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Obamacare 'Abortion Surcharge': The Facts Behind The Rumor

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Adding fuel to a growing misinformation campaign about abortion coverage under Obamacare, Rep. Chris Smith (R-N.J.) recently kicked a bees' nest of Catholics and anti-abortion activists when he asserted that Obamacare contains an "abortion surcharge and a secrecy clause" that forces "pro-life Americans ... to pay for other people's abortions."

In fact, the policy does not require anyone who does not want abortion coverage to pay for it. Under the law, states have to offer at least one health plan on their insurance exchanges that doesn't cover abortion services at all. If a state decides it does want to have health plans that cover abortion services on its exchange, and if a woman chooses one of those plans, then she has to pay a separate fee of at least $1 to a separate account for that coverage in order to make sure no federal dollars are used to support abortion services.

For people who opt into a health plan that covers abortion, the Affordable Care Act requires that health plans "provide a notice to enrollees" at the time of enrollment that their plan includes the surcharge, but those plans are not allowed to advertise the specific surcharge. This is the aspect of the policy that Smith calls a "secrecy clause."

"This secrecy clause requires insurance companies to bury the abortion surcharge in the summary of benefits so Americans shopping for an insurance plan on the exchange won't know about the abortion surcharge until they sign up for coverage -- and even then they could easily miss the fine print," the congressman said in a statement. "Undoubtedly many enrollees will be shocked when they get a bill for the Obama abortion surcharge. Once enrolled, even pro-life Americans will be forced to pay for other people's abortions."

Anti-abortion advocates and conservative media outlets have latched onto Smith's claim, and the rumor about the secret, compulsory "$1 abortion surcharge" has caught fire. The Washington Post ran a blog post on Friday citing the "abortion surcharge" and the "abortifacient mandate" as evidence that Obamacare secretly covers abortions, and the president of Americans United for Life mentioned the surcharge in an email to supporters last week as part of her argument for why Obamacare is unconstitutional.

"If Obamacare is not struck down, Americans participating in health plans that cover abortion through state Exchanges will be required to pay a portion of their insurance premium directly to fund abortion," said Charmaine Yoest. "But by striking down the law, the Supreme Court can negate this massive expansion of abortion."

Most complaints about the surcharge neglect to point out that every American will have the option to choose a plan through the state exchanges that does not cover abortion at all, and hence will not be required to pay any such surcharge. And the contraception mandate, which the Washington Post blog inaccurately referred to as an "abortifacient mandate," only covers methods of birth control that prevent pregnancy.

Erin Shields, a spokeswoman for the Department of Health and Human Services, cleared up the confusion about abortion and the Affordable Care Act in a statement to HuffPost on Monday.

"Under the new health care law, federal funds continue not to be used for abortion services, except those in cases of rape or incest or where the life of the woman is endangered," she said. "No one will be required to choose a plan that covers these services and no taxpayer dollars will be spent on them. Before choosing a health plan, consumers will know whether the plan covers these services. And if it does, payments will be made into a separate account to ensure no federal dollars fund these services."

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