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The Affordable Care Act already prevents federal funds from being spent on abortions in covered plans, but some Republicans are pushing for harder limits as they seek a deal to address health care costs
Josh Marcusin San FranciscoThursday 27 November 2025 15:32 GMTComments
CloseTrump denies he pushed two-year Obamacare subsidies extension
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Disagreements in Congress about abortion could derail the Republican Party’s ability to come up with a grand deal on healthcare.
Any delay could prove politically toxic, as the GOP faces pressure from voters over spiking health care costs and Affordable Care Act subsidies that are expiring at the end of the year, while President Trump is pushing hard to scrap Obamacare altogether for a vaguely defined “Trumpcare” replacement.
Thus far, much of the drama has played out behind the scenes or by implication. A White House plan reportedly circulating on Capitol Hill called for a two-year extension of the subsidies, though President Trump never carried out an expected Monday announcement of the plan, and the supposed proposal avoided the abortion issue entirely.
This came as a shock to some in Congress, where Republicans and lobby groups have pushed to extend the ACA’s existing abortion funding limits and cut off subsidies entirely to plans that cover abortion.
“The current system is not working to deliver healthcare at reasonable prices for everyday Americans,” White House Spokesman Kush Desai told The Independent when asked about the state of White House plans and the president’s stance on the abortion question. “Democrats’ push to maintain these high prices by giving more money to insurance companies is not a real solution for President Trump.”
open image in galleryThe issue of abortion could prevent Republicans from getting enough support to reach a deal on the future of expiring Obamacare subsidies and Trump’s larger goal of ending the ACA (AFP via Getty Images)Sen. Mike Rounds of South Dakota has said there won’t be “any” Republican votes to extend the subsidies without new abortion restrictions on Obamacare, which already prevents federal funds from being spent on abortions, though some states use separate funds to cover the procedure in plans on the ACA marketplace.
“We believe strongly taxpayer dollars should not go to fund abortions,” Rounds said earlier this month. “[Democrats] have a different point of view, but it’s pretty clear that Republicans are solid on that particular issue.”
The abortion issue is reportedly a quiet “red line” for many Republicans who the president might ask to support an unpleasant vote on extending part of Obamacare, a longtime rival’s signature legislation that the GOP has been trying to repeal for 15 years.
“Look, it’s no secret that this administration is not rushing to put a lot of political capital on the issue of abortion if they can avoid it,” Patrick Brown, a fellow with the conservative think tank Ethics and Public Policy Center, told Politico. “It’s not something I think they have any interest in highlighting.”
open image in gallerySenate Republicans including Majority Leader John Thune have suggested provisions in a future health deal that would bar federal funds from going to plans that cover abortion (AFP via Getty Images)The administration may need to wield some influence to get the abortion restrictions into the deal, as a choice either way will enrage someone.
The advocacy group Susan B. Anthony Pro-Life America has warned it will penalize anyone who votes to continue the subsidies without the abortion limits.
“We oppose any health care plan that fails to include this safeguard,” Marjorie Dannenfelser, the president of the group, told Politico. “Our position is consistent and will not change.”
Meanwhile, virtually no Democrats in Congress would agree to a proposal extending abortion restrictions beyond those purposefully built into the original ACA to comply with the Hyde Amendment, which prohibits the use of federal funds for abortions in most cases.
open image in galleryDemocrats consider the abortion restrictions a nonstarter in health care negotiations (AP)Sen. Brian Schatz, Democrat of Hawaii, has suggested the abortion discussion itself is an attempt by Republicans to find political cover as they remain divided on what to do over healthcare, an issue that’s bedeviled the party for years.
“At that point, they’re just unserious about extending the ACA [funds],” he told NBC News. “Once they get into restrictions on abortion, everyone knows what that means. It means that they would like to say they’re for extending ACA, but that they don’t have the votes to do it right now.”
Even without the abortion issue on the table, Republicans remain divided about how to move forward on healthcare, as they face a mid-December deadline to vote on the subsidies that was offered to Democrats as part of the deal to reopen the government earlier this month.
Republicans in the Senate, following President Trump’s lead, have proposed replacing the ACA subsidies with federally funded, HSA-style “Trump Health Freedom” accounts and new provisions allowing Americans to shop for health plans across state lines.
open image in galleryPresident Trump has said he favors a deal that would replace subsidies with health savings accounts, but has suggested he’d be open to potentially extending the ACA supports (Reuters)The pro-business Republican Main Street Caucus, meanwhile, has suggested extending the subsidies with new income and premium requirements the GOP says will reduce costs and cut down on fraud.
The president has previously said the “only” plan he will support is one that ends subsidies to insurers and gives funds directly to Americans, though this week he suggested he would be open to extending the ACA supports if it helps get Republicans toward a larger healthcare deal.
Whatever the party decides, it is facing clear political pressure to do something about health costs, which are set to continue rising in 2026.
Thanks to the beginning of open enrolment season this month, many are already factoring in expected higher premiums, and affordability issues look set to dominate the 2026 midterm elections.
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