November 19, 2025

How an abortion debate could doom ACA subsidies

Abortion restrictions have entered the conversation surrounding renewing subsidies for health insurance policies under the Affordable Care Act (ACA.) Senate Republicans now say they’re open to extending ACA tax breaks set to expire at the end of the year — but only if Democrats accept stricter abortion restrictions in American insurance plans. 

The GOP position could doom the ACA subsidies altogether.

The subsidies were a key factor in what became the longest federal government shutdown in U.S. history. For 43 days, the Senate failed to approve a temporary spending plan that would reopen the government because Democrats wanted renewed subsidies, while Republicans wanted what they called a “clean” funding bill. 

In the end, several Democrats agreed to vote for the bill, and Republicans promised to discuss ACA subsidies once the government reopened. 

Abortion regulations as they stand

Now that conversations surrounding the ACA have begun, Republicans have come forward to say Democrats will have trouble getting their votes due to abortion policies within the proposed legislation. 

The main argument stems from the Hyde Amendment, a 1977 provision that bars federal funding from being used for abortions. However, some ACA enrollees can still access abortion services through Obamacare using state funding. 

In 2010, former President Barack Obama negotiated with antiabortion Democrats to pass the ACA. They compromised on a $1 surcharge that enrollees can pay per month to cover abortions for themselves, ensuring they’re funded by individuals and states, not the federal government. 

However, that’s what Republicans want to change. 

What Republicans are saying

The Washington Post reports Republicans are under pressure from activists who oppose abortion rights, who insist that any ACA extension include additional abortion restrictions. 

Prior to the Senate passing a bill to reopen the government, Senate Majority Leader John Thune, R-S.D., said Republicans want to change the 2010 state funding compromise. 

“A one-year extension along the lines of what [Democrats] are suggesting, and without Hyde protections — there’s just not even, doesn’t even get close,” Thune said. 

Sen. Mike Rounds, R-S.D., made a similar comment, saying, “You can’t do it under your existing framework, and you’re never going to get any Republican votes because we believe strongly taxpayer dollars should not go to fund abortions.”

Democrats’ argument

Meanwhile, Democrats argue that ACA subsidies comply with the Hyde Amendment because abortion funding is coming from the states, not the federal government. Sen. Jeanne Shaheen, D-N.H., said the issue has already been addressed.

She told NBC News that any changes to abortion restrictions are a “nonstarter,” saying the Hyde Amendment is “not an issue. We already dealt with that issue.”

Sen. Elizabeth Warren, D-Mass., called the Republicans’ proposal a “backdoor abortion ban.” 

Meanwhile, Sen. Tammy Baldwin, D-Wisc., said the proposal would move the country closer to banning abortion altogether. 

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