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Affordable Care Act: Family Planning

Health Insurance Reform & Women

Family Planning Expanded

  • Despite tremendous pressure from the National Conference of Catholic Bishops, the Obama administration refused to expand the religious exemption in the Affordable Care Act. As a result, students and employees of religiously-affiliated institutions that are not churches (e.g. hospitals, universities, insurance agencies) will have the same right as students and employees of other institutions to access birth control in their health plans without co-pays or deductibles.

  • Religiously-affiliated institutions will not be required to provide or refer for contraception directly, but insurance companies will be required to cover it, without copays or deductibles, just as with any other employer or institution.

Abortion Restricted

  • The Stupak/Pitts Amendment in the House health care bill, which would have banned all coverage of abortion in insurance plans offered in the new state insurance exchanges, was finally defeated when the House passed the Senate bill. The amendment would have essentially prohibited women from buying abortion coverage in the state insurance exchanges, even with their own money.

  • An amendment offered by Senator Nelson (D-NE) was added to the Senate bill in order to secure Nelson's support to bring the bill up for a final vote and to break the Republican filibuster. Under the amendment that finally passed, abortion access is restricted but coverage is not completely banned. In accordance with current federal law (the Hyde Amendment, see below), abortions may not be covered by any federal subsidy or federal funding but individuals may buy insurance plans with abortion coverage as long as they pay for it with their own money. To "segregate" the payments in plans providing abortion coverage, an individual receiving a federal subsidy must make two payments, one for the bulk of the coverage and a second for an allocation fund that would provide the abortion coverage. An individual state may "opt-out" of this provision, but it would require the state to pass a new law prohibiting its insurance exchange from including plans that cover abortion services. State insurance exchanges must offer at least one plan that does not offer abortion coverage.

Hyde Amendment Unchanged

  • Under the Hyde Amendment, which became federal law in 1976, no federal funds can be used for abortion funding except in the case of rape, incest or danger to the woman's life. These restrictions do not apply to private insurance plans or coverage. Today, the majority of private insurance plans cover abortion services.

  • This insurance reform package could not have been a vehicle for overturning the Hyde Amendment because there simply were not the votes in either the House or Senate to defeat the Hyde Amendment at that point. The women's movement must change the political climate to defeat the Hyde Amendment in the future. The fight over this health insurance reform shows how important it is to win a pro-choice majority in both the House and Senate. But it also reveals that some pro-choice members, especially Republicans, were willing to vote to restrict abortion coverage in an effort to split the Democratic vote and to defeat health care reform in its entirety.

Updated June 27, 2012


  1. Feminist Majority Foundation, Feminist Newswire
  2. FACT SHEET: Women's Preventive Services and Religious Institutions
  3. Full text of the Patient Protection and Affordable Care Act of 2010 PDF
  4. U.S. Supreme Court
  5. Abortion Care Coverage and Health Reform. Planned Parenthood.