protection and Affordable Care Act, Section 1303, "Special Rules,” page 50, signed into law on Mar. 23, 2010, available at www.thomas.gov, states:
"(a) STATE OPT-OUT OF ABORTION COVERAGE.—
(1) IN GENERAL.—
A State may elect to prohibit abortion coverage in qualified health plans offered through an Exchange in such State if such State enacts a law to provide for such prohibition...
(A) IN GENERAL.—
Notwithstanding any other provision of this title (or any amendment made by this title)—
(i) nothing in this title (or any amendment made by this title), shall be construed to require a qualified health plan to provide coverage of services described in subparagraph (B)(i) or (B)(ii) as part of its essential health benefits for any plan year...
(B) ABORTION SERVICES.—
(i) ABORTIONS FOR WHICH PUBLIC FUNDING IS PROHIBITED.—The services described in this clause are abortions for which the expenditure of Federal funds appropriated for the Department of Health and Human Services is not permitted, based on the law as in effect as of the date that is 6 months before the beginning of the plan year involved.
(ii) ABORTIONS FOR WHICH PUBLIC FUNDING IS ALLOWED.—
The services described in this clause are abortions for which the expenditure of Federal funds appropriated for the Department of Health and Human Services is permitted, based on the law as in effect as of the date that is 6 months before the beginning of the plan year involved."
The US Government Accountability Office (GAO) report titled "Health Insurance Exchanges: Coverage of Non-Excepted Abortion Services by Qualified Health Plans," published on Sep. 15, 2014 and available at gao.gov, stated:
"Consistent with federal and state law, QHPs [qualified health plans] may cover... benefits, such as abortion services. PPACA prohibits the use of federal funds made available to offset the cost of QHP coverage—that is, income-based tax credits and subsidies—to pay for 'non-excepted abortion services,' which, based on the law applicable to the 2014 benefit year, are abortion services performed except where the pregnancy is the result of an act of rape or incest, or the life of the pregnant woman would be endangered unless an abortion is performed. While QHPs may cover non-excepted abortion services, PPACA places requirements on the provision of such coverage. These include the requirement to estimate the cost of coverage of such services, at an amount of no less than $1 per enrollee, per month, and to collect from each enrollee an amount equal to the actuarial value of the coverage—segregated from any other premium amounts collected by the QHP—to be used to pay for the costs associated with providing non-excepted abortion services...
[I]n the course of our work, we identified instances where practices of private issuers and others may have been inconsistent with federal requirements related to the coverage of non-excepted abortion services.
Fifteen issuers and the Washington Health Benefit Exchange... did not itemize the premium amount associated with non-excepted abortion service coverage on enrollees' bills nor indicate that they send a separate bill for that premium amount."
The Catholic Health Association of the United States said in its Sep. 17, 2014 statement published on chausa.org under the title "CHA Responds to Government Accountability Office Report":
"CHA was concerned to read in the GAO report that there were apparently some instances in certain states where the provisions to protect against federal funding of abortion appear not to have been implemented as required by the ACA law and the executive order that accompanied it.
We recognize that there are 50 different states with 50 different insurance commissioners and regulations, as well as over 2,000 different insurance plans. This represents a real challenge for monitoring, but it must be done. The ACA law requires it. We were pleased to see that CMS recognized this and is committed to working with qualified health plans and state insurance departments to address this critical issue.
It is important to recognize that the ACA law explicitly forbids the use of federal funds for abortion except in the cases covered by the Hyde Amendment. This critical provision must be adhered to in every state, irrespective of how challenging it is to monitor."
Does Obamacare Fund Abortion Services for Cases Other Than Rape, Incest, or to Save the Life of the Mother?
Mary Harned, JD, Staff Counsel for Americans United for Life, stated in her Sep. 16, 2014 article for National Review titled "GAO Says Abortion Coverage 'Inconsistent with Federal Requirements' in Obamacare Exchanges":
"Sadly, and at last, a new report by the federal Government Accountability Office (GAO) has revealed that the Obama administration has utterly failed to keep its promises to prevent taxpayer funds from being used to pay for abortions in insurance plans offered through exchanges established under the Affordable Care Act (ACA)...
Issuers of insurance plans that cover abortions in state exchanges are supposed to collect from enrollees a 'separate payment' for abortion coverage (i.e., the abortion premium) and a 'separate payment' for everything else. Federal funds should only be comingled with the second pot of money.
The language in the law is unambiguous — 'separate payments' are required. Yet, insurance issuers are not collecting separate payments...
Further, under the ACA the abortion premium is supposed to be 'segregated' from any federal subsidies, with issuers filing 'segregation plans' with their state health-insurance commissioner explaining how they will maintain the integrity of taxpayer funding.
...[A]t least one state department of insurance was unaware that issuers needed to file their plans for segregating the abortion premium from taxpayer funds with the state. At least two issuers indicated that they had not filed segregation plans, and at least one was not aware of any direction by the state to file such a plan."
