A fight over taxpayer funding for abortion that nearly blew up the Affordable Care Act seven years ago is brewing once again.
Conservative groups are warning members of Congress they will oppose an Obamacare repeal-and-replace bill if it doesn’t include language to effectively prohibit any federally subsidized health plans from covering abortion.
An Obamacare repeal would otherwise be highly attractive to abortion foes, as House Speaker Paul Ryan has promised it will defund Planned Parenthood, one of their chief priorities. But whether the final bill allows abortion coverage is emerging as a make-or-break issue.
“We’re in a quandary,” Tom McClusky, lobbyist for the March for Life, told the Washington Examiner. “Here they have legislation that is likely to defund Planned Parenthood. Except it’s highly likely we would score again the bill if it allowed taxpayer-funded abortion.”
Family Research Council President Tony Perkins said the Obamacare replacement plan Republicans are considering “would very likely continue the taxpayer funding of abortion” through refundable tax credits.
“Obamacare’s accounting gimmicks did not prohibit taxpayer money from funding abortion, nor will the Republicans’ tax credits unless it is specifically excluded,” Perkins said in a statement provided to the Washington Examiner.
The issue has been simmering under the surface, even as abortion-opposing groups have publicly applauded the Obamacare repeal efforts.
It centers around language known as the Hyde Amendment, which sparked a major battle back in 2009 and 2010 when Congress was working on the healthcare law. Hyde prohibits taxpayer funds from being used for abortions except in the cases of rape, incest or when the woman’s life is threatened.
Abortion-opposing groups fought for the Hyde Amendment to be included in the Affordable Care Act, to ensure that its taxpayer-funded subsidies woudn’t go to marketplace plans that cover abortion services.
Democrats instead included language requiring plans to keep the subsidies separate from dollars used to pay for abortions, a provision liberals viewed as a sufficient guard against taxpayer funding for abortion, but that didn’t satisfy conservatives who said the funding was all fungible.
More than a dozen abortion-opposing Democrats who voted for the law lost their next election under furious retribution from conservative groups who worked to get them unseated.
Now Republicans have a chance to repeal much of the healthcare law they hate. Leadership said this week that they will have legislation ready next month. But it’s not at all clear whether they will be able to repeal and replace the law in a way that satisfies anti-abortion activists.
That’s because Republicans, even those who most oppose abortion, are stuck between a rock and a hard place on how to do it.
They likely can’t include the Hyde language in the budget reconciliation bill being used to repeal and partially replace the healthcare law, under Senate parliamentarian rules. A reconciliation bill can pass with just 51 Senate votes, a big advantage to Republicans who won’t need to get Democrats to sign on, but all the bill’s provisions must directly affect federal spending levels.
But if Republicans prohibit abortion coverage in a later bill replacing Obamacare, which would require 60 votes to avoid a filibuster, they would make it even harder to gain the eight votes from Democrats they would need to pass it.
There’s not an immediate, obvious solution to the problem, said Kyle Buckles, a spokesman for Rep. Vicky Hartzler, R-Mo., a member who’s been raising the issue with GOP leadership.
“The congresswoman is very concerned about it and is bringing up her concerns with leadership,” Buckles said. “We have to put efforts forth to find a solution.”
Abortion opponents say they don’t have a resolution either, suggesting only that they won’t support a GOP-led health plan if it allows federally subsidized plans to cover the procedure, as Obamacare did. “I would not want Republicans to make the same mistakes,” McClusky said.
Of the two goals—to defund Planned Parenthood and ban funding for abortion coverage—it’s impossible to prioritize one over the other, said Russell Moore, president of the Ethics and Religious Liberty Commission, the public public wing of the Southern Baptist Convention.
“I think they’re both of fundamental importance,” Moore said. But he, too, isn’t sure how both could be done.
“I think that’s an ongoing conversation right now,” Moore said. “I think we have all sorts of strategy sessions and meetings taking place as to how we can accomplish that.”
Obamacare alternatives proposed by many Republicans, including proposals from Ryan, Health and Human Services Secretary-designate Tom Price and the Republican Study Committee, say explicitly that taxpayer funds can’t be used for insurance that covers abortions.
And on Tuesday, the House passed a bill banning Obamacare marketplace plans from covering abortion if federal subsidies are used to help pay for them, although the legislation is not expected to make it through the Senate.
Still, many Republicans weren’t around to witness the big battle over Hyde that occurred when the Affordable Care Act was being passed. Lobbyists say that’s why they’re worried members don’t understand the issue.
“It’s one of those issues they don’t think about unless it’s pointed out to them,” McClusky said.
