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Federal Abortion-Mandate Opt-Out Act

Model Legislation & Policy Guide

For the 2018 Legislative Year

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Introduction

The federal Patient Protection and Affordable Care Act (ACA), signed by President Barack Obama on March 23, 2010, requires individual states to operate and maintain “health insurance Exchanges.” Individuals with incomes up to 400% of the federal poverty level receive tax credits to apply towards health insurance plans in the new Exchanges.

States must also establish Small Business Health Options Programs (SHOP), which are Exchanges where small employers can purchase health coverage for their employees. The federal government has also established Exchanges in (the majority of) states that did not choose to create their own.

Importantly, health insurance plans offering abortion coverage are allowed to participate in a state’s Exchange(s) and to receive federal subsidies unless the state legislature affirmatively opts-out of offering these plans. If a qualified individual chooses a plan that covers abortion, his or her tax credit cannot be used to directly pay for abortions; however, the tax credit subsidizes the insurance plan which covers abortions.

Further, the ACA imposes an “abortion premium” upon all Americans enrolled in plans that cover abortions within the Exchanges. Americans enrolled in these plans—even if inadvertently or through employment—will be required to pay a portion of their insurance premium directly into a pot of money used exclusively for abortions.

Contrary to some perceptions, President Obama’s March 24, 2010 Executive Order does not make the new healthcare law conform to the longstanding principle of the Hyde Amendment and other federal law: that the federal government will not pay for abortions or for insurance plans that cover abortions.

Significantly, specific language in the ACA permits a state to opt-out of allowing insurance plans that cover abortions to participate in that state’s health insurance Exchange(s).[1] The law does not distinguish between an Exchange established by a state and one established by the federal government. An opt-out law applies to an Exchange regardless of how it is established and managed.

To assist state legislators in opting-out of providing health insurance plans with abortion coverage through their health insurance Exchanges, regardless of whether the Exchanges are established by the state or by the federal government, AUL has developed the Federal Abortion-Mandate Opt-Out Act. For more information and drafting assistance, please contact please contact AUL at (202) 289-1478 or Legislation@.

Steven H. Aden, Esq.

Chief Legal Officer & General Counsel

Americans United for Life

The Federal Abortion-Mandate Opt-Out Act

HOUSE/SENATE BILL No. ________________

By Representatives/Senators ________________

Section 1. Title.

This Act may be known and cited as the “Federal Abortion-Mandate Opt-Out Act.”

Section 2. Legislative Findings and Purposes.

a) The Legislature of the State of [Insert name of State] finds that:

1) Under the Patient Protection and Affordable Care Act (ACA), federal tax dollars, via affordability credits (subsidies provided to individuals up to 400% of the federal poverty level), are routed to Exchange-participating health insurance plans, including plans that provide coverage for abortions.

2) Federal funding of insurance plans that provide abortion coverage is an unprecedented change in federal policy. The Hyde Amendment, as passed each year in the Labor Health and Human Services Appropriations bill, and the Federal Employee Health Benefits Program (FEHBP) prohibit federal funds from subsidizing health insurance plans that provide coverage for most abortions. Under the ACA, however, Exchange-participating health insurance plans that provide abortions can receive federal funds.

3) The provision of federal funding for health insurance plans that provide abortion coverage is nothing short of taxpayer-funded and government-endorsed abortion.

4) However, the ACA allows a State to “opt-out” of permitting health insurance plans that cover abortions to participate in the Exchanges within that State, prohibiting tax dollars from subsidizing insurance plans that cover abortions within that State.

5) It is the long-standing policy of the State of [Insert name of State] that [Insert statement(s) about state laws and policies on funding for abortion, use of state resources to promote or perform abortions, and/or restrictions on insurance plans that cover abortions].

6) The decision not to fund abortion places no governmental obstacle in the path of a woman who chooses to terminate her pregnancy. Rust v. Sullivan, 500 U.S. 173, 201 (1991).

