Republican demands for stronger anti-abortion provisions as part of any extension of enhanced ObamaCare subsidies are not only a sticking point to a bipartisan deal: They complicate any alternative GOP health care agenda.
The fight is a key test for anti-abortion activists who have been vocally frustrated at the Trump administration's lack of action on other priorities, such as rolling back Biden-era regulations allowing mail-order abortion pills and the Food and Drug Administration's approval of a generic version of mifepristone in October.
At issue are whether federally funded plans can cover abortion procedures and medications.
While the long-standing Hyde Amendment and other similar laws prevent federal funds from being used to cover abortions, they do not prohibit Affordable Care Act marketplace plans from covering abortions, so long as they are funded by state or private dollars. Some states allow — or even require — Affordable Care Act marketplace plans to include abortion coverage, using state funds. Anti-abortion activists and Republicans want to prohibit federally funded plans from covering those plans at all.
Susan B. Anthony (SBA) Pro-Life America released a media memo last week outlining the long history of Republicans aiming to prevent taxpayer funding of abortion, noting anti-abortion organizations have long opposed ObamaCare plans covering abortion, and that Republicans in the House have previously passed and long championed legislation to change that.
"Preventing taxpayer funding of abortion is a minimum requirement for any new Obamacare spending advanced by a Republican Congress and Administration," the memo said.
The prominent anti-abortion group is not stopping there — it is announcing Tuesday that it is taking the unusual step of including on its lawmaker scorecard a discharge petition led by House Minority Leader Hakeem Jeffries (D-N.Y.), which attempts to force a vote on extending the subsidies as-is for three years.
Jeffries needs a handful of Republicans to sign on to the petition to bypass GOP leaders and force a vote, and is pressing centrist GOP members — many of whom will be facing tough reelection bids next year and have supported a one-year temporary extension in the past — to sign on.
Such scorecards usually count only for recorded votes, and the move to count signatures on the discharge petition shows how aggressive SBA is advocating on this issue. Any lawmaker who signs the Jeffries petition will have a negative mark. That could make Republicans think twice, too, about any discharge petition effort for an alternate bipartisan compromise.
"With the midterms on the horizon, Republicans need to just continue to hold strong. Taking the pro-life base for granted is not a smart political move for Republicans," SBA spokesperson Kelsey Pritchard said. "At SBA alone, we are investing $80 million to retain GOP majorities in the House and the Senate during the midterms, so members must continue to stand firm on this."
GOP leadership and most Republicans in Congress seem to agree. Expanding abortion prohibitions to ObamaCare plans are top priorities for Speaker Mike Johnson (R-La.) and many other Republicans, according to leadership sources. Many senators have expressed support for the Hyde expansion, as well.
Those kinds of changes to the subsidies, though, seem to be a nonstarter for Democrats, who argue no federal dollars are flowing to abortion services under ObamaCare's current structure. Sen. Ron Wyden (D-Ore.) said on the Senate floor last month that the GOP demands to expand those abortion restrictions "amounts to nothing short of a backdoor national abortion ban."
The result seems to be an insurmountable conflict that threatens to stop any extension of the ObamaCare subsidies.
Yet Republicans aren't publicly closing the door on negotiations yet. Senate Majority Leader John Thune (R-S.D.) told reporters Monday that bipartisan talks are still underway for some kind of subsidy extension deal.
As Republicans start to pitch alternate health care plans, abortion ban expansions could be central to those, too. Sen. Rick Scott (R-Fla.), for instance, last month pitched a plan to establish "Trump Health Freedom Accounts" with funds that could be applied to health care premiums — noting they would be "Hyde-compliant by restricting use on abortion health plans or abortion services."
Gavin Oxley, media relations manager at Americans United for Life, said he thinks the White House understands how nonnegotiable the Hyde component is to any GOP-backed plan.
"If the Republicans or the Trump administration were to push something forward without Hyde, it would ultimately fracture the Republican Party and the voter base that got Trump elected," Oxley said. "The pro-life movement is a large faction of a broader conservative movement, and we would be very disappointed in even an attempt to pass something without Hyde."
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