Executive Order 13535-- Patient Protection and
Affordable Care Act's Consistency with Longstanding Restrictions on the
Use of Federal Funds for Abortion
EXECUTIVE ORDER
ENSURING ENFORCEMENT AND IMPLEMENTATION OF ABORTION RESTRICTIONS IN THE PATIENT PROTECTION AND AFFORDABLE CARE ACT
By the authority vested in me as President by the Constitution and the
laws of the United States of America, including the "Patient Protection
and Affordable Care Act" (Public Law 111-148), I hereby order as
follows:
Section. 1. Policy. Following the recent enactment of the
Patient Protection and Affordable Care Act (the "Act"), it is necessary
to establish an adequate enforcement mechanism to ensure that Federal
funds are not used for abortion services (except in cases of rape or
incest, or when the life of the woman would be endangered), consistent
with a longstanding Federal statutory restriction that is commonly known
as the Hyde Amendment. The purpose of this order is to establish a
comprehensive, Government-wide set of policies and procedures to achieve
this goal and to make certain that all relevant actors -- Federal
officials, State officials (including insurance regulators) and health
care providers -- are aware of their responsibilities, new and old.
The Act maintains current Hyde Amendment restrictions governing
abortion policy and extends those restrictions to the newly created
health insurance exchanges. Under the Act, longstanding Federal laws to
protect conscience (such as the Church Amendment, 42 U.S.C. 300a-7, and
the Weldon Amendment, section 508(d)(1) of Public Law 111-8) remain
intact and new protections prohibit discrimination against health care
facilities and health care providers because of an unwillingness to
provide, pay for, provide coverage of, or refer for abortions.
Numerous executive agencies have a role in ensuring that these
restrictions are enforced, including the Department of Health and Human
Services (HHS), the Office of Management and Budget (OMB), and the
Office of Personnel Management.
Sec. 2. Strict Compliance with Prohibitions on Abortion Funding in Health Insurance Exchanges.
The Act specifically prohibits the use of tax credits and cost-sharing
reduction payments to pay for abortion services (except in cases of rape
or incest, or when the life of the woman would be endangered) in the
health insurance exchanges that will be operational in 2014. The Act
also imposes strict payment and accounting requirements to ensure that
Federal funds are not used for abortion services in exchange plans
(except in cases of rape or incest, or when the life of the woman would
be endangered) and requires State health insurance commissioners to
ensure that exchange plan funds are segregated by insurance companies in
accordance with generally accepted accounting principles, OMB funds
management circulars, and accounting guidance provided by the Government
Accountability Office.
I hereby direct the Director of the OMB and the Secretary of HHS to
develop, within 180 days of the date of this order, a model set of
segregation guidelines for State health insurance commissioners to use
when determining whether exchange plans are complying with the Act's
segregation requirements, established in section 1303 of the Act, for
enrollees receiving Federal financial assistance. The guidelines shall
also offer technical information that States should follow to conduct
independent regular audits of insurance companies that participate in
the health insurance exchanges. In developing these model guidelines,
the Director of the OMB and the Secretary of HHS shall consult with
executive agencies and offices that have relevant expertise in
accounting principles, including, but not limited to, the Department of
the Treasury, and with the Government Accountability Office. Upon
completion of those model guidelines, the Secretary of HHS should
promptly initiate a rulemaking to issue regulations, which will have the
force of law, to interpret the Act's segregation requirements, and
shall provide guidance to State health insurance commissioners on how to
comply with the model guidelines.
Sec. 3. Community Health Center Program. The Act establishes a
new Community Health Center (CHC) Fund within HHS, which provides
additional Federal funds for the community health center program.
Existing law prohibits these centers from using Federal funds to provide
abortion services (except in cases of rape or incest, or when the life
of the woman would be endangered), as a result of both the Hyde
Amendment and longstanding regulations containing the Hyde language.
Under the Act, the Hyde language shall apply to the authorization and
appropriations of funds for Community Health Centers under section 10503
and all other relevant provisions. I hereby direct the Secretary of HHS
to ensure that program administrators and recipients of Federal funds
are aware of and comply with the limitations on abortion services
imposed on CHCs by existing law. Such actions should include, but are
not limited to, updating Grant Policy Statements that accompany CHC
grants and issuing new interpretive rules.
Sec. 4. General Provisions. (a) Nothing in this order shall be
construed to impair or otherwise affect: (i) authority granted by law or
Presidential directive to an agency, or the head thereof; or (ii)
functions of the Director of the OMB relating to budgetary,
administrative, or legislative proposals.
(b) This order shall be implemented consistent with applicable law and subject to the availability of appropriations.
(c) This order is not intended to, and does not, create any right or
benefit, substantive or procedural, enforceable at law or in equity by
any party against the United States, its departments, agencies, or
entities, its officers, employees or agents, or any other person.
BARACK OBAMA
THE WHITE HOUSE,
March 24, 2010.
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