7) Moreover, it is permissible for a State to engage in unequal subsidization of abortion and other medical services to encourage alternative activity deemed in the public interest. Rust v. Sullivan, 500 U.S. 173, 198 (1991).

8) Citizens of the State of [Insert name of State], like other Americans, oppose the use of public funds – both federal and state – to pay for abortions. For example, a January 2010 Quinnipiac poll showed that 7 in 10 Americans were opposed to provisions in federal healthcare reform that use federal funds to pay for abortions and abortion coverage.

9) The Guttmacher Institute, which advocates for unfettered and taxpayer-funded access to abortion confirms that more women have abortions when they are covered by public programs.

10) It is an accepted principle of economics and public policy, that when you subsidize or pay for a service or product, you increase demand for that service or product.  Moreover, it is reasonable to conclude that this principle applies to the delivery of medical care in general and to the provision of abortions in particular.

11) Given that more women have abortions when they are covered by public programs and that public or private insurance coverage of a procedure generally leads to increased usage of that procedure, the State of [Insert name of State] concludes that the incidence of abortion would increase with the subsidization of insurance plans that cover abortion.

(b) Based on the findings in subsection (a) of this Act, it is the purpose of this Act to

affirmatively opt-out of allowing qualified health plans that cover abortions to participate in Exchanges within the State of [Insert name of State].

Section 3. Definition.

As used in this Act only, “abortion” means the act of using or prescribing any instrument, medicine, drug, or any other substance, device, or means with the intent to terminate the clinically diagnosable pregnancy of a woman with knowledge that the termination by those means will with reasonable likelihood cause the death of the unborn child. Such use, prescription, or means is not an abortion if done with the intent to:

(a) Save the life or preserve the health of the unborn child;

(b) Remove a dead unborn child caused by spontaneous abortion; or

(c) Remove an ectopic pregnancy.

Section 4. Opt-Out.

a) No abortion coverage may be provided by a qualified health plan offered through an

Exchange created pursuant to Patient Protection and Affordable Care Act (ACA) within the State of [Insert name of State].

b) This limitation shall not apply to an abortion performed when the life of the mother is

endangered by a physical disorder, physical illness, or physical injury, including a life-endangering physical condition caused by or arising from the pregnancy itself.

Section 5. Construction.

(a) Nothing in this Act shall be construed as creating or recognizing a right to abortion.

(b) It is not the intention of this Act to make lawful an abortion that is currently unlawful.

Section 6. Right of Intervention.

The [Legislature], by joint resolution, may appoint one or more of its members, who sponsored or cosponsored this Act in his or her official capacity, to intervene as a matter of right in any case in which the constitutionality of this Act or any portion thereof is challenged.

Section 7. Severability.

Any provision of this Act held to be invalid or unenforceable by its terms, or as applied to any person or circumstance, shall be construed so as to give it the maximum effect permitted by law, unless such holding shall be one of utter invalidity or unenforceability, in which event such provision shall be deemed severable herefrom and shall not affect the remainder hereof or the application of such provision to other persons not similarly situated or to other, dissimilar circumstances.

Section 8. Effective Date.

This Act takes effect on [Insert date].

AUL’s annual publication Defending Life is available online at .

For further information regarding this or other AUL policy guides, please contact:

Americans United for Life

2101 Wilson Boulevard, Suite 525

Arlington, Virginia 22201

202. 289.1478 | Fax 202.289.1473 | Legislation@



©2017 Americans United for Life

This policy guide may be copied and distributed freely as long as the content remains unchanged and Americans United for Life is referenced as the creator and owner of this content.

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[1] Patient Protection and Affordable Care Act of 2010, 42 U.S.C. § 18023(a) (2011) (“A State may elect to prohibit abortion coverage in qualified health plans offered through an Exchange in such State if such State enacts a law to provide for such prohibition.”)

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