A proposed bill would impose a far-reaching ban on private insurance coverage for abortions under Obamacare, and could see tens of thousands lose out
Republicans in Congress are advancing a bill that imposes a far-reaching prohibit on private insurance coverage for abortion services for as long as the Affordable Care Act remains in effect and would build permanent a longtime banning on the use of Medicaid to cover abortions.
The bill, H R7, would be facilitated Donald Trump to fulfill a promise that helped his volatile presidential campaign procure the purposes of major anti-abortion rights activists. In an open letter published in September, he vowed to sign the Hyde amendment, a perennial budget rider that Congress has approved every year for 40 years, into permanent law. Since 1976, the Hyde amendment has prevented millions of women who rely on Medicaid, the government-funded insurance for low-income individuals, from utilizing it to cover their abortions.
But if the bill passes, the most immediate changes will be felt on insurance policies exchanges where millions of women buy healthcare coverage.
HR7 prohibits insurance carriers from offering policies that contain abortion coverage on the exchanges set up under Obamacare to sell insurance coverage to individuals. It proscribes low-income women who qualify for a healthcare subsidy from receiving it if they buy a healthcare plan that covers abortion. And it would withhold the small business taxation credit from employers who offer policies with abortion coverage.
Critics of HR7 fear it could impose a widespread ban on private insurance coverage of abortion by banning abortion coverage in the smaller subset of private insurance policies that are sold on the Affordable Care Act exchanges.
Because many insurance carriers offer policies to individuals on the exchanges that are similar to the group policies they sell to companies, covering abortion in one case but not the other requires an extra layer of administration.
Health experts said they could not be certain that would be the outcome.
What that would do to other plans, we dont genuinely know, said Laurie Sobel, the associate director for womens health policy for the Kaiser Family Foundation, a healthcare think tank. But she noted that after Obamacare began necessitating health care policies to offer contraceptive coverage, insurance carriers enforced the coverage in the same route across the market for group and individual policies alike.
With very limited exceptions, health insurance companies basically did the same thing with everybody, Sobel said. That is worrisome in terms of, if abortion coverage was restricted in the marketplace, insurance companies might just adopt that policy across the board.
The ban on using subsidies or taxation credits toward policies with abortion coverage has the potential to impact significant changes, because carriers could be reluctant to design plans that so many women or small business owners would be ineligible to buy. In 2016, there were 871,000 uninsured females eligible to buy policies containing abortion coverage utilizing subsidies, according to the Kaiser Family Foundation.
Under the bill, tens of thousands more who have already used their subsidies to purchase insurance would lose abortion coverage.
The bills restrictions on the health insurance exchanges would cease to apply if and when legislation passed by Republican in Congress repeals the Affordable Care Act. But the bill is almost certainly a preview of the length to which Republicans will go to restrict abortion when they come to replace Obamacare.
Its a pretty sweeping bill, said Destiny Lopez, a director of All Above All, a coalition of abortion rights groups that opposes the Hyde amendment. Its an attempt to withhold abortion from nearly all women in the US through burdensome regulation intended to stop insurers from encompassing abortions. It could curtail abortion for nearly every woman in this country in some manner, and do significant damage including with regard to to low-income women.
Insurance coverage for abortion is already limited in a way that forces thousands of women to pay for abortions out of pocket. Twenty-five states restrict the sale of insurance policies encompassing abortion on their nation exchanges. And exchanges in six other countries dont offer any schemes that cover abortions, possibly because Congress enforced extra administrative obstacles under the ACA for providing abortion coverage.
A 2013 study found that merely about a quarter of abortion patients who had insurance used it to cover their procedure. Those who didnt use their insurance overwhelmingly said their insurance did not cover abortion or they werent sure.
The bill would also convert a slew of existing, provisional bannings on abortion coverage into permanent statute. These include outlaws on abortion coverage for women on federal insurance, such as many Native American girls, women in the Peace Corps, in federal prisons, or those enrolled in Medicare or the Youngster Health Insurance Program, and prohibit the city of Washington DC fromusing its own local funds to subsidize abortion services.
The House of Representatives approved a version of the bill on Tuesday, and the Senate will consider similar legislation next week. But Republican in that chamber may be required to peel off eight Democratic or independent votes for the 60 needed to overcome a filibuster. Unless Republican leaders change the Senates regulations to remove the filibuster, the fate of the bill may lie with Democrat facing re-election in 2018 in states that voted for Trump.
Were confident that the Senate will continue to be a firewall on this issue, said Lopez.
Also on Tuesday, Republican introduced a federal heartbeat bill that they say would effectively eliminate abortion, but is less likely to pass even the House.
Despite Hydes longevity, progressive lawmakers in recent years have adopted efforts to see it overturned. Even Hillary Clinton, in her 2016 bid for the presidency, promised to attempt to remove Hyde from future budget bills. HR7, although it does not change the fact that women on Medicaid have long been forced to pay for any abortion services out of pocket, would make it harder for a future Democratic Congress or chairman to do so.
HR7 is titled the No Taxpayer Funding for Abortion and Abortion Insurance Full Disclosure Act of 2017. Republican congressman Chris Smith of New Jersey introduced the bill in early January, as he has for several years running.
At an event to announce the bill, Smith said he supports repealing and replacing the Affordable Care Act, but that it is necessary to restrict the ways in which the law facilitates abortion coverage until that time.
No one knows how quickly the replace portion will actually occur, Smith said. In the meantime, the unborn child is about to be killed with public fund. We need to enact a statute that takes abortion out of[ Obamacare ].
This article has been amended on 25 January, 2017, to correct an assertion that the contraception mandate did not apply, initially, to all insurance plans.