The exchanges, or marketplaces, opened Oct. 1 to enroll people who have no health insurance or pay for it themselves. Pro-life advocates inside and outside Congress greeted the latest step to implement the controversial 2010 Affordable Care Act with concerns about policies that apparently will increase the number of taxpayer-funded abortions.
-- The Obama administration has issued a final rule that would cover abortions for members of Congress and their staffs, thereby violating a longstanding federal law.
-- The law, under the guidance of the administration, could enable about 5.5 million girls and women to gain abortion coverage, resulting in what possibly could be more than 100,000 additional, publicly subsidized abortions per year.
The health care law has faced pro-life opposition throughout its contentious existence. Pro-life organizations, including the Southern Baptist Ethics & Religious Liberty Commission, opposed the legislation while it was under congressional consideration, decrying its government subsidies for abortion.
During the law's last two years, the ERLC, as well as other pro-life and religious freedom organizations, have sought reversal of what became known as the abortion/contraception mandate, a rule issued by the Department of Health and Human Services that requires employers to pay for coverage of workers' contraceptives, including medications that can cause abortions. The ERLC and others have unsuccessfully urged the Obama administration to provide adequate conscience protections for individuals and institutions.
As it has previously, the Republican-controlled House of Representatives addressed the abortion-funding issue in a Sept. 29 vote. The House passed an amendment to bar subsidies for insurance plans that cover elective abortions and to protect religious liberty under the abortion/contraception mandate. The amendment was part of legislation to continue funding for the federal government.
The Senate, however, removed those pro-life provisions. House leaders reportedly decided to drop their effort to include them in the overall measure, thereby disappointing pro-lifers. Differences between the two houses resulted in a partial shutdown by the federal government Oct. 1.
The Office of Personnel Management issued its final rule Sept. 30 regarding health insurance in the exchanges for Congress and its staff members. Its rule does not violate a 30-year-old ban on federal payment of abortion and federal payment of the administrative expenses for abortion coverage, according to OPM.
Pro-life members in the House, as well as pro-life organizations, disputed that claim.
The Smith Amendment -- an annual spending measure sponsored by Rep. Chris Smith, R.-N.J., that was first enacted in 1983 and has been in effect most years since -- prohibits federal funds from being used for "abortion, or the administrative expenses in connection with any health plan under the Federal employee health benefits program which provides any benefits or coverage for abortions."
In announcing the rule, OPM said it "does not administer the terms of the health benefits plans offered" on exchanges that offer abortion coverage. Pro-lifers, however, said OPM would be providing administration in relation to the coverage for Congress, thereby breaching the Smith Amendment.
If a congressional employee chooses an exchange plan that covers elective abortion, OPM "will collect the employer and employee premium contributions and in turn disburse them to the abortion-covering plan," clearly violating the amendment, Smith and 83 other House members said in a Sept. 6 letter to the agency, protesting what was then a proposed rule.
Susan Muskett, senior legislative counsel for the National Right to Life Committee, said of the final rule in a written statement, "The Constitution does not grant the President the authority to retroactively rewrite the laws."
The Charlotte Lozier Institute (CLI) reported Sept. 26 the multi-state plans that are part of the exchanges could result in an additional 71,000 to 111,500 insured abortions. Those abortions would be either funded fully through Medicaid expansion or heavily by subsidies through the exchanges, according to CLI, the research arm of the pro-life Susan B. Anthony List.
HHS has indicated the multi-state plans will include at least one plan in each exchange that covers abortions, even though the ACA fails to provide such a guarantee in states where such coverage has not been barred, CLI reported. Twenty-seven states and the District of Columbia have not excluded abortion from the insurance exchanges.
"The issue of whether the Affordable Care Act creates streams of taxpayer funding for abortion has been hotly debated.... hrough the Multi-State Plans alone, Americans will be complicit in the deaths of thousands of unborn children each year through their tax dollars," said Charles Donovan, CLI's president, in a written release.
Under the HHS abortion/contraception mandate, drugs covered include Plan B and other "morning-after" pills that possess a post-fertilization mechanism that can cause an abortion by preventing implantation of tiny embryos. The rule also covers "ella," which -- in a fashion similar to the abortion drug RU 486 -- can even act after implantation to end the life of the child.
The exchanges are to begin operating Jan. 1.
Tom Strode is Washington Bureau chief for Baptist Press. Get Baptist Press headlines and breaking news on Twitter (@BaptistPress), Facebook (Facebook.com/BaptistPress) and in your email (baptistpress.com/SubscribeBP.asp).
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