Randy Hultgren, JD, US Representative (R-IL), stated on Sep. 17, 2014 in prepared remarks delivered on the House floor and available on hultgren.house.gov under the title "Watch: Obamacare Forces Taxpayers to Cover Abortion on Demand, GAO Report Confirms":
"I rise today disturbed by a report confirming that the Affordable Care Act provides for a massive expansion of abortion, funded by the taxpayer. This week, the non-partisan Government Accountability Office revealed that 1,036 of the plans offered under Obamacare, and eligible for taxpayer subsidies, cover abortion on demand. Although the President promised in 2009 that no federal dollars would be used to fund abortions, the law’s accounting gimmicks showed otherwise...
Clearly, there’s been a lack of full disclosure by the administration and the insurance companies who have ignored the law, a law which failed to provide adequate safeguards for the taxpayer. Many Americans are thus unwittingly paying for a procedure which violates their most deeply held beliefs."
John Boehner, Speaker of the US House of Representatives (R-OH), said in his Sep. 16, 2014 statement published on speaker.gov under the title "Boehner: GAO Report Confirms Taxpayers Fund Abortions Through ObamaCare":
In 2010, President Obama and the leaders of the Democratic majority in Congress rammed through a government takeover of America’s health care system over the objections of the American people. The measure passed the House in part because the White House and Democratic leaders insisted that ObamaCare would not use taxpayer funds to support elective abortions.
Today’s GAO [Government Accountability Office] report confirms that under the president’s health care law, abortions are being paid for with taxpayer funds by more than 1,000 exchange plans across the country. This information has been hidden from the American public for years by the Obama Administration, which repeatedly denied congressional requests for its public release."
Chris Smith, US House Representative (R-NJ), stated in an undated response to the Jan. 26, 2015 Washington Post article titled "Does Obamacare Provide Federal Subsidies for Elective Abortions?," written by Michelle Ye Hee Lee and available at washingtonpost.com:
"[T]he President's health care law authorized massive subsidies to assist millions of Americans to purchase private health plans that cover abortion on demand...
In order to gain the votes of several pro-life holdout congressional democrats needed for passage of the Affordable Care Act, President Obama issued an executive order on March 24, 2010 that said: 'the Act maintains current Hyde Amendment restrictions governing abortion policy and extends those restrictions to newly created health insurance exchanges.'...
Recent history now shows the President’s solemn promise to extend Hyde to the Affordable Care Act was a lie.
While the Hyde Amendment prohibits federal funds to any health plan that includes abortion except for rape, incest or to save the life of the mother, the Secretary of the Treasury pursuant to notice by the Secretary of Health and Human Services, is today making monthly advance payments with U.S. taxpayer funds to insurance companies or to exchanges to pay for health insurance plans that subsidize abortion on demand.
It couldn’t be more clear—the President is not extending the Hyde Amendment to the 'newly created exchanges'."
The United States Conference of Catholic Bishops stated in its Sep. 16, 2014 press release titled "Cardinal O'Malley: Government Report Confirms Bishops' Concern on Abortion Coverage," available on usccb.org:
Despite repeated claims by President Obama and other supporters that the ACA would not promote abortion, the [Government Accountability Office] report identified over a thousand health plans eligible for federal premium subsidies that cover elective abortions. On five state exchanges, every plan covers such abortions in 2014; in another three large states, 95 to 98 percent of the plans do so. The Act’s alleged requirements regulating abortion coverage do not exist or are widely ignored. Many health plans do not inform enrollees about their inclusion of abortion coverage; they do not tell them how much they are being charged for such coverage; and they do not charge a 'separate payment' for abortions that is distinct from the premium payment eligible for federal tax subsidies. While state insurance departments are supposedly tasked by the federal government with ensuring that these health plans maintain segregated accounts for abortion funds to keep them separate from federal funds, the report indicates that this is not taking place.
Matthew Clark, JD, Associate Counsel with the American Center for Law and Justice (ACLJ) in Media and Government Affairs, stated in his Jan. 18, 2012 article "How ObamaCare Uses Taxpayer Money to Pay for Abortions," available at www.aclj.org:
"...[T]here is no language in ObamaCare that prevents tax dollars from being used to pay for abortions. The proposed amendment to ObamaCare that would have prevented all taxpayer funding for abortions that was debated in Congress, known as the Stupak-Pitts Amendment, was not included in the final bill signed by President Obama...
...[T]he Executive Order signed by President Obama, which he claimed would ‘ensure that Federal funds are not used for abortion services,' did not prevent taxpayer funds from being used for abortions...
The bottom line is because the law fails to contain any provision actually preventing federal funds from being used to subsidize insurance plans that cover abortions, ObamaCare greatly increases taxpayer funding for abortions."
