With the enhanced Obamacare subsidies Democrats passed as part of their “Covid emergency” in 2021 set to expire on Dec. 31, congressional Republicans are considering what, if anything, to do about it. In a recent interview, House Speaker Mike Johnson, R-La., said, “I don’t love the policy” of extending the subsidies, “but I understand the political realities and the realities of people on the ground.”
Respectfully, I don’t think he understands the political realities in the slightest. Apart from Johnson’s convenient case of amnesia — remember when Republicans said they wanted to repeal Obamacare rather than expand and extend it? — the speaker is ignoring one major issue. Extending the enhanced subsidies would 1) keep taxpayer dollars flowing to plans that fund abortion and 2) allow blue states to create “slush funds” for abortion tourism that undermine the protections that pro-life states, including Johnson’s home state of Louisiana, have worked diligently to enact.
Federal Dollars to Plans Covering Abortion
The Federalist and conservative think tanks have reported on how the enhanced subsidy regime encourages billions of dollars in fraud via improper enrollments. Recently, the Congressional Budget Office released an analysis indicating it also agrees with this premise. While the budget reconciliation legislation signed into law in July contained some changes to limit this fraud, retaining a subsidy regime that allows households with the lowest income levels to obtain zero-dollar benchmark insurance will automatically encourage people to misrepresent their income to qualify for “free” coverage.
But lawmakers should also recognize that an extension would continue delivering federal funds to plans that cover abortion. Since Barack Obama, Nancy Pelosi, and other pro-abortion politicians rammed through Obamacare, federal funds have flowed to more than 1,000 insurance plans covering abortion.
Section 1303 of the law sets parameters for state insurance Exchanges regarding abortion. States can, and some do, prohibit all Exchange plans from covering the procedure. But where states cover abortions beyond those permitted by the federal Hyde Amendment — that is, abortions except in cases of rape, incest, or purportedly to save the mother’s life — Section 1303 requires insurers to segregate premiums. Insurers must charge enrollees at least $1 monthly for abortion coverage; this surcharge cannot be funded via federal subsidies and must be kept in a separate account, which only funds abortion procedures.
Since Obamacare’s passage, pro-life groups, recognizing that money is fungible, have derided the Section 1303 mechanism as an accounting gimmick. A coalition of such groups recently wrote to Congress stating, “[I]f Congress makes changes to … or extends [Obamacare] coverage [i.e., the enhanced subsidies], the changes must include complete application of Hyde [Amendment] policy,” by prohibiting taxpayer funds from flowing to plans covering abortion.
‘Slush Fund’ for Abortion Tourism
Recent developments in Maryland demonstrate another major problem in the already-flawed Obamacare accounting mechanism. Since its Exchange opened in 2014, Maryland insurers had accumulated a surplus of $25 million in the designated accounts covering Section 1303 abortions. In May, Democrat Gov. Wes Moore signed a law confiscating 90 percent of that accumulated surplus, and 90 percent of any surplus from future years, to fund a new state grant program “support[ing] equitable access to abortion care clinical services across the state.”
The executive director of Maryland Right to Life noted that the Maryland law “uses insurance premiums from insured women to abort the children of uninsured women.” And because the law allows funding for “individuals in the state” rather than residents of the state, and extends grant eligibility beyond abortion providers to abortion access groups, it also takes money paid by Maryland residents to fund the abortions of women residing outside Maryland who travel to the state for their abortions.
One of the bill’s sponsors, Del. Lesley Lopez, D-Montgomery, invited other states to mimic Maryland:
Maryland has been a leader on a lot of reproductive bills for the past 30 years, and so in that way, this bill fits into that legacy. It’s also nationally significant, because there’s 25 or 26 other states that can take this model and run with it. We’re looking for California, Illinois, New York, those bigger states that are sitting on potentially hundreds of millions of dollars to take what we’ve done here in Maryland and implement it there.
If other states follow Lopez’s suggestion, blue states would collectively have “hundreds of millions of dollars” to fund abortions and abortion-related travel, circumventing restrictions imposed by red states.
A Binary Choice
Last week, Rep. Jen Kiggans, R-Va., introduced a bill (H.R. 5145) to extend the enhanced Obamacare subsidies, currently scheduled to expire on Dec. 31, for one additional year. The legislation includes no changes to Section 1303, leaving undisturbed Maryland’s emerging strategy to fund abortions for out-of-state residents. Her office did not respond to my requests for comment as to why her bill excluded pro-life protections or whether she would support including them as part of any legislative package.
But if Johnson wants to talk about “political realities” relating to the enhanced Obamacare subsidies, there’s one in particular he should consider: The Hyde Amendment is a binary choice — it’s either in or out of legislation. If the speaker wants to support an extension of enhanced Obamacare subsidies without Hyde protections, and in so doing allow blue states to create “slush funds” for abortion tourism that undermine the pro-life protections Louisiana has enacted, that’s his prerogative.
But, to this observer at least, political realities — not to mention good policy — suggest another alternative. Those Republican “leaders” thinking about playing footsie with Democrats to enact policies that will perpetuate wasteful spending and encourage fraud, while enriching the abortion industry at the same time, should think again.
