A new provision in the Republican reconciliation bill could strip federal health care funds from states that require insurance plans to cover abortion, potentially jeopardizing coverage for millions.
Inserted via a last-minute manager’s amendment, the measure targets Affordable Care Act funds, barring them from going to state health plans that include abortion services. Thirteen states — including California, New York, Illinois, and Oregon — currently mandate abortion coverage in state-regulated insurance.
If passed, state leaders would be forced to decide between preserving abortion access and maintaining essential federal subsidies for health care.
Though Republicans have long argued that abortion policy should be left to the states, this amendment marks a shift in strategy. Some GOP lawmakers now say federal dollars give them a stake in what states do, especially on abortion.
The move comes as access to reproductive care continues to be reshaped post-Roe, with red states restricting abortion and blue states expanding protections. Democrats warn the measure amounts to financial coercion.
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