Sponsors (50)
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Prohibits the use of federal taxpayer funds to pay for abortions and changes how the Affordable Care Act (ACA) applies to plans that cover abortion. It removes eligibility for ACA premium tax credits and certain small‑employer tax credits for health plans that include abortion coverage, allows separate abortion‑only policies to be sold if no tax credit pays for them, and requires plans to disclose whether abortion is covered and to itemize any abortion-related premium surcharge. The bill also adds a new chapter to Title 1 of the U.S. Code to codify the prohibition on taxpayer-funded abortions.
Amend Title 1, United States Code by adding at the end a new chapter described as prohibiting taxpayer-funded (federally funded) abortions. The section text indicates a new chapter is to be inserted but does not include the chapter text in this excerpt.
Amend the table of chapters for Title 1, United States Code by adding at the end a new item corresponding to the newly added chapter. The excerpt shows the table will be updated but does not display the exact table entry text.
Disallows the refundable premium tax credit and cost-sharing reductions under section 36B(c)(3) for any coverage provided by a qualified health plan that provides coverage for abortion.
Permits individuals to purchase separate coverage (or a plan that includes abortion) for abortions described in the provision, provided that no premium tax credit is allowed for premiums for that separate coverage or plan.
Permits non-Federal health insurance issuers to offer separate abortion coverage or plans that include abortion, provided premiums for that separate coverage or plan are not paid with amounts attributable to the premium tax credit or advance payments of the credit under section 1412 of the Affordable Care Act.
Who is affected and how:
People enrolled in Marketplace (qualified exchange) plans: Directly affected because plans that include abortion will no longer qualify for ACA premium tax credits. Consumers choosing plans that cover abortion may lose or receive reduced premium subsidies, raising their net premium cost. Separate abortion‑only products could be offered but would not be subsidized, making them more expensive out of pocket.
Employers (especially small employers): Employers that offer health plans including abortion coverage may lose eligibility for certain small‑employer tax credits. Some employers may alter plan design (remove abortion coverage or offer separate products) to preserve tax benefits for employees.
Qualified health plans and issuers / Insurers: Must change plan designs, enrollment systems, premium billing, and notices to comply. Carriers will need to flag plans that cover abortion for subsidy ineligibility, show any abortion‑related surcharge separately, and possibly develop separate abortion‑only products.
Individual taxpayers and households: Tax credit recipients who value abortion coverage may face higher premiums. Tax administration and reconciliation processes will need to ensure credits are not provided for ineligible plans, which may affect advance payments and year‑end reconciliations.
Health care access and public health: Making abortion coverage ineligible for subsidies is likely to reduce the affordability of that coverage, potentially reducing coverage uptake and increasing out‑of‑pocket costs for abortion services. This could disproportionately affect low‑ and middle‑income individuals who rely on tax credits to afford coverage.
Administrative and legal systems: Exchanges, insurers, employers, and the IRS will incur operational costs to implement eligibility checks, separate product administration, and new notice requirements. The interplay with state insurance laws and mandates may generate legal disputes or compliance complexity.
Overall effect: The bill removes subsidy support for abortion coverage in private health plans and imposes new disclosure and plan design rules, shifting costs and administrative burdens to consumers, employers, insurers, and tax/enrollment systems. The net result is likely reduced subsidized availability of abortion coverage and higher direct costs for people seeking such coverage.
Adds a new chapter to title 1, United States Code, prohibiting taxpayer-funded (federally funded) abortions.
Amends 26 U.S.C. 36B(c)(3) to add disallowance language for the refundable premium tax credit with respect to coverage that provides abortion and to add a new subparagraph permitting purchase or offering of separate abortion coverage or plans so long as no credit is allowed for premiums for such coverage or plan.
Amends subsection (h) of section 45R to exclude from the definition of the relevant term any health plan that includes coverage for abortions (with limited exceptions) and to add explicit language allowing employers and issuers to provide separate abortion coverage or plans so long as employer contributions eligible for the credit are not used to pay for such coverage.
Amends 42 U.S.C. 18023(b) by striking specified paragraphs, redesignating another paragraph, and replacing paragraph (3) with new notice rules requiring disclosure of the extent of coverage for certain abortion-related services at enrollment and in marketing/advertising/materials, and requiring separate disclosure of any surcharge attributable to such services when plan premiums are disclosed.
Rewrites paragraph (6) of 42 U.S.C. 18054(a) (multi-State plans) to require that, in entering into contracts, the Director ensure that no multi-State qualified health plan offered in an Exchange provides health benefits coverage for which the expenditure of Federal funds is prohibited under title 1, United States Code.
Read twice and referred to the Committee on Finance.
Introduced January 22, 2025 by Roger F. Wicker · Last progress January 22, 2025
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Read twice and referred to the Committee on Finance.
Introduced in Senate