The House passed a bill Tuesday that ultimately seeks to limit abortion services by keeping federal dollars as far away from them as possible.
The No Taxpayer Funding for Abortion Act, or H.R. 7, was approved on a 227-188 vote Tuesday. The bill would expand restrictions on funding in light of the federal subsidies now available for private insurance plans under the Affordable Care Act.
The bill is a bit of a misnomer, as federal funding is already largely prohibited from going toward abortion services. The Hyde Amendment, first passed in 1976, bars such funding except in cases of rape, incest, or endangerment to the pregnant woman. The provision is not permanent law, but it is passed each year as a rider to the appropriations bill.
Until the ACA, the Hyde Amendment applied primarily to Medicaid, as the major vehicle for publicly funded care. However, the health care law complicates things, as it is the first time federal funding is going toward private health plans, in the form of tax credits to low-income individuals. As a result, President Obama signed an executive order in 2010 that prevents the subsidies from being used for abortion services.
However, the No Taxpayer Funding for Abortion Act would take restrictions further, essentially codifying and significantly expanding the Hyde Amendment. The bill seeks to make the amendment permanent law, and to prevent federal funds from going not just toward abortions themselves but toward any plan, provider, or facility that offer such services.
The ACA does not prevent insurance plans from including abortion coverage, although every exchange must include one plan that does not.
If a plan does not offer abortion coverage, or offers it only under the three exceptions, then there is no conflict and federal subsidies may be applied to the plan in full. If the plan does include abortion coverage, subsidies may go toward the rest of the plan except those services. If a woman elects to have an abortion, the cost of that procedure is separate from the rest of her premium, and she is fully responsible.
H.R. 7 would prevent subsidies from going to these latter plans at all, for both individuals and small businesses. The bill would ban federal funds from being applied to any health plan that includes abortion coverage, and would prohibit any federal or D.C. health facility, and any provider employed by the federal government or D.C., from offering those services.
This means that small businesses and individuals would need to select only plans that do not cover abortion, or forgo the tax credits they are eligible for, regardless of whether the consumers actually use the abortion services.
The bill gives insurers a big incentive to drop abortion coverage from their plans, or risk losing the large pool of consumers who receive the law's subsidies. Abortion coverage is historically relatively ubiquitous in health plans, so the effect could be far-reaching.
Supporters of the bill argue that the separation currently in place is not sufficient, and that taxpayers will end up subsidizing others' abortions through their premiums. Many have not been shy in acknowledging that the elimination of abortion services is their ultimate goal.
"During the time the Hyde Amendment has been in place, probably millions and millions of innocent children and their mothers have been spared the horrors of abortion," Chairman Bob Goodlatte said at the House Judiciary Committee's markup of H.R. 7 this month. "The policy we will be discussing today has likely given America the gift of millions more children and, consequently, millions more mothers and millions more fathers, millions more lifetimes and trillions more loving gestures and other human gifts in all their diverse forms."
Abortion-rights supporters point to that goal in their arguments against H.R. 7. They say the bill would penalize women for obtaining services that aren't related to abortion and would cause insurers to drop coverage, limiting access to abortion. Furthermore, they say, the bill would put the determination of rape or incest under the jurisdiction of the IRS rather than providers, because it is the agency overseeing the ACA tax credits.
"The real goal of this bill is to make abortion and coverage for abortion services paid for by private individuals with their own money unavailable," said ranking member John Conyers. "It does it by adding restrictions and imposing an unprecedented penalty under the guise of the federal tax code on privately funded health care choices made by women in consultation with their families and their faith."
States could still choose to provide their own funding for abortion services under the bill, but not D.C. This would leave women in the District without any real recourse for assistance.
The vote comes as the Republican Party is demonstrating renewed enthusiasm for its base's antiabortion message.
The Republican National Committee passed a resolution last week that encourages candidates to speak up against abortion and the "war on women" narrative. Although the majority of the public remains in favor of upholding Roe v. Wade, the GOP wants to focus the debate on specific, contentious elements — such as taxpayer funding — to paint Democrats as extremists.
Republican state officials have passed a record number of abortion restrictions in recent years — 205 in the past three years, with 70 in 2013 alone, according to a recent analysis by the Guttmacher Institute — but H.R. 7 would take a big step in limiting abortion access on a national level.
The Senate is unlikely to pass the No Taxpayer Funding for Abortion Act, and the White House issued a statement Monday strongly opposing the bill.