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The Alexander-Murray Health ‘Deal’ Sends Tax Dollars To Abortion Coverage


Update: The bill was released late last night and does not include any restrictions of federal funding to insurance plans that pay for abortions.

Amidst the rumored press reports about what the supposed “insurer stabilization bill” negotiated between Senate Health, Education, Labor, and Pensions Committee Chairman Lamar Alexander (R-TN) and Ranking Member Patty Murray (D-WA) may contain, one Twitter commenter made an astute observation: Unless the agreement contained explicit language forbidding it—language Murray likely would not endorse—the agreement will appropriate approximately $25-30 billion to subsidize insurance plans that cover abortion.

That fact alone should give conservatives pause. Coming on a week when Senate Republican leaders seek to pass a budget precluding another attempt to defund Planned Parenthood, the nation’s largest abortion provider, the Alexander-Murray deal would not only fail to advance the pro-life cause, it would, by extending subsidies to insurers who cover abortions, actively undermine it.

Follow the Money

Here’s some background regarding federal restrictions on abortion funding. The Hyde Amendment, named for former Rep. Henry Hyde (R-IL), prohibits federal funding of abortion, except in the cases of rape, incest, or to save the life of the mother.

However, this restriction, first enacted in 1976 and renewed every year thereafter, only applies to the Department of Health and Human Services (HHS) appropriations bill to which it is attached annually. If funding flows outside the HHS appropriations measure, those funds would not be subject to the Hyde restrictions, and could therefore subsidize abortion coverage.

Obamacare contained just such funds—for instance, the premium tax credits used to subsidize plans on insurance exchanges. While Obamacare includes a “segregation mechanism” designed to separate the portion of premium payments used to cover abortion, pro-life groups have recognized this mechanism as an accounting gimmick—one the Obama administration didn’t even bother to enforce.

Is Hyde Language Added?

Obamacare included other funding that recipients could use for abortion coverage. Section 10503 of the law appropriated $9.5 billion for community health centers from 2010 through 2015. Because the legislation made such funding mandatory—that is, appropriated federal tax dollars outside the annual HHS spending bill to which the Hyde Amendment applies—recipients of that $9.5 billion could have used the federal dollars to fund abortions.

When extending the community health center funding as part of a larger Medicare bill in spring 2015, Republican leaders recognized the lack of pro-life protections, and insisted on adding them to extend the mandatory health center funding. As a result, Section 221(c) of the bill (page 68 here) said that the same requirements that applied to other Public Health Service Act funding provisions—that is, the Hyde Amendment funding restrictions—would also apply to the community health center funding.

However, if Alexander does not explicitly add the Hyde Amendment protections to the “stabilization bill,” the cost-sharing reduction payments to insurers will be used to fund plans that cover abortion. There is little reason to believe Murray would endorse such a restriction. If the Hyde Amendment restrictions apply to the cost-sharing reduction payments to insurers, then in order to receive said payments, it is likely insurers would have to stop offering abortion coverage on exchanges—an outcome Murray, and Democrats, would not wish to countenance.

Massive Funding Amounts

The “stabilization bill” would likely seek to provide massive funding amounts to insurers—roughly $3 to $4 billion for the rest of this calendar year, and $10 to $11 billion for each of years 2018 and 2019, based on Congressional Budget Office spending estimates. These significant sums would surely represent the second-largest expansion of federal abortion funding, behind only Obamacare itself.

Some conservatives may therefore have concerns that this “stabilization bill” would violate pro-life principles, and insist on included pro-life language as a necessary (but not necessarily sufficient) requirement for their support of the legislation. Given that House and Senate Republican leaders demanded and received Hyde protections regarding community health center funding two years ago, under a Democratic president, conservatives should demand—and receive—no less with a Republican in the White House.