Talking points and health-care restrictions prevent people from enrolling in ACA

Open-enrollment for marketplace health insurance began at the beginning of this month and with open-enrollment each year come the falsehoods and inaccuracies from the anti-choice movement.

These inflammatory talking-points have been going around since the Affordable Health care Act was passed in 2015. Chief among these false talking points is the argument that the Affordable Care Act (ACA), provides federal subsidies for abortions — it is a blatant lie.


The ACA does not subsidize abortion care. In fact, since the ACA passed, many states have taken steps to restrict insurers' ability to cover abortion in their health plans. Twenty-three states restrict or ban abortion coverage on the health insurance exchanges; eight states have laws that restrict abortion coverage for all private plans. Kansas and Oklahoma are two of those states.

In passing the ACA Congress decided against guaranteeing coverage of abortion care federally and established rules state-to-state rules on abortion coverage. States that do allow non-federally funded insurance coverage of abortion services have to offer at least one health plan on their insurance exchanges that doesn’t cover abortion services at all.

However, states retain the option to ban abortion coverage in marketplace plans outright. Some states, like Washington and Oregon, pay 100 percent of the cost of elective abortions without passing on any cost to the federal government. Under the ACA, health insurance plans could cover some or all elective abortions, but they can’t use federal tax credits and subsidies to offset the cost. Insurance providers that cover elective abortions must charge consumers separately and deposit the money into a separate account that contains no federal money.

But these facts do not deter the anti-choice movement from reviving the abortion talking point every year at open-enrollment time that ACA subsidizes abortion services. In fact, the Hyde Amendment, a radically discriminatory and dangerous piece of legislation passed in 1976, specifically blocks federal Medicaid funding for abortion services. Under the Hyde Amendment, Medicaid cannot even cover abortion when a woman’s health is at risk.

Many states hostile to abortion have gone even further to restrict women’s reproductive rights by prohibiting private insurance companies from including abortion coverage in their policies. Ten states passed bans on abortion coverage and 25 banned coverage in their exchanges.

Banning private health insurance coverage is just one of several ways states increase the burden on people seeking abortion care. The fact is that banning insurance coverage for a medical procedure forces the patient in certain locations to pay out of pocket for a procedure that can cost up to thousands of dollars. For many, this is an insurmountable burden to accessing necessary health care.

Health insurance bans, like the ones in Oklahoma, Kansas, Idaho, Texas, Utah and several other states, are an obstacle to a federally protected right. In many of these states, patients don’t even know that their insurance coverage is banned if they want an abortion. In an analyses of ACA marketplace plans, the Guttmacher Institute and the Kaiser Family Foundation have found that some states offer no plans that cover abortion at all. To argue that a federal ban needs to be in place, such as two presidents of anti-choice organizations have done recently, is to demand that people who can afford to pay for health care out of pocket are the only ones who get access to their federally protected right to abortion.

The anti-choice open enrollment talking points wield a veto power over coverage for all people. Anti-choice extremists want to control not only what level of health care people are able to access, but also what types of insurance they are able to purchase. This intense control is unconscionable and punitive, particularly from a movement that purports to respect individuals. These policies further silo abortion services outside the realm of regular health care.

Every year we have heard these anti-choice talking points and every year they remain false. But what does change year to year are the restrictions that are keeping more and more people from the health care they need and the increasing violence abortion providers endure because of these falsehoods. The lies must be addressed as just that, lies and then relegated to the dustbin of history.

Julie A. Burkhart is the founder and CEO of Trust Women Foundation. Trust Women opens clinics that provide abortion care in underserved communities so that all women can make their own decisions about their health care. Follow her on Twitter @julieburkhart.