A recent fund-raising letter from Democrats for Life (DFL) may have caused confusion about Americans United for Life’s position on the Patient Protection and Affordable Care Act (ACA), by suggesting that AUL somehow sees ACA as a pro-life law. Let’s be clear: this is the opposite of AUL’s view; AUL has been and remains one of the strongest critics of ACA due to its anti-life aspects. This has been clearly documented on our website and in many articles related to ACA.
Here is a brief recap on how ACA is not a pro-life law:
1. The ACA does not comprehensively prohibit the use of federal tax dollars authorized by and/or appropriated through the act for abortions or abortion coverage. This failure has already seen repercussions — several states attempted to include abortion coverage in their high-risk pools. Only after their efforts were exposed did HHS issue regulations prohibiting abortion coverage through the pools; however, Nancy-Ann DeParle, director of the White House Office of Health Reform, clarified that the restriction on abortion coverage “is not precedent” for other programs or policies covered by the ACA.
2. The ACA permits Qualified Health Plans (QHPs) to provide abortion coverage to enrollees through state exchanges. #more#The premium segregation requirement designed to prevent federal subsidies from being used to directly pay for abortions through QHPs does not alter the fact that the act departs from the status quo on abortion funding — the Hyde Amendment and other federal programs such as the Federal Employee Health Benefits Program (FEHBP) prohibit federal subsidies from supporting insurance plans that cover abortions, regardless of whether the federal dollars are used to directly pay for abortions.
3. The premium segregation requirement in the ACA is dependent on the continued existence of the Hyde Amendment. In other words, if Congress ever fails to add the Hyde Amendment to the yearly Labor, Health & Human Services (LHHS) Appropriations Bill — an omission the abortion lobby actively fights for — insurance plans that cover abortions within state exchanges will be permitted to directly use federal subsidies to pay for abortions.
While abortion funding and coverage under the Indian Health Care Improvement Act is prohibited, this prohibition is also dependent on an annual appropriations rider.
4. AUL warned that the “preventive care” mandate in the ACA could be used to require insurance plans to cover abortions or abortion-inducing drugs. As we expected, the Health Resources and Services Administration (HRSA) is mandating that insurance plans fully-cover “all Food and Drug Administration approved contraceptives [and] sterilization procedures.” This mandate includes drugs and devices with known life-ending mechanisms of action, including the abortion-inducing drug ella.
5. While at least one multi-state qualified health plan in an exchange must not provide coverage for abortion, abortion coverage is otherwise permitted in the multi-state qualified health plans.
6. While the ACA prohibits discrimination by insurance plans participating in the new government exchanges against a health-care provider or health-care facility unwilling to provide, pay for, provide coverage for, or refer for abortions, it does not proscribe discrimination by government entities. This falls short of the protection encompassed in the Hyde-Weldon Amendment, added annually to LHHS appropriations bill.
7. The ACA fails to ensure that its provisions will not preempt state law conscience protections. This failure already has tangible consequences; it allows the HRSA preventive services mandate to disrupt the conscience protections for health-care payers that are contained in the laws of several states.
So, no, the ACA is not pro-life on abortion. The paltry “limitations” on abortion in the bill are largely tied to annual appropriations riders that could be eliminated at the whim of a Congress. For the first time, insurance companies are going to be required by federal law to cover abortion-inducing drugs. And insurance plans that cover abortions can benefit from taxpayer subsidies, with states’ only recourse being to pass a new law prohibiting the practice. Are we clear now?
— Mary Harned is staff counsel with Americans United for Life. William L. Saunders is senior vice president of legal affairs.