COMMUNIQUÉ
Conscience Cause
Religious Liberty & the Affordable Care Act
by Daniel McConchie & Anna Franzonello
No matter one's opinion on the policy, it should be uncontroversial to observe that President Obama's signature achievement, the Affordable Care Act (ACA), dramatically increases federal control of the healthcare market. The U.S. Supreme Court's decision upholding the ACA's mandate that individuals purchase insurance or be "taxed" leaves many asking how the product they must buy will square with their conscience.
A chief concern for many Christians and people of faith is whether they will be paying for abortion and abortifacient drugs under the law. Unfortunately, the ACA creates several scenarios in which the answer is yes. The ACA is a historic shift away from the federal government's longstanding policy that abortion should not be subsidized as healthcare.
Since 1976, the Hyde Amendment, named for the late pro-life Congressman Henry Hyde, has prohibited federal funds from being used for abortions or insurance plans that cover abortion. Under Hyde, federal programs such as Medicaid do not cover abortion. However, the rider only applies to Labor, Health and Human Services (LHHS) appropriations. Many politicians talked about the Hyde Amendment during the healthcare debate, but the ACA's funding does not go through the LHHS budget. Hence, Hyde doesn't apply; the ACA follows its own rules.
The ACA's Abortion Mandates
One of ACA's requirements is that, by 2014, state-based "exchanges" be established for the purchase of private health insurance. The federal government will provide premium subsidies for those who do not qualify for Medicaid but whose household income is between 100 and 400 percent of the poverty level. Considering that a family of four earning up to $92,200 per year will qualify for this assistance—paid directly from the Treasury to the insurance plan—taxpayer funding under the ACA will be immense.
The ACA permits subsidies to be applied to plans in the exchanges that cover abortions (something Hyde would prohibit), but it currently does not allow these federal dollars to pay for abortions directly. Instead, it mandates that every person participating in the exchanges whose plan covers abortion must pay at least $12 a year into a special abortion fund. Thus, to get around the prohibition against tax dollars paying directly for abortion, the ACA creates a mandate under which private dollars pay directly for abortion.
It will not be easy to avoid paying this abortion premium. Plans outside the exchanges may be cost-prohibitive or provide substantially fewer benefits. Moreover, the ACA restricts notification of which exchange plans cover abortion to the time of enrollment and, even then, only in the summary of benefits. Thus, you can't know whether a particular plan covers abortion until you sign up.
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