GAO Says Abortion Coverage ‘Inconsistent with Federal Requirements’ in Obamacare Exchanges

by Mary Harned

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). And the administration accepts no responsibility for this failure.  

Given the ACA’s extensive list of shortcomings and controversies, the GAO report may elicit little more than a yawn from the media. Yet, the report is stunning in that it documents how the Obama administration has abandoned and even undermined the very promises that enabled the health-care legislation to pass the U.S. House of Representatives.

When objections to taxpayer funding for abortion or abortion coverage nearly brought down the bill, it took an eleventh hour “compromise” — statutory language provided by Senator Ben Nelson (D., Neb.) and a promised executive order — to save the ACA. Now, over four years later, the GAO report confirms that the abortion deal was effectively meaningless.

We hate to say we told you so, but here goes: We told you so.

At the heart of Senator Nelson’s language is an accounting mechanism intended to ensure that federal funds are not used to directly pay for abortions. 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. In fact, the Obama administration is telling issuers that they do not need to collect two checks. When issuers seek guidance from the Centers for Medicare & Medicaid Services (CMS), they are told that they can merely itemize the amount of a premium that will be used to pay for abortions. 

However, insurance issuers are not doing even this — the GAO found that insurance issuers are not itemizing the abortion premiums nor sending a separate bill for the premiums. 

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.   

Astonishingly, while the “segregation plans” were not the focus of their report, GAO uncovered evidence that at 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. 

CMS told GAO that neither the ACA nor CMS regulations “require” an issuer to file a segregation plan. Yet, President Obama waxed eloquent in his executive order about how this accountability would ensure that taxpayer funds are not used for abortion.

The GAO notes that if insurance issuers do not file such plans, “It is unclear how state departments of insurance are to ensure that issuers are complying with [the ACA’s] segregation requirements.” 

Exactly.

States that do not require these “segregation plans” cannot know if and how much taxpayer funding is being used to pay for abortions. Insurance issuers who are not collecting separate payments or even itemizing abortion premiums are not likely to be keeping abortions premiums separate from federal funds. 

So, abortions are being paid for out of federally subsidized premiums. That is taxpayer funding for abortion, people. What was that promise that President Obama made back in 2009, again?

— Mary Harned is staff counsel for Americans United for Life.

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