Dozens of pro-life leaders sent a letter to Congress Thursday afternoon urging Republican senators and representatives to honor their commitment to prohibit taxpayer-funding of elective abortion coverage under any health-care bill to replace Obamacare.
“Currently, any bill funding healthcare must carry restrictions on abortion funding or it will end up funding the brutal practice of abortion,” the letter states. “That is why the Republican platform rightly calls for a ‘permanent ban on federal funding and subsidies for abortion and healthcare plans that include abortion.’ The platform continues stating, ‘We will not fund or subsidize healthcare that includes abortion coverage.’ President Trump also pledged his opposition to taxpayer funding for abortion in his 2016 letter to Pro-life Leaders.”
The letter runs through Republican health care bills and proposals that would prohibit federal funding of elective abortion coverage and concludes: “We are encouraged by this longstanding commitment by Republicans to ensure that no Republican healthcare proposal, including those that provide tax credits for health insurance, funds abortion or plans that cover abortion and urge you to ensure this essential pro-life policy is included in any healthcare legislation considered to replace Obamacare.”
The letter strikes an optimistic and non-confrontational tone, but privately pro-life leaders have expressed concern about Republican efforts to repeal and replace Obamacare. One Obamacare replacement plan recently introduced by Republican senators Bill Cassidy of Louisiana and Susan Collins of Maine didn’t simply fail to deal with Obamacare’s abortion-funding problem; the Cassidy-Collins plan would actually increase taxpayer-funding of elective abortion.
Pro-life leaders say they have been given reassurances by Republicans in Congress that any Obamacare replacement will satisfy their concerns, but they haven’t seen legislative language yet that would address the issue of abortion in Obamacare’s exchanges. Without their support, it’s hard to see how a partial repeal-and-replace bill could pass either the House or the Senate.
The Senate can pass a bill without having to overcome a 60-vote hurdle under budget reconciliaition rules, and that’s why Republicans are using reconciliation to deal with Obamacare. But there are special rules governing reconciliation, and there has been some confusion over whether abortion funding may be addressed under it. For example, a Heritage Foundation budget analyst who now works in the Trump White House argued that Planned Parenthood could not be defunded under reconciliation. That analysis turned out to be incorrect; Congress passed a budget reconciliation bill in December 2015 that cut off almost all federal funding of Planned Parenthood. Pro-life groups are hopeful that a similar solution could be reached regarding a reconciliation bill that partially repeals and replaces Obamacare.
The issue of elective abortion coverage under Obamacare was an extremely contentious issue when the legislation was working its way through Congress in 2009 and 2010. Pro-life groups attempted but failed to get Congress to attach the Stupak amendment to Obamacare in order to prohibit funding for elective abortion coverage. (The Stupak amendment allowed “separate supplemental coverage” for elective abortion provided that federal funds were not used to pay for it. HHS secretary Kathleen Sebelius testified that “most private plans do not cover abortion.”) The law ended up establishing by default that federally-subsidized state-run exchanges would include at least one plan that covers elective abortion, but states could pass a law opting out of this requirement. According to a January 2016 report by the Kaiser Foundation, 25 states had passed laws banning coverage of elective abortion on their Obamacare exchanges.
Republicans are facing many challenges in their attempt to repeal and replace Obamacare, but their ability to win the support of pro-life leaders will be a key indicator of whether or not they can succeed.
