The Graham-Cassidy bill, the newest bill attempting to repeal the ACA, is an attack on women’s health care rights. This bill will make it harder for women to get insurance coverage for abortion care. It will make it more difficult for Medicaid recipients to visit Planned Parenthood. It will even create new ways for the government to restrict access to abortion. It will allow insurance companies to stop offering maternal care. It’s clear this bill will harm women.
The new concerns for reproductive rights in Graham-Cassidy largely stem from its block grant program. As Vox’s Sarah Kliff explains, the bill would repeal Obamacare’s individual tax credits and the Medicaid expansion in 2020, and replace them with grants to the states. Those grants could then be spent in a variety of ways — on high-risk pools, for instance, or on programs “to help individuals purchase health benefits coverage.” But, crucially, none of the money from the grants could be spent on insurance coverage for abortion.
Many states already have restrictions on insurance coverage for abortion. But Graham-Cassidy would require all states to ban abortion coverage in any program that gets federal block grant money. If it took money to offer subsidies for individual coverage or otherwise bolster the individual market, then it would have to restrict abortion coverage on that market. If it used federal funds to offer subsidies to employers, the ban on abortion coverage would affect the employer market too.
Essentially, the federal government would have the states over a barrel — if they wanted money to help keep their residents covered, they’d have to sacrifice abortion coverage to get it.
Because there’s no telling yet exactly what states would do with the block grants, or how the law would be interpreted, it’s not clear what the impact of the abortion restrictions would be. But the block grant program would certainly offer the federal government a new and powerful tool to restrict abortion coverage, including in states that have few restrictions in place now.
It’s also worth noting that spending for the bill would expire in 2026, meaning that unless Congress acted to replace the block grant money somehow, anybody who relied on that money for any reproductive health care — or, indeed, any health care at all — would be out of luck.