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.
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?
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.