In 2009 and 2010, Beltway pro-life groups received a great deal of criticism for their strong opposition to the Affordable Care Act (ACA). Pro-lifers argued that some provisions of the ACA could compromise the conscience rights of employers and might result in greater taxpayer subsidies for abortion, but not everyone agreed. At the same time, many commentators argued that health-care reform would only have a negligible impact on abortion rates. Others tried to make the case that expanding access to health insurance might actually reduce the incidence of abortion.
Recent data from the Alaska Department of Health and Social Services demonstrates that some of these pro-life concerns were warranted. In 2015, Alaska expanded Medicaid coverage under the ACA, and pro-life analysts predicted that this would increase publicly funded abortions in the state. Medicaid expansion was predicted to place anywhere from 10,000 to 15,000 Alaskan women of childbearing age onto a state Medicaid program, which covers abortion. Additionally, Medicaid expansion would likely encourage some women whose insurance plans did not cover abortion to transfer to a Medicaid plan that did.
One year later, new data indicate that those concerns were well-founded. Alaska’s annual abortion report for 2016 shows a sharp increase in both the number and percentage of abortions funded by Medicaid. Total numbers of Medicaid-funded abortions rose from 438 abortions in 2015 to 556 in 2016 — a 27 percent increase. In 2015, Medicaid paid for 33 percent of abortions carried out in the state. By the end of 2016, more than 44 percent of all abortions in Alaska were covered by Medicaid and thus paid for by taxpayers. Public funds covered over 100 more abortions in 2016 than in 2015, even though the overall incidence of abortion slightly decreased over the same period.
The Charlotte Lozier Institute also predicted that Alaska’s Medicaid expansion would encourage abortion by increasing taxpayer funding of Planned Parenthood. The 2016 annual report of Planned Parenthood’s Alaskan affiliate — Planned Parenthood of the Great Northwest and the Hawaiian Islands – shows that 34 percent of Planned Parenthood’s patients in Alaska were Medicaid patients. Although the report does not state how many of these patients received abortions, it is worth noting that all four of Planned Parenthood’s Alaskan health centers perform abortions, making it likely that many of these Medicaid patients were abortion-seeking women.
There is a body of research showing that “big abortion” requires big government. The U.S. abortion rate increased sharply during the 1970s in part because, for much of the decade, abortions for low-income women were paid for with federal Medicaid dollars. However, ever since the Hyde Amendment was upheld by the Supreme Court in 1980 — prohibiting federal funds from directly reimbursing providers for the cost of abortion procedures – abortion rates in the U.S. have consistently fallen. These new data from Alaska illustrate that Obamacare has the potential to reverse decades of pro-life progress by directing a greater amount of public funding to abortion procedures each year.