“It Could Sway Either Way”: Republicans Await Word From Trump in Abortion Fight

The Republican White House is open to a deal to extend the Biden-era expansion of the Affordable Care Act, so long as those negotiations come after Democrats reopen the government. It is a demand that has left conservatives on Capitol Hill and anti-abortion advocates across the country on edge.

“We think that we can open the government and then have the conversation about what best health care policy fits the needs of the American people,” Vice President JD Vance told RealClearPolitics at the beginning of October. It was the first day the government went dark. Nearly every day afterwards, the anti-abortion lobby has demanded that any conversation come with caveats.

Their backstop is a brick wall: a ban on federal funding for abortion. The Hyde Amendment has never applied to Obamacare, and anti-abortion advocates are demanding that if lawmakers extend the Biden-era expansion of ACA subsidies, they include that prohibition for the first time.

One pro-life operative called it “the critical juncture” in all negotiations. The White House has not tipped its hand publicly and did not return RCP’s request for comment. While sources close to the talks believe the administration is publicly being noncommittal on the issue because extending the subsidies without Hyde protections would be a nonstarter, Republicans on the Hill are waiting to hear from President Trump.

“They are still keeping it close to the chest,” a senior Republican Senate staffer told RCP before predicting that the issue “could sway either way.” Their office is caught in a holding pattern for now as the shutdown drags on. “We’re keeping our ears open,” they said, “to see what the White House is going to recommend we do.” Anti-abortion advocates, on the other hand, have been explicit.

More than one hundred pro-life groups, led by Susan B. Anthony Pro-Life America, sent a letter last week to Congress drawing a line in the sand. “Any funding for Obamacare,” they wrote, “whether through cost-sharing reductions or premium tax credits, is forced taxpayer funding of abortion, unless such funds are definitively limited to coverage that excludes elective abortion.”

It is the latest in a debate that runs back to the earliest days of Obamacare. A dozen states require abortion coverage in their ACA plans, according to KFF, while another 13 states do not include coverage limitations or requirements. The remaining 25 have explicit prohibitions against abortion in place.

Liberals insist that the law already segregates taxpayer funds, even without the Hyde Amendment in place, so that government dollars are not used to directly pay for abortion. Conservatives counter that those existing guardrails amount to “an accounting gimmick” because the law also requires insurers to collect a separate surcharge for abortion coverage. They note, for instance, that Maryland tapped into a $25 million Obamacare fund recently to cover the cost of women traveling there from out of state to receive an abortion.

Sen. Tommy Tuberville told RCP the arrangement amounts to “an Obamacare loophole that allows taxpayers to pay for abortions.” The Alabama Republican praised Trump for delivering “on several key pro-life wins,” including a reversal of the Biden administration’s abortion travel policy for military members and called on Congress to “do our job to ensure that zero taxpayer dollars go towards paying for abortions.”

The fight comes as Trump has made overtures to Democrats and promises that he is willing to shore up the healthcare program he spent so much political capital trying to repeal during his first term. “Obamacare has been a disaster for the people,” the president told NBC News earlier this month, “so we want to have it fixed so it works.”

There is a new wrinkle in the ongoing Obamacare fight: Former President Joe Biden’s extension of enhanced ACA subsidies, via the Inflation Reduction Act, which made insurance coverage available to millions of additional Americans. They are set to expire at the end of the year. Even some staunchly anti-abortion Republicans, like Georgia Rep. Marjorie Taylor Greene, are now backing the extension and reminding GOP leadership that their MAGA voters rely on the healthcare subsidies.

The fear among anti-abortion activists is that the White House could potentially waver in its pro-life commitments. It would be out of character for Trump, who is fond of referring to himself as “the most pro-life president ever” and who helped appoint the Supreme Court majority that overturned Roe v. Wade. But some conservatives are still wary and point to the administration’s decision to approve a new generic abortion drug, mifepristone, as reason for caution.

Among fiscal conservatives on Capitol Hill, the preferred outcome is for Biden’s expansion of Obamacare to expire as scheduled. If Trump makes a deal to “fix” the healthcare program as he has suggested, however, one congressional aide told RCP, “then the Hyde Amendment needs to be attached.”

This article was originally published by RealClearPolitics and made available via RealClearWire.