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WASHINGTON, March 13, 2012 (LifeSiteNews.com) – The final rule for the health care exchanges set for implementation under the federal health care law has maintained an original accounting arrangement allowing taxpayer funding of abortion, despite the Hyde amendment.

The Department of Health and Human Services this month issued a final rule regarding the exchanges required under the Patient Protection and Affordable Care Act (PPACA). The rule provides for taxpayer funding of insurance coverage that includes elective abortion through a direct abortion subsidy. 

To comply with the accounting requirement, plans will collect a separate $1 abortion surcharge from each premium payer. As described in the rule, the surcharge can only be disclosed to the enrollee at the time of enrollment, and insurance plans may only advertise the total cost of the premiums without disclosing the abortion surcharge.

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PPACA allows for one insurance plan in each exchange to refuse to cover abortion, while the rest are permitted to cover the procedure.

The final rule also mentions that several commenters had expressed concerns about further abortion coverage in federally-administered “multi-state” plans, but says only that the standards for those plans will be described later. No part of PPACA prevents such plans from covering abortions.

The law mandates that the new exchanges be operational by January 1, 2014. The final rule notes that the federal government will force implementation of an exchange in any state that refuses to create one.

The abortion surcharge was one of several points of contention named by pro-life advocates when battling the health care law before its passage two years ago, in March 2010. Pro-life leaders argued that the abortion surcharge amounted to a meaningless accounting gimmick designed to skirt accusations that federal premium subsidies would be used to pay for the procedure in abortion-covering plans.

Susan Muskett, senior legislative counsel at National Right to Life, told LifeSiteNews.com that the final rule “reinforces the serious pro-abortion effects that Obamacare will have on America.” She said the abortion subsidy setup flouted the intention of the Hyde amendment, which specifically bars federal dollars from funding health insurance plans that cover abortion, except for in cases of rape or incest.

“Under Obamacare, there’s going to be hundreds of billions of dollars that’s going to be paying for federal premium subsidies,” said Muskett. For many in America, she said, being forced to pay for abortion-subsidizing plans is “just as bad” as directly paying for the abortions themselves.

The accounting trick is not unlike the “accommodation” President Obama announced last month regarding the HHS mandate forcing religious employers to cover abortifacient drugs and sterilizations, also authorized under PPACA. Obama attempted to sidestep the controversy by claiming that insurance companies would simply offer free birth control to women covered by their religious employers – a fix that left the original mandate unchanged.

In terms of how to respond to the final rule, Muskett said that “we don’t even have all the pieces of the puzzle yet,” such as the details on abortion in multi-state plans, but that NRLC will continue to support efforts to repeal the health care law.