The report’s release is likely to elicit new election-year attacks on congressional Democrats. Report: ACA abortion rules ignored

There are widespread instances of Obamacare insurance plans violating the rigid rules surrounding whether customers can use federal health care subsidies on insurance policies that cover abortion procedures, according to a Government Accountability Office investigation.

The report, commissioned by House Republican leadership and obtained by POLITICO on Monday night, found that 15 insurers in a sample of 18 are selling Obamacare plans that do not segregate funds to cover abortion (except in cases of rape, incest or the mother’s life) from their Obamacare subsidies.


The Affordable Care Act requires that insurers collect separate payments from customers for abortion coverage so that taxpayer money in the form of subsidies do not cover abortions. Adoption of the complex payment scheme — which essentially requires customers to send two separate payments to their insurers — was pivotal to getting the health law through Congress. Anti-abortion Democrats brokered the arrangement shortly before the law passed, threatening to vote against it without the restrictive language.

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The report’s release is likely to elicit new election-year attacks on congressional Democrats from anti-abortion groups and Republicans who warned that Obamacare would allow for taxpayer subsidized abortions.

Among a sample of 18 insurers, “all but three issuers indicated that the [abortion coverage] benefit is not subject to any restrictions, limitations, or exclusions,” the GAO wrote in its report.

The vast majority of people who bought coverage on the exchanges did so with subsidies. According to government figures, 87 percent of the 5.4 million people who bought a plan on HealthCare.gov in the last enrollment period did so with at least some subsidy .

There is no data provided on how many plans have paid for abortions so far.

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The GAO report found that in Connecticut, Hawaii, New Jersey, Rhode Island and Vermont, all insurance plans offered on the exchanges cover abortions above and beyond the exceptions for rape, incest and the mother’s life. The health law required the Office of Personnel Management to ensure there was at least one insurance policy in each state that did not cover abortion except in the restricted circumstances.

The Obama administration, in a response to a draft copy of the report, defended its actions.

The Centers for Medicare and Medicaid Services said Tuesday that it regularly communicated the technical details of abortion coverage to health insurance companies. The agency said that it would provide additional clarifying information in the coming days.

“CMS will work with stakeholders, including states and issuers, so they fully understand and comply with the federal law prohibiting the use of federal funds for abortions,” spokesman Ben Wakana said.

A Health and Human Services Department official confirmed that the law requires issuers to collect separate payments, but said that the law doesn’t specify how that needs to be done.

Critics of the dual payment track have long questioned the structure of the arrangement, saying that it was essentially inoperable. If a plan wants to cover abortion, it has to estimate the cost of coverage — no less than $1 per enrollee, per month — and collect that money from customers in a separate way than via their tax subsidies. Then, the pots of money have to remain separate.

Nationally, 1,062 plans in 28 states only cover abortion in the cases of rape, incest or to preserve the mother’s life, and 1,036 plans cover abortion services in a wider variety of circumstances, the GAO said.