Abortion impasse may shut down effort to reduce premiums

WASHINGTON (AP) — The polarizing politics of abortion have burst into the congressional budget debate, overwhelming bipartisan efforts to help millions of consumers who buy their own health insurance policies get relief from soaring premiums.

On Monday, Senate and House Republicans released their latest plan to stabilize the Affordable Care Act's insurance markets. It calls for new federal money to offset the cost of treating the sickest patients and restores insurer subsidies that President Donald Trump terminated last year.

That's clearly a shift from when repealing "Obamacare" was the GOP's demand. But the fine print of the GOP offer includes restrictions on abortion funding that Democrats have already rejected, a "poison pill" to abortion rights supporters. They say the proposal could block abortion coverage by some health insurance plans consumers purchase with their own money.

Lawmakers of both parties have been negotiating over a health insurance stabilization bill for months, but chances it will be added to the budget deal appear to be dwindling. Some experts estimate such legislation could reduce premiums by 20 percent to 40 percent, after two years of relentless increases.

The office of one of the leading Democratic negotiators, Sen. Patty Murray of Washington, on Monday called the Republican offer "partisan," saying in a statement it came as a surprise.

In an interview last Friday, Murray said her GOP counterparts have only recently started raising the issue of abortion restrictions.

"To me that is just unacceptable," Murray said. "Why would they add it on at the last minute?" She complained that some Republicans were taking the stabilization bill "hostage."

Republicans say their longstanding support for restrictions on abortion funding is well-known.

Abortion is just one of several divisive social issues complicating prospects for a $1.3 trillion spending bill that would keep the government open and provide funding increases for military and domestic programs.

Others include a Republican demand for stronger "conscience" protections for clinicians, and a Democratic maneuver to protect family planning money for Planned Parenthood clinics, which provide birth control for many low-income women.

Federal funding for abortion has long been restricted by a series of laws known as the Hyde amendment, which prohibit taxpayer funds from being used to pay for abortions, expect in cases of rape, incest or when the woman's life is endangered.

Abortion remains a legal medical procedure in the United States, covered by many employer plans. However, the abortion rate has dropped significantly, from about 29 per 1,000 women of reproductive age in 1980 to about 15 in 2014. Better contraception, fewer unintended pregnancies and state restrictions may have played a role, according to a recent scientific report.

Former President Barack Obama's Affordable Care Act attempted a compromise over abortion coverage.

Passed with only Democratic votes, the health law allowed plans sold through HealthCare.gov to cover abortion, provided they didn't tap taxpayer subsidies that help consumers pay premiums. Instead the plans must collect a separate premium for abortions, and keep the accounts strictly separate.

The ACA also allowed states to prohibit abortion coverage in their insurance markets, and about half have done so.

But abortion opponents decried Obama's compromise as a bookkeeping exercise. They wanted the Hyde amendment applied to plans sold through HealthCare.gov and state insurance markets.

The new GOP bill would apply Hyde restrictions to two streams of federal money.

One is restored subsidies that compensate insurers for required discounts on copays and deductibles for low-income people.

The second funding stream would stabilize insurance markets by helping cover costs for the sickest patients.

Abortion rights supporters say that the second prohibition could result in abortion restrictions for health insurance that consumers buy with their own money outside of HealthCare.gov. That's because a fund to help with the costs of the sickest patients would help reduce premiums across all plans in a given state.

Sen. Lamar Alexander, R-Tenn., a leading negotiator for the GOP, tried to debunk such concerns late Monday, telling reporters "there's no chance of that."

Alexander pointedly reminded Democrats that Congress and the White House are under GOP control and the Hyde restrictions represent what Republicans can accept.

Other Republicans say they've already compromised, by signing onto legislation that tries to fix problems with the ACA.

"I'm willing to ensure payments are there to bring premiums down," said Rep. Chris Smith, R-N.J. "But we don't want to be complicit in taking the lives of unborn children."

AP Writer Alan Fram contributed to this report.