No, there isn't a “monthly abortion fee” in the Senate bill

Right-wing media are up-in-arms about what they are falsely claiming is a “requirement for a monthly abortion fee” in the Senate health care reform bill.

In reality, there is no such “fee.” Rather, the right is distorting a provision of the bill that requires insurance plans that offer abortion coverage to segregate their funds so that tax dollars aren't used to fund abortion coverage. And since the bill says that every state's health exchange must offer at least one plan that doesn't cover abortion (except in cases of rape, incest, or a danger to the mother's life), consumers won't be forced to fund abortions with their premiums either.

The misinformation food chain started when House GOP leader John Boehner's staff posted the following on his blog, under the headline, “Sen. Reid's Government-Run Health Plan Requires a Monthly Abortion Fee”:

Just like the original 2,032-page, government-run health care plan from Speaker Nancy Pelosi's (D-CA), Senate Majority Leader Harry Reid's (D-NV) massive, 2,074-page bill would levy a new “abortion premium” fee on Americans in the government-run plan.


[A] monthly abortion premium will be charged of all enrollees in the government-run health plan. It's right there beginning on line 11, page 122, section 1303, under “Actuarial Value of Optional Service Coverage.” The premium will be paid into a U.S. Treasury account - and these federal funds will be used to pay for the abortion services.

Section 1303(a)(2)(C) describes the process in which the Health Benefits Commissioner is to assess the monthly premiums that will be used to pay for elective abortions under the government-run health plan and for those who are given an affordability credit to purchase insurance coverage that includes abortion through the Exchange. The Commissioner must charge at a minimum $1 per enrollee per month.

Drudge quickly linked to Boehner's post and proclaimed, “Reid's Government-Run Health Plan Requires a Monthly Abortion Fee... .” By this afternoon, Rush Limbaugh was claiming that Boehner had “found” in the Senate bill a “requirement for a monthly abortion fee.”

This is simply false.

“Monthly abortion fee” implies there is some sort of extra charge assessed to consumers in order to pay for abortions. But this isn't the case. Rather, the bill sets up requirements by which insurance plans segregate their funds so that federal dollars don't pay for abortion coverage.

Section 1303(a)(2)(B) requires insurers who cover any abortions that are not currently allowed to be paid for with federal funds to use money not provided by the federal government to “segregate an amount equal to the actuarial amounts determined under subparagraph (C) for all enrollees.” This “segregated” money is what can be spent on abortion coverage.

Subparagraph (C) of Section 1303(a)(2) -- the subparagraph that Boehner and Limbaugh claim “describes the process in which the Health Benefits Commissioner is to assess the monthly premiums that will be used to pay for elective abortions” -- simply lays out a process by which insurers determine how much of their money to segregate in order to ensure that federal money doesn't pay for elective abortions.

If you choose to purchase a plan that covers abortion, it's completely expected that a portion of your premium pays for abortion coverage. Saying that this creates some sort of additional “abortion fee” is like saying that there's a “monthly heart attack fee” because the plan covers heart attacks.

Which brings us back to Limbaugh, who took the distortion a step further by claiming, “You will be required to pay a monthly abortion premium.” Not just individuals who purchase an insurance plan that covers abortion, but apparently each and every “you” listening to Limbaugh's show.

In reality, you won't be required to pay a “monthly abortion premium,” and you won't even be required to have your premiums help pay for abortion coverage. The bill requires that each exchange offer at least one insurance plan that doesn't cover abortions. If you purchase one of those plans, your premiums won't be used to cover abortion.