People For the American Way

Latest Anti-Choice Attacks Would Devastate Health Care for Millions

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Latest Anti-Choice Attacks Would Devastate Health Care for Millions

Anti-choice members of Congress are marking this week’s eighth anniversary of the Affordable Care Act by pushing yet another attack on comprehensive reproductive health care. For ACA market stabilization to be added to the latest government funding package, they want it to include expansive new abortion restrictions. As People For the American Way and more than thirty organizational allies noted in our March 2 letter to the Senate, the ACA already restricts health insurers from paying for abortion coverage with U.S. government funds. What Representative Ryan Costello, R-Pa., and others have proposed is an unnecessary political attempt to put abortion coverage even further out of reach for millions of Americans. Our Senate letter follows below and is available here. Click here to view the House letter.

Dear Senator,

As organizations committed to advancing reproductive health, rights, and justice, we believe every person should be able to make decisions about abortion with dignity and respect, without politicians interfering. Our organizations are committed to increasing health care access and coverage for everyone, no matter how much money they make, where they live, or where they get their insurance.

Unfortunately, anti-abortion politicians in Congress are attempting to eliminate consumers’ ability to buy comprehensive health plans by inserting abortion restrictions into proposals regarding private insurance. The restrictions would prevent the funds in these proposals from going to comprehensive health plans that include coverage of abortion, which would have a devastating impact on access to abortion coverage for millions of people across the country and could even make it impossible for qualified health plans to cover abortion at all.

As an example, H.R. 4666, legislation introduced by Rep. Ryan Costello (R-PA-6), would prohibit Cost Sharing Reduction (CSR) payments to plans that cover abortion, forcing insurers to choose between offering comprehensive health plans that include coverage of abortion and losing critical CSR payments. Undoubtedly this would result in fewer consumers having the option of obtaining insurance coverage for abortion. Under the Affordable Care Act (ACA), CSR payments help lower the costs of certain ACA marketplace plans for low and moderate income individuals. Burdensome restrictions in the ACA already prevent qualified health plan issuers from using CSRs to pay for abortion coverage beyond instances where a woman’s life is endangered or she is a survivor of rape or incest. The Costello bill would expand on these already harmful restrictions by preventing the plan from receiving CSR payments at all, if the plan covers abortion. Political attempts, like those proposed in the Costello bill, to add even more burdensome restrictions on abortion coverage are unnecessary and will put abortion coverage further out of reach for many.

The threat to private insurance coverage for abortion extends beyond the prospect of conditioning funds for CSR payments. The Costello bill attempts to ban abortion in the “Patient and State Stability Fund,” which could reach into the individual and employer sponsored insurance markets. This fund could be used in multiple ways, including direct payments to health insurers or health care providers, funding for reinsurance programs, and subsidies to help people pay premiums and cost sharing, so the impact on abortion coverage could be far reaching. Imposing abortion bans on such a fund, or a traditional reinsurance program, would lead to many plans dropping abortion coverage altogether.

These proposals are misguided and will have a devastating effect on insurance coverage for abortion in the private marketplace. Already, too many women are denied abortion coverage because of how much they earn or where they live because of a patchwork of harmful federal and state laws that prohibit insurance coverage of abortion in public programs like Medicaid and in the private insurance market.

For many, coverage for abortion care means the difference between getting the health care they need and being denied that care. The impact of such a denial can have long-term, devastating effects on a woman and her family’s economic future. A recent study found that a woman who seeks but is denied abortion care is more likely to fall into poverty than a woman who is able to get the care she needs.1

The goal of expanding abortion restrictions in proposals like H.R. 4666 is clear: to push abortion coverage out of reach for all women. We urge you to reject this legislation and any other proposal that expands abortion restrictions under the ACA.


Advocates for Youth
American Civil Liberties Union
Black Women’s Health Imperative
Catholics for Choice
Center for Reproductive Rights
Human Rights Campaign
In Our Own Voice: National Black Women’s Reproductive Justice Agenda
Jacobs Institute of Women’s Health
NARAL Pro-Choice America
National Abortion Federation
National Asian Pacific American Women’s Forum (NAPAWF)
National Center for Lesbian Rights
National Council of Jewish Women
National Family Planning & Reproductive Health Association
National Health Law Program
National Institute for Reproductive Health (NIRH)
National Latina Institute for Reproductive Health
National LGBTQ Task Force
National Network of Abortion Funds
National Organization for Women
National Partnership for Women & Families
National Women’s Health Network
National Women’s Law Center
New Voices for Reproductive Justice
People For the American Way
Physicians for Reproductive Health
Planned Parenthood Federation of America
Sexuality Information and Education Council of the United States (SIECUS)
The Afiya Center
Unite for Reproductive & Gender Equity
Women With a Vision
Women’s Law Project

1 Foster DG, Dobkin LM, Upadhyay UD. “Denial of abortion care due to gestational age limits.” Contraception.2013;87(1):3 5.


Abortion, Anti-Choice, Countering Attacks on Women's Equality, health care, letter, Obamacare, reproductive health care, Ryan Costello, Trumpcare