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I heard that...

...federal funds will be used to pay for abortions if healthcare reform passes. Is that true?

The proposed healthcare reform bills do not change current law prohibiting public insurance programs from paying for abortions, except in the case of incest or rape or to save the life of the mother. Depending on what the final healthcare reform bill looks like, however, it could be argued that federal funds could pay for abortion. There are a number of scenarios, explained below, that raise concerns about this issue.

According to federal law, it is currently illegal for Medicaid, Medicare, or any federally-funded healthcare plan to pay for an abortion, except in the case of incest or rape or to save the life of the mother. The new proposed healthcare reform bills do not change current law for public insurance programs. According to President Obama's speech on September 9th, current law will apply to any proposed options and will not allow any federal dollars to pay for abortions, with the same current exceptions of rape, incest, or to save the life of the mother.

There are three areas of concern regarding federal funds and abortion in the healthcare reform proposals.

  • Federal funds could pay for elective abortions through the proposed public option. The President and others have stated that federal funds will not be used to cover elective abortions for people covered by the public insurance option. If there is a public insurance option, as proposed in the House and Senate bills, people would pay premiums to have that insurance. Under the House bill, H.R. 3962, abortion coverage would be prohibited in the public option. The Senate bill, H.R. 3590, proposes that if the Secretary of Health and Human Services, (HHS) can guarantee that the premium funds can be separated from federal funds, then abortion coverage could be offered in the public option, but cannot be required as part of the essential benefits package. The National Right to Life Committee's (NRLC) interpretation of this is that once a premium is paid to the HHS for the public insurance coverage, those premiums are no longer private dollars and become federal funds. If those funds are then used to pay for an abortion, the NRLC and others believe that the federal government is paying for abortions.

     

    Since the public option will be managed by HHS, the NRLC might have an argument that federal dollars would be paying for abortions. Others would argue that an individual has the right to purchase abortion coverage and that her premiums should be viewed as private funds as they would if the individual purchased private insurance coverage. If the final proposal does not include a public insurance option, the issue of abortion being covered in a public plan will be irrelevant.

  • Insurance plans offered through government-run insurance exchanges could cover abortions and this will mean that public funds are used to pay for abortions. The current House and Senate proposals include the idea of government-run insurance exchanges, or central marketplaces where people or businesses can shop for and purchase health insurance. Some plans offered through these exchanges might include coverage for abortions. Since the government will administer the exchanges using public funds, some people equate this with having public dollars paying for abortions.

     

    This will not be true. If the exchanges are set up based on the guidelines in the current proposals, public funding used to run the exchanges will not be given to insurance providers. The public funds will be used to set up the exchanges and help people find insurance that fits their needs. These public funds will not be used to pay for care.

  • People who qualify for government subsidies to purchase private insurance could use their government subsidy to pay for abortion coverage. Some healthcare reform proposals include government subsidies to help lower-income Americans buy private insurance. Currently, 87% of employer-based private health insurance plans cover abortions (Sonfield, Gold, Frost, and Darroch, 2004). If a person getting a subsidy chooses to buy private insurance that covers an abortion through the insurance exchange, some people feel that is the same as public money paying for an abortion. Both the Senate and House proposals require that the funds used to cover abortion services offered through a subsidized private plan must come from personal premiums so that the federal subsidy does not pay for an abortion.

Sources:

Sonfield, A., Gold, R. B., Frost, J. J., & Darroch, J.E.. (2004, March-April). U.S. insurance coverage of contraceptives and the impact of contraceptives coverage mandates, 2002. Perspectives on Sexual and Reproductive Health, 36, 72-79. http://www.nrlc.org/AHC/NRLCmemoFederalFundsnotPrivateFunds.html http://energycommerce.house.gov/Press_111/20090730/hr3200_capps_1.pdf

Additional Resources

House Health Care Bill Criticized as Panel Votes for Public Plan, New York Times

Religious Progressives Raise Concerns About Abortion in Healthcare Reform, U.S. News & World Report

Since 1997, The Health Foundation of Greater Cincinnati has invested over $111 million in projects that improve the health of the Cincinnati area. With major healthcare reform imminent, the Health Foundation aims to be a source for credible, timely information that can inform people in our region about the healthcare reform debate. While we do not support any specific plan or approach, we do support certain principles that we believe would improve access to healthcare and make our region healthier.

The Health Foundation supports a healthcare system that:

Please visit http://www.healthfoundation.org/reform for more information.