Senate conservatives are taking a firm stand, demanding that any extension of Affordable Care Act (ACA) funding must include significantly stricter limitations on abortion coverage within insurance plans.
A group of Republican leaders who insist that taxpayer dollars should never be used to fund abortions, want to leverage the current dispute over COVID-era subsidies to ensure that public funds are not used for that purpose.
While current law already prohibits federal funding, such as premium tax credits, from flowing directly toward abortion care in ACA plans, consistent with the long-standing Hyde amendment, Republicans argue these existing safeguards are insufficient.
They seek to implement new “Hyde protections” or what critics call “Hyde plus-plus” restrictions.
This push aims to close loopholes that allow some states to permit abortion coverage through the ACA marketplaces using separate state or private revenue streams. By imposing “Hyde plus-plus” rules, Republicans are attempting to prevent federal funds from supporting coverage altogether, even if it is financed separately, effectively seeking to eliminate abortion coverage completely.
Senate Majority Leader John Thune (R-S.D.) has stressed that a deal extending the funds without these vital Hyde protections “doesn’t even get close”. Furthermore, Sens. Mike Rounds (R-S.D.) and Steve Daines (R-Mont.) have warned that the proposal is mandatory.
The influential organization Susan B. Anthony Pro-Life America is championing this effort, demanding the restrictions be attached to the funding. The organization provides a score for lawmakers based on their voting record on abortion issues.
“Since Democrat offers to pass a ‘clean’ extension of these ACA subsidies would extend funding of elective abortion coverage through Obamacare, Susan B. Anthony Pro-Life America strongly opposes and will score against any such offers — even for one year,” SBA President Marjorie Dannenfelser told senators in a letter dated Nov. 7 and shared with NBC News. “A vote for this extension is a vote for abortion coverage. Votes will be scored, and double-weighted, in each member’s profile on SBA Pro-Life America’s National Pro-Life Scorecard”.
Democrats, however, have branded the move a “nonstarter,” claiming existing guardrails are adequate. The involvement of the abortion issue in the debate over the subsidies adds another layer to the dispute between the two parties.
Democrats argue that the subsidies, originally introduced during the Biden administration and the COVID pandemic, keep health insurance premiums affordable for over 20 million Americans with ACA plans. If these key subsidies lapse, millions could face debilitating premium increases.
The principle at stake, according to Sen. Daines, is fundamental: “Hyde has been a longstanding principle here of not allowing the federal taxpayers to be used for abortion”.