With the passage of the Patient Protection and Affordable Care Act (PPACA) and the individual mandate, which forces every American to purchase government-approved insurance plans or pay a penalty, came another mandate which many see as an unprecedented threat to their liberty.
Buried within the individual mandate is the “abortion premium mandate.” This mandate requires that all who are enrolled in insurance plans which cover elective abortion must pay a separate premium which serves as a direct abortion subsidy. This mandate could potentially leave many Americans stuck between a rock and a hard place as they must choose between following their consciences and providing for the healthcare needs of their families.
In March 2012, the Department of Health and Human Services issued a final rule regarding the healthcare exchanges. Despite the Hyde Amendment, the annual appropriations limitation which bars federal funds from being used to pay for most abortions, Section 1303 of PPACA prescribes a mechanism for plans that use a separate surcharge in order to cover elective abortions for each enrollee. The surcharge can only be described to the customer during enrollment and the insurance plans may advertise the total cost of the plan while not making known the abortion charge.
The law requires that new exchanges be functional by January 1, 2014, although many states are now balking at setting up their own exchanges. The final rule notes that the federal government will implement and operate an exchange itself in any state which refuses to create one. The number of states that become subject to this approach appears to be increasing as governors and legislatures exercise their right not to enact certain features of ObamaCare.
Meanwhile, with these rules set in place, a growing number of states are moving to bar abortion funding in their exchanges so that they can stop public dollars from being sued to subsidize or extend coverage of abortion. Twenty states have taken action as of February 2013 to prevent elective abortion from being included in their exchanges. Along with states that have prohibited abortion funding via Medicaid, or via state employee insurance and private insurance plans, these states are trying to insure that their rights as states and their citizens’ rights of conscience will be protected.
As all states are required to have an exchange up and running by 2014 or face the prospect of the federal government running an exchange for them, abortion coverage will no doubt continue to be a highly contested issue as each state attempts to apply PPACA to their system. The new law and the liberty of the American people are in a precarious balancing act. In an attempt to preserve their liberty, it is likely Americans will continue to call on their states to take action in order to stop coerced funding of abortion via the new exchanges.
State Abortion Funding Limits
|STATE||Public Funding for Indigent||States Employee Insurance||Exchanges||Private Plans|
|District of Columbia||X|
|TOTAL:||34 states prohibit public funding of abortions for indigent women.||18 states restrict abortion coverage in insurance plans for public employees.||20 states prohibit coverage in plans offered through the exchanges.||8 states have laws restricting insurance coverage of abortion in private insurance plans.|
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[i] Information in this summary is current through February 1, 2013.
[ii] States prohibit coverage of partial birth abortions for public employees, except in cases of life endangerment and “substantial risk of grave impairment of her physical or mental health.”
[iii] Enforcement permanently enjoined by court order.