Although the House is poised to vote on ObamaCare subsidies next year, Republicans are still heavily divided on whether to pursue innovation in the form of a new health plan, abandoning ObamaCare, or to settle on a modified extension.
Along either path, Republicans will be held accountable to include the protection of taxpayers in the Hyde Amendment, which bars taxpayer abortion funding through plans in the Affordable Care Act's marketplace.
Democrats are proposing a "clean" extension of the enhanced Affordable Care Act premium tax credits, which are set to expire soon. Under the threat of premiums increasing an average of 114 percent for the more than 24 million Americans who get their health insurance through the Affordable Care Act marketplace, it is understandable why disillusionment has surrounded the Republicans.
But any plan that does not include Hyde can never be viewed as "clean."
Affordability has been the recent bane of Republicans, costing the party contentious elections in Virginia and New Jersey just a month ago. Left largely unaddressed, it is costing Republicans the traction they had gained with Gen Z in 2024. Any plan that does not prevent massive premium increases will only endanger the already bleak chances Republicans have to maintain control after the coming midterm election.
Yet ObamaCare is only narrowly avoiding a fated collapse with each vote. Many Republicans argue they should vote down an extension of the enhanced tax credits that maintains the increasingly troubled status quo. Extending the Affordable Care Act in its current state would only cost taxpayers more at a time when ignoring economic struggles for everyday Americans will hurt Republicans most.
Either way, rightfully chief among the top priorities of Republican congressmen is the effort to include explicit Hyde protections, blocking the subsidization of abortion through extended tax credits or otherwise. An emphasis on Hyde may seem detached from the Republicans' central exigency of affordability, holding yet another chip in the game of political poker as obstinately nonnegotiable. But these protections are part of the greater agenda to lower the costs of health care.
Under the Affordable Care Act, private insurers are required to collect abortion "surcharges," separate from standard premiums for enrollees. So long as the accounting is separated, plans on the ACA Marketplace are currently allowed to cover elective abortion. Subsequent guidance under the Obama administration allowed consolidation of these payments, escalating the issue of fungibility and essentially circumventing the Hyde Amendment's protections altogether.
During President Trump's first term, the administration issued new guidance to correct the issue of consolidated payments, but it was again overturned under President Biden. To prevent executive overreach, Congress must now protect federal tax dollars by explicitly including Hyde protections against any plan that covers elective abortion.
The Hyde Amendment, rooted in bipartisanship, has been historically the most popular pro-life provision ever enacted into law, remaining in favor for nearly 50 years. Pro-life advocates hail Hyde for its protection of unborn human lives -- saving more than 2.6 million since the first appropriations rider in 1976. But with affordability at its worst, it has a fiscal justification as well, since Americans do not want to see their hard-earned tax dollars used for abortion.
Holding fast to such popular protections should not be difficult for Republicans. If Republicans join their Democratic colleagues in abandoning the will of their constituents by extending ObamaCare subsidies without Hyde, it will spell permanent fracture for the Republican establishment -- a risk the party cannot take going into the 2026 midterms. Pro-lifers cannot depend on Republicans to fight the more challenging legislative battles if they are willing to compromise including Hyde in any federal health plan.
Admittedly, the inclusion of Hyde protections is not a path forward in itself. There will still be debate among Republicans on whether to extend the Affordable Care Act subsidies or deconstruct ObamaCare altogether, but Hyde is central to furthering these affordability efforts.
The American people will take notice when the Republicans act on every chance to put money back in their constituents' pockets. If they play their cards right, Republicans just might earn back enough of their base's trust to sustain them through the 2026 midterms.