Congressional Republicans must strengthen, not weaken, Hyde protections

(National Review) The extension of Affordable Care Act subsidies has become a very salient policy issue in the new year. At a Tuesday policy retreat at the Kennedy Center, President Trump told House Republicans that they need to be a “little flexible” regarding the Hyde amendment — the annual provision that largely prevents federal tax dollars from paying for elective abortions. President Trump’s comments generated a firestorm of criticism from beltway pro-life groups — who insist that Hyde protections are non-negotiable in any legislation that extends federal subsidies for the Affordable Care Act.

Pro-lifers have a strong point. In fact, the current negotiations over extending Affordable Care Act subsidies are actually an apt time to strengthen, rather than weaken, Hyde amendment protections. Some history is instructive. When President Obama signed the Affordable Care Act into law in 2010 — abortion coverage was one of the most contentious issues. For awhile, it appeared that a coalition of House Republicans and House Democrats with misgivings about public funding for abortion might prevent passage of the Affordable Care Act.

In the end, President Obama was able to secure to votes of most of these House Democrats by pledging to sign an executive order that would extend Hyde amendment protections to health insurance plans offered by the state-based exchanges. However, as many pro-life legal analysts pointed out — the executive order was largely symbolic. Executive orders only cover actions by the executive branch. They could not prevent private insurers from offering subsidized health insurance plans through exchanges that covered legal abortion.

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Indeed, the concerns expressed by pro-life lawyers were proven correct. In the months after the passage of the Affordable Care Act, the National Right to Life Committee found that HHS agreed to subsidize high risk insurance plans in Pennsylvania, Maryland, and New Mexico, all of which included abortion. Furthermore, a 2014 analysis by the Government Accountability Office analysis found that 23 states offered subsidized exchange-based health insurance plans which covered elective abortions.

Taxpayer funding of abortion should be an important issue for pro-lifers. Every recent federal budget has included a version of the Hyde amendment. However, a growing number of states have begun to use their own taxpayer dollars to fund elective abortions through Medicaid. Indeed, since 2018, Medicaid programs in Illinois, Maine, Delaware, Rhode Island, and Nevada have all started to cover elective abortions. This is part of the reason why abortion rates have increased in some states post-Dobbs.

Overall, a very broad body of political science, economics, and public health research shows that taxpayer funding of abortion increases abortion rates. The fact that Republicans have unified control of government during the expiration of Affordable Care Act subsidies provides them with a unique opportunity to advance important pro-life policy goals. Indeed, strengthening Hyde amendment protections in Affordable Care Act subsidies will reduce taxpayer funding of abortion, protect the conscience rights of taxpayers, and save lives.