ACA Abortion Restrictions (E.O. 13535)

Summary

Makes sure that government money is not used to pay for abortions, except in special cases like rape, incest, or to save the mother's life.

What problem does this solve?

The Affordable Care Act created new health insurance plans, and it was unclear how existing rules against using federal money for abortions would apply. This order directs government agencies to create strict accounting rules to ensure federal funds are kept separate and not used for abortion services in these new plans.

What does this order do?

Establishes an enforcement system for abortion funding rules

Creates a government-wide policy to ensure federal funds are not used for abortion services, except in cases of rape, incest, or to save the life of the woman, consistent with the Hyde Amendment.

Requires separation of funds in health insurance exchanges

Directs the Office of Management and Budget (OMB) and the Department of Health and Human Services (HHS) to create guidelines for separating federal tax credits from private money used to pay for abortions.

Applies funding restrictions to Community Health Centers

Ensures that new federal funds for Community Health Centers under the Affordable Care Act cannot be used for abortion services, following existing Hyde Amendment rules.

Upholds conscience protections for healthcare providers

Confirms that existing laws protecting healthcare providers and facilities from being forced to provide, pay for, or refer for abortions remain in effect.

Who does this affect?

Women seeking reproductive healthcare through ACA insurance exchanges
Health insurance companies
State health insurance commissioners

What is the real world impact?

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Enforces existing law in a new system

Applies the long-standing Hyde Amendment, which bans federal funding for most abortions, to the new health insurance exchanges created by the Affordable Care Act. This ensures consistency between old and new healthcare programs.

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Provides political assurance

Issued to reassure lawmakers and the public that the Affordable Care Act would not expand public funding for abortion. This helped secure the final votes needed to pass the healthcare law.

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Creates barriers to abortion access

Critics argue that the strict accounting rules create significant administrative burdens for insurance companies. This could lead them to stop offering abortion coverage altogether, even when paid for with private funds, limiting options for women.

When does this start?

This order sets a specific deadline for government agencies, starting from its signing on March 24, 2010.

Model segregation guidelines

The Director of the OMB and the Secretary of HHS must develop model guidelines for separating funds within 180 days of March 24, 2010.