A proposed bill would enforce a far-reaching prohibit 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 prohibition on private insurance coverage for abortion services for as long as the Affordable Care Act remains in effect and would induce permanent a longtime forbidding on the use of Medicaid to cover abortions.
The bill, H R7, would allow Donald Trump to fulfill a promise that helped his volatile presidential campaign procure the support 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 feel 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 people. It proscribes low-income women who qualify for a healthcare subsidy from receiving it if they purchase 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 enforce a widespread forbid on private insurance coverage of abortion by banning abortion coverage in the small 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, encompassing 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 schemes, we dont actually 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 involving health care policies to offer contraceptive coverage, insurance carriers enforced the coverage in the same way across the market for group and individual policies alike.
With very limited exceptions, health insurance companies essentially 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 could also consequence significant changes, because carriers could be reluctant to design plans that so many women or small business owners would be ineligible to purchase. In 2016, there were 871,000 uninsured women eligible to buy policies containing abortion coverage use subsidies, according to the Kaiser Family Foundation.
Under the bill, tens of thousands more who have already utilized 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 lengths to which Republican 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 alliance 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 covering abortions. It could restrict abortion for nearly every woman in this country in some manner, and do significant damage in particular 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 nations limit the sale of insurance policies encompassing abortion on their country exchanges. And exchanges in six other states dont offer any plans that encompass abortions, perhaps because Congress imposed extra administrative hurdles under the ACA for abortion coverage.
A 2013 study found that only 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 bans on abortion coverage into permanent law. These include bannings 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 towns 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 Republicans in that chamber will need to peel off eight Democratic or independent votes for the 60 needed to overcome a filibuster. Unless Republican leaders change the Senates regulations to eliminate the filibuster, the fate of the bill may lie with Democrats facing re-election in 2018 in states that voted for Trump.
Were confident that the Senate will continue to be a firewall on this matter, said Lopez.
Also on Tuesday, Republicans 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 president 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 proportion will actually occur, Smith said. In the meantime, the unborn child is about to be killed with public funding. We need to enact a ordinance that takes abortion out of[ Obamacare ].
Such articles has been amended on 25 January, 2017, to correct an assertion that the contraception mandate did not apply, initially, to all insurance schemes.