A sign on an insurance store advertises Obamacare in San Ysidro, San Diego, Calif., October 26, 2017. (Mike Blake/Reuters)

At the end of last year, the Trump administration finalized a rule intended to enforce a provision of the Affordable Care Act, requiring that insurers offering health-care plans under Obamacare collect payments for elective abortion separately from other payments.

During Barack Obama’s presidency, this provision wasn’t enforced, as the administration permitted Obamacare insurers to bill for elective-abortion procedures along with fees for other services. If the Trump administration’s new rule goes forward without challenge, it will take effect on June 27.


According to the pro-life Susan B. Anthony List, in half of the 24 states that provide taxpayer-funded Obamacare plans, at least 80 percent of the plans cover elective abortion; eight have only plans that cover elective abortion. In fact, a handful of states explicitly require all insurers offering plans in the state to cover abortion.

The pro-life lobbying effort in favor of this new rule stemmed from the fact that the majority of individuals who obtain health care through the ACA’s exchanges also receive tax subsidies to help them pay their premiums. As a result, pro-life groups argue that if payments for elective abortion are processed along with fees for health-care services, taxpayer money will be entangled in funding abortion.

Despite the efforts of pro-life Republicans at the time Obamacare was passed, Democratic lawmakers and President Obama refused to enact a version of the bill that explicitly prohibited the taxpayer funding of abortion.



In both 2018 and 2019, a large group of U.S. representatives sent letters to the Department of Health and Human Services, asking for regulations that would address what they called “the severe problems with the ACA in regard to abortion coverage.” They pointed out that the Obamacare legislation itself required insurance companies on the ACA exchanges not to use federal subsidies to pay for elective abortion, as well as to collect separate payments for abortion procedures and deposit them into a separate account to fund elective abortions.

Though this new rule isn’t the huge pro-life victory some anti-abortion groups are suggesting, it will force insurers to comply with the bare-minimum protections for taxpayers set forth in Obamacare.