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Public Policy - Health Care Reform


Abortion and Health Care Reform

The health care reform law enacted in 2010 (the "Affordable Care Act", or "ACA") contains both direct and indirect federal funding for elective abortions, and would require every American with certain health insurance policies to contribute directly to the funding of elective abortions. The President issued an executive order that claimed to address these concerns, but the order actually has no practical effect.

The Status Quo Before the ACA was Passed -- No Federal Funding for Abortion

  • Before the ACA was passed, it had long been established that federal funds would not be used to pay for elective abortions, nor did any federal funds go to insurance plans that covered elective abortions. Federal employee benefit plans do not cover elective abortions, and federal health insurance programs for the poor (Medicaid) also do not pay for elective abortions.

  • If individuals wished to have an elective abortion, they either had to pay for it with their own money or obtain a private insurance plan that covers elective abortion.

The Health Care Law Changes this Status Quo

  • Under the ACA, elective abortion would be considered "health care" – despite the fact that it is the only medical procedure designed to take a life.

  • The ACA defines the services that must be covered in health insurance plans by using terminology such as "outpatient services", "family planning", "physicians' services", "preventive services", etc. Federal courts have interpreted all of these terms to include abortion.

  • The law would allow private health insurance plans that cover elective abortion to receive government subsidies, with a transparent book-keeping trick that claims to segregate those funds from the money used to pay for abortions.  Despite this trickery, the reality is that federal money would go to insurance plans that cover elective abortion, and would indirectly be paying for them.

  • It would also impose a $1 per month fee on all those who are enrolled in plans that cover elective abortions.  These funds would go directly to pay for elective abortions.  In other words, federal law would, for the first time, require people to pay directly for elective abortions.

  • Efforts were made to amend the ACA before it was passed (e.g., the Stupak Amendment), but these were rejected by Congress.   Lawsuits have been filed challenging the law on many grounds, but the law still stands.

  • Although the President signed an executive order that claimed to exclude payments for abortions, in fact such an order has no legal effect -- an executive order cannot amend a statute, nor can it overrule court decisions interpreting statutory language.

  • For a full explanation of how the ACA would cover abortions, see this fact sheet and this more detailed legal analysis by the United States Conference of Catholic Bishops' General Counsel.

The Hyde Amendment Does Not Provide Any Protection

  • The Hyde Amendment limits federal Medicaid funding for abortion to those cases where it is necessary to preserve the life of the mother, or if the pregnancy was the result of rape or incest.

  • The Hyde Amendment does not apply to the programs set up under the health care law.

  • The Hyde Amendment is not a permanent federal statute -- it is an amendment to the budget that has to be passed every year, and which can be removed at any time.

  • As a result, the health care law must be specifically amended to exclude abortion coverage and payments, and to restore the status quo under which no federal funds were used to pay for abortions.

New Legislation is Required to Prevent Abortion Funding and to Protect Conscience Rights

  • Several states have taken advantage of a provision in the health care law, and have passed so-called “opt-out” bills. These bills would prohibit insurance plans that cover abortion from participating in that state’s insurance exchange program. The New York State Catholic Conference supports this legislation and has obtained a commitment from an Assembly member to sponsor it.

  • Two bills have been introduced in Congress to correct the abortion funding problem in the health care law.  One, the "No Taxpayer Funding for Abortion Act", would ensure that no federal program -- either in the health care law or otherwise -- would pay for abortions, and also provides for conscience protection.  Another bill would apply the Hyde Amendment provisions to the new health care law.  We strongly support the passage of either of these bills.



Background on the Issue

For decades, the Catholic Bishops of the United States have been in favor of reforms to our health care system that ensure several important goals, particularly: 

  • Respect for life from conception to natural death.

  • Access for all, with a priority for the poor.

  • Preserving freedom of conscience.

  • Preserving the freedom of individuals and families to make choices about health care.

  • Restraining costs and applying them equitably to all participants.

Our bishops have made clear that the following essential principles must be respected in any health care reform bill:

  • Abortion cannot be paid for -- directly or indirectly -- by federal dollars or included as a mandatory feature of health insurance.

  • Unborn children must be covered by any health insurance plan.

  • The right to conscience of health care professionals and institutions must be respected.

  • Care should not be rationed due to age, disability, expected length of life, cost considerations or arbitrary judgments about their "quality of life".

  • The elderly, handicapped, and chronically ill should not be pressured into euthanasia or assisted suicide.

  • Assisted suicide cannot be paid for or promoted by taxpayer dollars. 

For more information, please visit the U.S. Bishops' webpage on Health Care Reform.



Edward T. Mechmann, Esq.,
Public Policy Coordinator



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