Without the Hyde Amendment, ACA plans will allow taxpayer-funded abortion

Last week, the U.S. House of Representatives advanced a three-year extension of the enhanced Affordable Care Act (ACA) tax credits, but it did not include the Hyde Amendment, a rider that prevents federal funds from paying for most abortions.

Pro-life advocates had urged Congress to include the taxpayer protection, but they failed to do so — a decision that risks increasing abortion numbers and adding more pressure on women to have abortions they don't want. It also sends the erroneous message to Americans that abortion is health care.

Key Takeaways:

• The House passed a three-year extension of ACA tax credits without the Hyde Amendment, which prevents federal tax dollars from paying for abortion.

• Seventeen (17) Republicans voted to pass the bill without adding the protections the Hyde Amendment offers for women, preborn children, and taxpayers. It is now before the Senate.

• The Hyde Amendment has saved an estimated 2.6 million lives from abortion.

• By allowing the bill to pass without pro-life protections, it is erroneously signaling that killing preborn children is health care.

The Backstory:

When the ACA was enacted under President Obama in 2010, it did not explicitly include the Hyde Amendment. Rather, Obama promised to sign an executive order to extend the Hyde Amendment protections to health insurance plans offered by the state-based exchanges.

While he followed through, that order was ultimately meaningless; it could not prevent private insurers on the ACA Marketplace from offering health plans that included abortion coverage.

"This compromise arose because abortion was rightly understood to be something separate from normal health care," wrote John Gerardi for National Review.

At the time, both Democrats and Republicans were largely on board with preventing taxpayer-funded abortion, meaning the ACA may not have passed without Obama's promise. In recent years, support for Hyde among Democrats has significantly declined amid party pressure to consider abortion as a "right" and as standard "care." Any so-called hindrance to abortion access is now portrayed as an attack on 'women's health care.'

The Department of Health and Human Services (HHS) ultimately did fund insurance plans through the ACA that included abortion coverage in 23 states.

According to KFF, or the Kaiser Family Foundation — a pro-abortion investor in the abortion pill's first U.S. manufacturer, Danco, as well as a non-profit health policy organization — there are 12 states that require all fully-insured group plans and individual plans to include abortion coverage. It's in these 12 states that — if the Hyde Amendment were attached to the ACA extension — individuals would not be able to use federal tax credits to get a Marketplace health plan.

However, 25 states have actively prohibited any insurance plans that cover abortion from participating in the Marketplace. Depending on the laws of a person's state of residence, they could be funding abortion through the ACA with their tax dollars.

Beyond this, plans that cover abortion have been charging enrollees a $1 per month fee to pay for abortion coverage, and that money must be kept separate from other funds. But that fee adds up to more money than the plan spends on abortions.

In Maryland, $25 million in funds set aside for abortion coverage was sitting unspent. Last year, the state decided to use the money to pay for women from out of state to travel to Maryland for abortions. This means that $25 million in Maryland taxpayer money is now paying to abort the children of women who don't live in the state. Other states are looking to make a similar move.

Do Taxes Pay for Abortions?

The Details:

In the House, all Democrats and 17 Republicans voted in favor of extending the ACA credits without adding the Hyde Amendment protections in a 230-196 vote last week.

The proposal is expected to fail in the Senate, which voted down a similar three-year extension in December. However, the passage in the House is a sign of the weakening resolve of politicians who claim to be pro-life.

The Republicans who voted in favor of the bill are Reps. Rob Bresnahan (Pa.), Brian Fitzpatrick (Pa.), Tom Kean (N.J.), Nick LaLota (N.Y.), Mike Lawler (N.Y.), Ryan Mackenzie (Pa.), Max Miller (Ohio), Maria Elvira Salazar (Fla.) David Valadao (Calif.), Mike Carey (Ohio), Monica De La Cruz (Texas), Andrew Garbarino (N.Y.), Jeff Hurd (Colo.), Zach Nunn (Iowa), Derrick Van Orden (Wis.), Robert Wittman (Va.), and David Joyce (Ohio).

Most Americans do not support taxpayer-funded abortion; however, in the years after 2010, abortion marketing campaigns have convinced more and more Americans that abortion is health care, and when health insurance companies and state Medicaid programs decide to cover the costs of even so-called elective abortions, it only further cements that false idea. When President Trump told House Republicans they needed to be a "little flexible" on Hyde (a statement which the administration is now said to be "clarifying"), enough of them listened, forming a significant crack in the pro-life message and in pro-life efforts.

At National Review, Gerardi noted:

There are various ways to define the term 'health care,' but fundamentally, it involves interventions to restore or maintain the body at a state of function and flourishing. Abortion is not a treatment to restore healthy functioning, but rather an intervention designed to artificially end the natural process of pregnancy, along with ending the life of the pre-born child. It is chiefly chosen for social, rather than medical, reasons: a woman’s lack of financial stability, lack of partner support, or simply not desiring to have a child at a specific point in her life.

Abortion is not health care, and Americans should not be forced to fund it.

Why It Matters:

If the Senate approves the extension, the subsidies will resume, and taxpayer dollars will fund abortions in certain states. Induced abortion — the direct and intentional killing of preborn children — will be treated as though it were any other health care decision.

By backing down and allowing abortion to be funded under the ACA, self-proclaimed pro-life politicians are not just being "flexible" but are wrongly conceding that killing is health care, which could have long-lasting implications on our society. But health care doesn't leave a human being intentionally dead.

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Without proper protections on the ACA, abortion numbers could continue to rise, as they have in states that pay for abortions through Medicaid, and as they have through abortion funds that have been created since the fall of Roe v. Wade in 2022. As research shows, when abortion is taxpayer-funded, the number of abortions increases.

"[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," explained Michael New for National Review.

This incentivizes abortion when many women already face immense pressure to abort.

More than 60% of women who have had abortions said they did so because of pressure from their partner, their parents, their job, or their financial status, educational status, or familial status. They are left feeling that, though they don't want an abortion, they should get one. If their health insurance provider tells them the abortion would be free of cost to them (at the expense of the taxpayer and as opposed to the costs of pregnancy care and of raising a child), that adds another layer of pressure that leads more women toward abortion, even when they don't truly want abortion.

Including the Hyde Amendment in the ACA would save lives.

According to the Charlotte Lozier Institute (CLI), as of September 30, 2025, about 2.6 million lives have been saved from abortion by the Hyde Amendment, which has been included as a rider on annual Congressional spending bills for 49 years, blocking federal funding from paying for most abortions under Medicaid, Medicare, Veterans Health Administration, and the Indian Health Services, with exceptions for abortions following a pregnancy from rape or when a woman's life is said to be in danger during pregnancy.

The Bottom Line:

Giving in and allowing Marketplace plans to pay for abortions through government subsidies means more women will have abortions, more taxpayer dollars will go to pay for the abortions, and more people will begin to accept the propagandistic euphemism of 'health care' when it comes to the intentional killing of defenseless, preborn children by abortion.