Right-Wing Media Helps Health Reform Law Opponents Invent "$1 Abortions"

Right-wing media are pointing to final regulations implementing health care reform legislation to revive long discredited myths about abortion coverage.

In early March 2012, the federal Department of Health and Human Services finalized a number of regulations implementing portions of the Affordable Care Act. One of the regulations implemented a provision requiring that insurance companies that choose to provide coverage for abortion through the health care exchanges ensure that federal money is not used to provide abortions. The regulations further require insurers to collect an additional abortion coverage fee from plan enrollees who choose a plan that covers abortion.

After the rules were announced, The Fox Nation excerpted a LifeNews.com piece under the false headline: "$1 Abortions in Obamacare." And Rush Limbaugh falsely claimed that the regulation “establishes state health care exchanges under Obamacare including an abortion premium mandate. You now, because of this implementation of the rule, you now will be forced to pay a dollar a month to cover abortion on your insurance policy.” Limbaugh also claimed that the fee “is coming out of your pocket, one way or the other.”

None of this is true. There are no "$1 abortions" in the Affordable Care Act. There are also no requirements that everyone pay a fee for abortion coverage; indeed, people always have the choice of picking a plan that doesn't cover abortion at all.

The Falsehood That Everyone “Will Be Forced To Pay A Dollar A Month To Cover Abortion On Your Insurance Policy”

Limbaugh's claim that “you now will be forced to pay a dollar a month to cover abortion on your insurance policy,” is simply not true.

The reason that the surcharge for abortion coverage exists at all is to make sure that federal money is not spent on abortion. Federal law bans the use of any federal funds for abortion except in cases of rape, incest, or where the life of the woman is in danger. The Affordable Care Act maintains that ban. Plans that cover abortion must charge enrollees an additional fee for abortion and keep those funds separate to ensure that no federal money is paid for abortion.

Moreover, people do not even have to choose a plan that covers abortion. The Affordable Care Act specifically says that in any health care exchanges that are established, there must be “at least one ... plan that does not provide coverage” for abortions. Therefore, a person who receives insurance through the exchanges can choose either a plan that covers abortion or one that does not. If the person chooses a plan that does not cover abortion, he or she does not pay a surcharge for abortion. Again, the regulations do nothing to change this provision.

Right-Wing Invents "$1 Abortions"

With respect to the right-wing media's claim about the impact of the Affordable Care Act on how much abortions cost, the Affordable Care Act does not set a price for abortions. Section 1303 of the Affordable Care Act states that insurance plans can cover abortions in cases of rape and incest and in cases where the life of the pregnant woman is in danger.

If an insurance plan chooses to cover abortion in other situations as well, it must charge an additional fee for this coverage. The Health and Human Services secretary determines the cost of this fee based “an average actuarial basis” for the entire population covered. But the cost of this fee may not take into account any cost savings that result from abortions, such as those resulting from a decrease in “prenatal care, delivery, or postnatal care.” No matter what the actuarial estimates are, the fee shall not be “less than $1 per enrollee, per month.” The regulations do nothing to change this provision.

In other words, private insurance companies that choose to cover abortions must overestimate the costs of abortion (since they are not allowed to take into account any cost reductions that result from abortion coverage). If this overestimate turns out to be less than $1 per month per enrollee, insurers still must charge enrollees $1 per month.