End 'hidden abortion surcharge' in Affordable Care Act, lawmakers tell HHS

shutterstock 1418533709 United States Capitol Building - Washington DC. Via Shutterstock

Over 125 members of Congress and other pro-life leaders have asked the Trump administration to clarify how abortion coverage is listed in healthcare plans under the Affordable Care Act (ACA).

A letter signed by over 100 House Members and 25 Senators was sent July 2 to the Secretary of Health and Human Services Alex Azar, asking him to finalize a rule that would require separate payments and accounts for elective abortion coverage in health plans offered under the ACA, in accordance with the original text of the law. 

The signatories, led by Rep. Michael Cloud (R-Texas) and Sen. Cindy Hyde-Smith (R-Miss), called the proposed rule "an important step in providing transparency and awareness," and pro-life leaders have issued their own statements of support for the letter.

"Obamacare was the largest expansion of taxpayer-funded abortion on demand since Roe," said Marjorie Dannenfelser, president of the pro-life group Susan B. Anthony List, upon release of the letter. 

"Consumers deserve transparent information about the hidden abortion surcharge and the opportunity to avoid plans that cover abortion during the 2020 open enrollment period."

Section 1303 of the ACA mandates that, for health plans offered under the law, elective abortion coverage merits a separate surcharge from enrollees, drawing a distinction between abortion coverage and health care coverage.

The legislator's letter notes that this surcharge arrangement remains a violation of the principle of the Hyde Amendment-a long-standing bipartisan federal policy barring taxpayer funding of abortions through Medicaid-but said it at least offered transparency about abortion coverage in health plans, according to the text of the original law.

The Obama administration chose to interpret Sec. 1303 to mean that elective abortion payments and health care payments would be made together in the health plans offered under the ACA, not separately, only requiring that health coverage on the plans be itemized and that abortion coverage be listed in that itemization, or that a single notice about abortion coverage to enrollees would suffice for compliance.

The legislators contend that this interpretation created a "hidden abortion surcharge" in many plans that enrollees may have been unaware of when choosing a plan.

For instance, in 2018 taxpayer-funded ACA plans in 24 states and Washington, D.C., offered elective abortion coverage with the abortion surcharge included, and in 10 of those states more than 85 percent of ACA plans covered abortion-on-demand, the SBA List reported.

"We continue to urge swift action to finalize the rule in time for 2020 open enrollment," the Members' letter to Azar stated.

Dannenfelser said that "the sooner the rule restoring the original intent of the law is finalized, the fewer excuses insurers will have for noncompliance," while maintaining that "Congress must still act to eliminate abortion funding from Obamacare."

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