Taxpayer Funding of Abortion in Obamacare

How it Works

Under Obamacare, as many as 111,500 additional abortions per year[1] could be heavily subsidized by taxpayers. This could happen in several ways:

  • Subsidies – The Affordable Care Act provides for subsidies in the form of refundable advanceable “affordability” tax credits that heavily subsidize the purchase of insurance plans that cover elective abortion.
    • Twenty four states[2] have opted out of providing elective abortion coverage in their exchanges but in those states that do not opt-out elective abortion-funding plans with federal subsidies can be made available.
    • In the 26 states that do not exclude elective abortion coverage from their exchanges, the affordability tax credit represents a subsidy for the purchase of plans that include such coverage, and the tax benefits for purchasers may reach as high as 100 percent of the premium. Such a massive subsidy to buy elective abortion coverage has never before been available to the public and it represents an imposition on all U.S. taxpayers. 
    • Consumers in abortion-funding plans directly subsidize the abortions of others by paying into an “abortion slush fund.” Those participating in the abortion-funding plans will pay a mandatory minimum $1 per month for abortion coverage.[3] This “accounting gimmick” is meant to give the illusion that funding for abortion coverage is separated from funding for other health care.
    • Americans may unknowingly purchase abortion-funding plans because of a secrecy clause embedded in the Affordable Care Act which stipulates that the surcharge be minimally disclosed only at the time of enrollment.[4]
  • Multi-State Plans – Only one pro-life plan (excludes elective abortion) is required to be established among the “multi-state plans” (MSP) run by the Office of Personnel Management offered in each state health exchange. The rest of the MSPs, partially subsidized by taxpayers, may include elective abortions coverage.
    • Intense review of the website, revealed that it is nearly impossible[5] for consumers to discern which plans exclude coverage of elective abortions and abortion-inducing drugs.
    • The clandestine abortion funding problems prompted the introduction of the Abortion Insurance Full Disclosure Act in Congress.[6]
    • Rep. John Shimkus (R-IL) asked HHS Secretary Kathleen Sebelius to provide a list of plans that are pro-life, as required by the health care law. She backtracked[7] on her promise to provide a list of plans to Congress in December 2013.
  • Medicaid Expansion – The Affordable Care Act incentivizes states to expand their Medicaid programs for the poor by raising the eligibility limits for lower-income residents based on family size and structure.
    • Slightly more than half of the states have chosen to expand their Medicaid rolls and roughly two thirds of these states pay for elective abortions for their Medicaid populations. As a result, millions of uninsured women in these states will become eligible for state tax-paid abortions as a result of Obamacare. 
    • These state tax funds will be paid directly to providers filing claims and not merely to insurance companies providing the coverage.
  • Abortion Drug Mandate – The “preventive services mandate” grants the Department of Health & Human Services, the right to define “preventive services” that must be available cost-free (no copay, no deductible, etc.) to the insured. Under this mandate, the Department has required plans to include abortion-inducing drugs.
    • This mandate coerces religiously affiliated organizations, pro-life groups, and morally opposed businesses to be complicit in providing coverage that includes abortion-inducing drugs despite moral or religious objections. 
    • New studies show that all emergency contraceptive can cause early abortions.[8]

What Happened?

In 2009, President Obama told a joint-session of Congress that “under our plan, no federal dollars will be used to fund abortion.”[9] Pro-life groups didn’t trust this promise and sought to encourage pro-life Democrats, led by Rep. Bart Stupak (D-MI), to oppose the bill.

  • The Affordable Care Act only passed the House of Representatives after the Stupak-led coalition accepted an Executive Order from President Obama, promising that taxpayer dollars would not be used to fund elective abortion. The very need for this promise confirmed that the law itself did not contain specific language preventing the funding of abortion.
  • Senior officials in the Obama Administration, including Rahm Emmanuel[10] and now Supreme Court Justice Elena Kagan, understood[11] that the Executive Order signed by President Obama represented a revocable promise and did not serve as a precedent for statutory interpretation.[12]
  • After fighting ferociously against the Stupak Amendment to ban abortion funding, Cecile Richards, president of America’s largest abortion provider, Planned Parenthood, praised the Executive Order solution telling supporters: “we were able to keep the Stupak abortion ban out of the final legislation and President Obama did not include the Stupak language in his Executive Order.”[13]

Why it Matters

To this day, Members of Congress and pro-life activists have been working on legislative fixes to the abortion-funding problems. At least six bills have been introduced to address different aspects of the problem including the No Taxpayer Funding for Abortion Act, the Protect Life Act, the Respect for Rights of Conscience Act, the Abortion Nondiscrimination Act, and the Health Care Conscience Rights Act.

  • Many pro-life Democrats who were linchpins of the ACA’s eleventh-hour passage lost their jobs in the 2010 midterm elections for betraying their pro-life principles and constituents. Some of those former Representatives have publicly decried the HHS Mandate as a direct violation of the abortion funding “compromise” they thought they had secured with President Obama.
    • “I would have never voted for the final version of the bill if I expected the Obama Administration to force Catholic hospitals and Catholic colleges and universities to pay for contraception.” – Former Pennsylvania Rep. Kathy Dahlkemper (11/21/11)[14]
    • “I myself do not appreciate the HHS mandate, when you demand that an employer must provide contraceptives despite their moral, legal objections to it. I think that’s wrong. I think it violates freedom of religion…I think the president is wrong on this one.” – Former Michigan Rep. Bart Stupak (9/4/12)[15]
  • Obamacare and its abortion funding and conscience rights problems will continue to be sources of both political and policy debate for the foreseeable future.



[3] Affordable Care Act, see §1303 (b)(2)(D)