WASHINGTON — In the second year of a federal mandate to have health coverage, pro-life Americans have yet to see fixes that would help them find health insurance free of elective abortion on state and federal exchanges.

According to Gallup, the nation’s uninsured population hit a new low of 12.9%, as more people bought health policies to fulfill the individual health-insurance mandate of the Affordable Care Act, also known as Obamacare, and avoid fines from the Internal Revenue Service.

But pro-life advocates fear that many people may be unaware that the health coverage they buy on the exchanges could mean their premium dollars — and the federal subsidies they may have received to cover those premiums — are paying for others’ abortions on that plan.

“People have to be very careful about what they buy, because at least half of the plans on the exchanges cover elective abortion,” said Chuck Donovan, president of the Charlotte Lozier Institute, a research arm of the Susan B. Anthony List.

The problem, Donovan added, is that there is “no truly easy way” to figure out which plans exclude elective abortion, as most health-insurance companies are not up front about that information to consumers.

The U.S. Conference of Catholic Bishops has been calling for legislative fixes to ACA, including Hyde Amendment-type legislation that would restrict all federal funding of elective abortion (not including cases of rape, incest and saving the life of the mother), as well as legislation mandating transparency and conscience protections.

“The Affordable Care Act continues to discourage transparency and informed consent among consumers who want to purchase a plan without abortion,” said Richard Doerflinger, associate policy director of the U.S. bishops’ Secretariat of Pro-Life Activities.

Over the summer, the Government Accountability Office found that, in a sample of 18 insurers, all but one allowed elective abortions to be covered under plans subsidized with federal dollars — a violation of federal law. And most insurers, in violation of federal rules, did not segregate private funds used for abortion from the pool of federal dollars allotted for health-insurance coverage. 

“You still have people buying plans without being informed that there is a separate charge that is going to be taken out of their premium solely to pay for other people’s abortions.”

 

Priority Legislation

Rep. Dan Lipinski, a pro-life Democrat from Illinois and co-chairman of the bipartisan House Pro-Life Caucus, said pro-life members in the Republican-controlled House are looking at legislation that would fix the issues of abortion funding and transparency. Two legislative items are the No Taxpayer Funding of Abortion Act and the Abortion Insurance Full Disclosure Act.

“The No Taxpayer Funding of Abortion Act would prohibit [elective] abortion across the government, including the ACA,” Lipinski said.

Lipinski added that it will “still be difficult” in the new Republican-controlled Senate, because while there may be a thin bipartisan pro-life majority — some Senate Democrats are pro-life, while some Republicans support legal abortion — they do not have the 60 votes necessary to break a filibuster.

Still, he said, “I’m hopeful that we can get this to move in the Senate.”

He added that while the White House has promised to require transparency on abortion coverage on the exchanges, “that is something we are going to have to make sure finally does occur.” He pointed out that HHS has failed to follow through on its own commitment to make sure federal subsidies never went to fund abortion coverage.

“It just goes to show that we have to continue watching how HHS is administering Obamacare and push for legislation that will eliminate taxpayer funding for abortion and also provide conscience protections,” he said.

Doerflinger added that, with respect to conscience protections, the Abortion Non-Discrimination Act is also among the USCCB’s “high priorities” for legislation. It would prevent people from being forced by governmental bodies to be involved in abortion or abortion coverage against their will. In California, for example, Catholic universities have been forced to cover elective abortions after state officials reinterpreted the law in August.

“That’s a law we have supported for years, and we’ve tried to get it into must-pass appropriations bills, but thus far we have not succeeded,” he said.

Lipinski said he was not sure whether Republicans would go so far as attaching the No Taxpayer Funding of Abortion Act to must-pass legislation.

“I’m very hopeful that happens, but I don’t know yet whether they’ll do that.”

Rep. Chris Smith, R-N.J., the Republican co-chairman of the Pro-Life Caucus, is the author of the No Taxpayer Funding of Abortion Act.

“One year ago, the House passed the No Taxpayer Funding for Abortion Act by a vote of 228-196,” Smith told the Register Jan. 9 via e-maili. “Obama threatened a veto, and the Senate failed to even vote on the measure.

“This year with stronger pro-life margins in the House I look forward to reintroducing the bill and I am confident the House will pass it with even greater support. I also look forward to working with the newly sworn Republican Senate to finally see a vote on this important legislation to stop abortion on demand from Obamacare.”

This week, however, the GOP’s House leadership instead prioritized the Pain-Capable Unborn Child Protection Act, a bill that would ban abortions after 20 weeks of pregnancy, which was passed by the House last year but failed to advance in the Democrat-controlled Senate. That bill was reintroduced in the House on Jan. 6, the first day of the 114th Congress.

 

Navigating the Landscape

In the meantime, the Charlotte Lozier Institute has set up a website called ObamaCareAbortion.com that helps provide information on elective abortion coverage in health-insurance plans.

“There are only four states that we know of that have no pro-life options at this point,” Donovan said, adding that the institute invites people to contact it if they have information that could be added to the site. The four states are Hawaii, New Jersey, Rhode Island and Vermont.

So far, 24 states have barred elective abortion coverage from their insurance exchanges, and 35 states have multi-state plans that theoretically provide at least one abortion-free option.

“There is at least one plan that does not cover elective abortion,” he said.

Donovan said CLI would like to see the government require insurance companies participating in the exchanges to make whether they offer elective abortion coverage prominent on their websites before people sign up for their plans.

“Right now, [the Office of Personnel Management] is committing to do that, HHS has made very scant progress on it, and with two years of Obamacare, that is certainly unacceptable,” he said.

But while a family can avoid elective abortion coverage, that plan still may not be a good fit, in terms of networked health providers. A person could buy an insurance plan that does not cover abortion, but then find out the hospitals and doctors they want are not covered (as they might be in other plans where part of their premiums would subsidize abortion coverage).

The No Taxpayer Funding for Abortion Act, he emphasized, would make sure that all health plans offered on the exchanges would not include elective abortion.

“It’s a major concern that networks are shrinking and that reimbursements to doctors are shrinking as well,” Donovan said. “More doctors are simply not accepting insurance because they can’t make ends meet, so they are going in other directions.”

 

The Health-Sharing Option

Doerflinger said that another option Catholics are increasingly exploring are health-sharing ministries, which fulfill the requirements of the law.

“It’s worth looking into,” he said. “It’s not exactly a health-insurance plan, but it is a pool people can pay into to share each other’s health costs.”

He pointed to Samaritan Ministries International’s new Catholic affiliate CMF CURO as a health-sharing option “completely in accord with Catholic teaching.”

“There are options out there, and people who are concerned about this should look into all of them.”

Peter Jesserer Smith is the Register's Washington correspondent.

Register senior editor Joan Frawley Desmond contributed to this report.