Efforts to include the provisions in a Senate bill hit a snag on July 21, when the Senate Parliamentarian announced that the protections violated the Byrd Rule and would thus require 60 votes, making their passage all-but-impossible in the closely-divided Senate.
After Senate Republicans were unable to pass their own health care proposals – multiple versions of the Better Care Reconciliation Act – they successfully opened debate on Tuesday to repeal and replace the current health care law, although it was not clear at the time which replacement bill they would ultimately vote on.
Then, the Susan B. Anthony List announced that they would be following the debate closely and working to ensure that the key pro-life provisions were included in a final bill.
"In the coming hours and days, we will be working amendment by amendment to make sure pro-life protections remain in the bill, knowing that all elements of the legislation could be subject to very close votes, as well as decisions by the parliamentarian," Marjorie Dannenfelser, president of the Susan B. Anthony List, stated on July 25.
During debate on Wednesday and Thursday, multiple ACA replacement proposals were voted down. On Thursday, Senators quickly drafted what was ultimately the final proposal, called "skinny repeal."
The "skinny repeal" included stripping Planned Parenthood of Medicaid reimbursements and redirecting over $400 million to "federally-qualified health centers" that do not offer abortions. Planned Parenthood Action fought the proposal, saying in a tweet that it would "block patients…from coming to Planned Parenthood for care."
That amendment, sponsored by Majority Leader Mitch McConnell, repealed the ACA's individual mandate that everyone purchase health insurance or risk being penalized with heavy fines.
Susan B. Anthony List supported this proposal, saying that Americans would no longer be forced to purchase health insurance "even if their only insurance options cover abortion," as was previously the case in several states.
According to a 2014 report by the Government Accountability Office, the health exchanges in five states – Connecticut, Hawaii, New Jersey, Rhode Island, and Vermont -- offered only plans with abortion coverage, and none without abortion coverage.
However, Hyde language establishing sufficient safeguards against tax credits being used to pay for abortion coverage still needed to be included in the bill. Sen. Luther Strange (R-Ala.) introduced an amendment on Thursday which he said would survive the Parliamentarian's standards.
Previously, the Affordable Care Act had actually opened up avenues for taxpayer funding of abortion coverage, through federal subsidies and tax credits being used to pay for plans with abortion coverage offered on the exchanges.
(Story continues below)
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Although an executive order by President Obama forbade the subsidies and credits from being used to pay for abortion coverage – abortions were meant to be billed separately from other coverage in federally-subsidized plans – such promises amounted to only an "accounting gimmick," former Congressman Joe Pitts explained in a February op-ed in The Hill. They did not constitute real protections against taxpayer funding of abortions, he said.
March for Life Action estimated that, according to numbers from the Guttmacher Institute, 100,000 abortions per year were performed under this ACA "reimbursement plan." And although the amount of money in available tax credits would shrink under the Senate proposal, the funding of abortions would continue, they said.
Strange's amendment, the senator explained in a speech on the floor, would protect tax credits from being used to pay for abortion coverage.
It would drop the value of tax credits paying for abortion coverage to 10 percent. "The remaining 90 percent," he said, would be "made available as Hyde-protected monthly payments to insurers to benefit the same people who relied on those tax credits."
"For too many, access to healthcare coverage comes only with the restriction of deeply-held personal convictions about the sanctity of human life," Sen. Strange said on the Senate floor.
"The amendment before us offers us the opportunity to end the flow of taxpayer dollars to abortion procedures, once and for all. It allows Hyde protections to be extended to all funds appropriated through the healthcare legislation we are considering today."