NRL News

Staggering $5 Billion in Premium Subsidies to ObamaCare Exchanges that Permit Elective Abortion Coverage – for Starters

by | Apr 14, 2014


By Susan T. Muskett, J.D. Senior Legislative Counsel

Editor’s note. This appeared in the online, digital edition of National Right to Life News for April. You can read this story and all the many other important news items and commentary at

TaxdollarsBased on the number of persons who had enrolled in ObamaCare as of March 1, at least $5 billion in federal tax subsidies will be available to help purchase health plans that cover elective abortion, with the figure sure to increase as additional millions of Americans enroll.

Obamacare provides federal subsidies on a sliding scale for millions of American families whose household income is 400 percent or less of the federal poverty level ($95,400 for a family of four). These subsidies are to be used to help purchase health insurance, and can only be used to purchase a health plan within an ObamaCare Exchange. An “Exchange” is a marketplace for the purchase of health insurance. ObamaCare requires an Exchange to be established in every state by 2014.

ObamaCare allows plans within a state’s Exchange, including federally subsidized plans, to cover all abortion, unless a state passes a law to prohibit such coverage. As of today, 24 states have enacted laws restricting Exchange-participating insurance plans from covering elective abortions.

But taxpayers in those 24 states still will be subsidizing the purchase of abortion-covering health plans in the other 26 states and the District of Columbia, which have not passed such laws – “abortion-covering states” for short.

The Kaiser Family Foundation estimates that the federal premium subsidies total $10 billion nationwide, based on federal enrollment data as of March 1, 2014. States with the most liberal abortion laws in the nation are among those receiving the largest share of the federal tax premium subsidies. California alone will receive over $2 billion in federal premium subsidies, New York another $466 million, Washington state another $285 million. (A full listing of the Kaiser Family Foundation’s state-by-state estimates can be found here.)

These figures do not reflect enrollments in Obamacare made on or after March 1, so the totals – both aggregate totals and totals for the largest, abortion-covering states – can be expected to increase sharply as later enrollment figures are analyzed.

A preliminary analysis, beginning with the $10 billion figure and subtracting the subsidies for the 24 states that have restricted elective abortion coverage, leaves an estimated $5 billion in federal tax subsidies that will flow in 2014 to ObamaCare Exchange plans in abortion-covering states.

To make matters worse, these federal premium subsidies are projected to dramatically increase over time. The Congressional Budget Office (CBO) projects that these federal premium subsidies will cost over $100 billion per year nationwide by 2018. The CBO’s February 2014 premium subsidy projections for 2015-2024 can be found here.

For the federal government to pay for health plans that cover elective abortion is a sharp departure from decades of federal policy under the Hyde Amendment, the Federal Employees Health Benefits program, and other federal programs. But because the ObamaCare law sharply departed from these principles, billions in tax subsidies now will flow to plans that cover elective abortion – and a lot of it will be paid for with taxes paid by people who live in states whose elected legislatures have made it clear, by enacting laws preventing Exchange plans from covering abortion, that they don’t favor tax-subsidized abortion coverage.

With respect to individual abortion-covering states, there is not sufficient data to estimate what percentage of the subsidies will end up paying for individual health plans that actually cover abortion. That is because information on which individual health plans cover abortion is difficult to obtain in many states – a situation that the Obama Administration has done nothing to remedy (see “Sebelius Continues to Take the Dodge Regarding Abortion Coverage Lawlessness on ObamaCare Exchanges”). But what evidence exists suggests that a major portion of the $5 billion will flow to abortion-covering plans.

In December 2013, Commonweal Magazine reported that “officials in Rhode Island and Connecticut confirmed that on their exchanges customers cannot buy plans without abortion coverage. A representative of Hawaii’s exchange said he thought all plans covered abortion, but couldn’t say for sure.”

The Huffington Post reported in September 2013, that “women in California, Connecticut, the District of Columbia, Hawaii, Maryland, Massachusetts, New York, Rhode Island, Vermont and Washington state will have access to health plans to cover abortion, officials from those states told HuffPost.”

Michigan is among the 24 states that enacted legislation restricting abortion coverage by the ObamaCare Exchange plans in their state. Pro-lifers in Michigan were forced to conduct a petition drive to put the bill before the legislature after the governor vetoed similar legislation the first time around, but it proved to be well worth it based on the projected federal premium subsidies that will flow to health plans in the Michigan Exchange. The Kaiser Family Foundation estimates that 126,000 Michigan residents will receive $328 million in federal premium subsidies, as of March 1 enrollment data.

A list of the states that have enacted laws preventing Exchange-participating insurance plans from covering abortions is posted on the NRLC website, here.

(Note: The Georgia legislature also recently passed legislation restricting abortion coverage by plans in their state’s ObamaCare Exchange and as this story goes to print the bill is awaiting the Governor’s signature, which would make Georgia the 25th state.)

Beginning in 2011 and as recently as this January, the Republican-controlled U.S. House of Representatives has repeatedly approved bills that would remove the abortion subsidies from Obamacare, but the Senate Democratic majority has refused to allow votes on such bills.