NARAL Pro-Choice America, formerly known as the National Association for the Repeal of Abortion Laws, stated in its Jan. 1, 2015 fact sheet titled "Nelson Provisions in Affordable Care Act Could Jeopardize, Stigmatize Women's Access to Abortion Services," available at prochoiceamerica.org:
"[S]egregating funds into two accounts, as is required by the health-care law, is a sufficient means of separating federal dollars from those used to cover abortion services. Many programs that receive federal funds do just this: firewalls are utilized to segregate federal dollars from private funds used for unauthorized purposes—such as covering abortion care or funding religious activities...
The Affordable Care Act explicitly bans federal funds from being used to pay for abortion services, except where the pregnancy threatens the life of the woman or the pregnancy is the result of rape or incest... Indeed, in August 2011, a federal court ruled in Susan B. Anthony List v. Driehaus that the Affordable Care Act does not impermissibly fund abortion services, finding that '[t]he express language of the PPACA does not provide for tax-payer funded abortion. That is a fact, and it is clear on its face.'"
The Henry J. Kaiser Family Foundation stated in a Sep. 19, 2014 issue brief titled "Coverage for Abortion Services and the ACA," written by Alina Salganicoff, Adara Beamesderfer, Nisha Kurani, and Laurie Sobel, and available at kff.org:
"Since 1977, federal law has banned the use of any federal funds for abortion, unless the pregnancy is a result of rape, incest, or if it is determined to endanger the woman’s life. This rule, also known as the Hyde Amendment, is not a permanent law; rather it has been attached annually to Congressional appropriations bills, and has been approved every year by the Congress...
The ACA reinforces the current Hyde Amendment restrictions, continuing to limit federal funds to pay for pregnancy terminations that endanger the life of the woman or that are a result of rape or incest... State Medicaid programs continue to have the option to cover abortions in other circumstances using only state funds and no federal funds. President Obama issued an executive order as part of health reform that restated the federal limits specifically for Medicaid coverage of abortion."
The White House website posted the following on its webpage "Myths & Facts," available at www.whitehouse.gov (accessed Sep. 6, 2012):
"Health insurance reform will NOT use your tax dollars to fund abortions.
The health insurance reform legislation maintains the status quo of no federal funding for abortions, except in cases of rape, incest or when the life of the woman is endangered."
Erin Shields, a spokeswoman for the Department of Health and Human Services, stated in her Apr. 2, 2012 article, "Obamacare 'Abortion Surcharge': The Facts Behind the Rumor," available online at www.huffingtonpost.com:
"Under the new health care law, federal funds continue not to be used for abortion services, except those in cases of rape or incest or where the life of the woman is endangered. No one will be required to choose a plan that covers these services and no taxpayer dollars will be spent on them. Before choosing a health plan, consumers will know whether the plan covers these services. And if it does, payments will be made into a separate account to ensure no federal dollars fund these services."
Norman K. Moon, JD, Senior US District Judge serving in the Western District of Virginia, stated the following, on Nov. 30, 2010, in his opinion in a lawsuit filed by Liberty University challenging Obamacare:
"…[T]he Act… contains strict safeguards at multiple levels to prevent federal funds from being used to pay for abortion services beyond those in cases of rape or incest, or where the life of the woman would be endangered...
In plans that do provide non-excepted abortion coverage, a separate payment for nonexcepted abortion services must be made by the policyholder to the insurer, and the insurer must deposit those payments in a separate allocation account that consists solely of those payments; the insurer must use only the amounts in that account to pay for non-excepted abortion services."
Barack Obama, JD, 44th President of the United States stated the following in his Mar. 24, 2010 executive order 13535 "Ensuring Enforcement and Implementation of Abortion Restrictions in the Patient Protection and Affordable Care Act," available at www.whitehouse.gov:
"Following the recent enactment 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 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)...
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)."
Brooks Jackson, Director of FactCheck.org, stated in a July 22, 2010 article, "Taxpayer-Funded Abortions in High Risk Pools," available at www.factcheck.org:
"The claim that the new federal health care law will use taxpayer funds to pay for abortions through 'high-risk pools' originated when the National Right to Life Committee issued a press release July 13. It said that Washington had approved a new insurance program that 'will cover any abortion that is legal in Pennsylvania.' Abortion foes also raised alarms about similar federally subsidized insurance pools being put together in New Mexico and Maryland...
State and federal officials have since scrambled to clarify their intentions. Pennsylvania officials issued a statement on July 15 saying that for any abortions performed because of reasons other than rape, incest or a threat to the mother's life, women 'will have to pay for them out their own pocket.' And New Mexico backed down just as quickly, issuing a July 15 statement saying 'elective abortion is not and has never been intended to be a benefit.'...
…[W]hatever Pennsylvania officials intended the stated federal policy is now clear: No abortions will be covered by the temporary risk pools except for those in cases of rape or incest, or to save the life of the mother."