The hearing on abortion funding got emotional for the 12 male members of the House Judiciary Subcommittee on the Constitution and Civil Justice Thursday.
Republicans continued their fight against abortion in considering the No Taxpayer Funding for Abortion Act, which would prevent women and small businesses from receiving Obamacare tax subsidies for health plans that include abortion coverage, except in cases of rape, incest, or danger to the mother's life.
Unsurprisingly, the hearing became a heated debate over abortion rights, with the congressmen and their three witnesses philosophizing on issues of religion, women's rights, the death penalty, and embryonic stem-cell research. Members tended to tread carefully and sometimes awkwardly, with Republicans declaring their opposition to abortion overall, and Democrats arguing that they were attempting to prohibit women from a constitutionally granted right.
"50 million dead children is enough," Chairman Trent Franks, R-Ariz., said bluntly in his opening statement, referring to the estimated number of abortions performed since the passage of Roe v. Wade.
In fact, federal funding for abortions is already prohibited under the law. If a woman elects to have an abortion, she is personally responsible for the premium to cover that procedure.
"This is a tax increase on women who choose to use their own money on abortion in certain circumstances," said ranking member Jerrold Nadler, D-N.Y.
Federal funding for abortion has been outlawed since the passage of the Hyde Amendment in 1976. The amendment prohibits funding of abortion services through federally sponsored Medicaid coverage.
The Affordable Care Act complicates this issue because it is the first time federal funding is going toward private insurance, in the form of tax credits for low-income consumers. As a result, the law requires abortion services be segregated from subsidized coverage.
The ACA neither requires nor prohibits exchange plans from including abortion coverage; the decision is up to the individual insurer. If a plan offers no abortion services, or offers them only in the case of rape, incest, and life endangerment, federal subsidies can go toward the plan as a whole. If abortions are included beyond these cases, the payment for the service must be made separately from the rest of the premium.
The law mandates that at least one plan be available on each exchange that does not include abortion coverage, should consumers be opposed.
Ultimately, discretion lies with the states, which are able to make the final ruling on inclusion of abortion coverage in exchange plans. Twenty-four states have elected to ban abortion services in their exchange plans thus far.
Those who support the bill worry about breaches in the Hyde Amendment through the exchanges, and they say consumers should not be subsidizing others' abortions. The two majority witnesses argued that most women and low-income individuals are opposed to abortions and do not actually want them included in insurance plans.
Opponents of the bill argue that federal funding is already blocked from abortion services, and the legislation is really an attempt by antiabortion advocates to ban abortions altogether — a claim many in the hearing did not seem to deny.
"Those who oppose abortion have tried and failed to make it illegal, so they're trying to make it almost impossible to obtain," said the minority witness, Susan Franklin Wood, associate professor of health policy and director of the Jacobs Institute of Women's Health at George Washington University.
Wood pointed out that abortion has historically been covered by many private insurance plans, but worries that passage of this bill would create a "chilling effect," causing insurers to end coverage.
The exception for rape and incest would require insurers and the IRS to make a judgment she says they are not qualified to make. "It raises a lot of regulatory, oversight, and implementation concerns that insurers have never been involved in. They could cut out [abortion coverage] entirely to not deal with these determinations."
Passage of the act would still allow states to provide funding for abortion services if they choose to do so. The exception is Washington, D.C., which would not be permitted to use local funds.
The bill would not likely pass the Senate or be signed by President Obama. Still, after 2013 — which saw the second-most abortion restrictions ever enacted by state legislatures in a single year — the hearing Thursday is an indication that House Republicans aren't giving up their fight anytime soon.