Dear Secretary Azar and Administrator Verma:
The Global Justice Center (“GJC”) submits this comment in response to the Department of Health and Human Services’ (“HHS”) Proposed Rule entitled Patient Protection and Affordable Care Act, Exchange Program Integrity, published in the Federal Register on November 9, 2018 (the “Proposed Rule”). For purposes of this submission, commentary is limited to the portion of the Proposed Rule that suggests changes related to the separate payment requirements in section 1303 of the Patient Protection and Affordable Care Act (“PPACA”).
GJC is an international human rights organization based in New York dedicated to achieving gender equality through the rule of law. For the past decade, GJC has been at the forefront of efforts to ensure that the law protects and promotes access to comprehensive sexual and reproductive health rights for women and girls around the world. As experts in women’s rights and human rights, we write to express our vehement opposition to the Proposed Rule.
First, the Proposed Rule would impose undue and onerous burdens on both insurers and consumers that violate women’s fundamental human rights, including to non-discriminatory health care. Second, by singling out abortion for special treatment from all other health services, the Proposed Rule reinforces the already stigmatizing and discriminatory treatment of abortion under the PPACA. Third, the Proposed Rule does not, as claimed, fulfill Congressional intent, since Congressional intent under the PPACA was to allow issuers to decide for themselves whether to provide abortion coverage beyond the limited exceptions allowed under the discriminatory and harmful federal Hyde Amendment. Finally, the Proposed Rule imposes undue burdens on insurers and consumers that will lead to unnecessary restrictions on comprehensive health care for women. The outcome, and tacit intent, of the Proposed Rule is to further stigmatize abortion and to impose onerous burdens on both insurers and consumers that will embarrass women, annoy and inconvenience consumers, and increase administrative burdens on insurers, all with the ultimate aim of discouraging insurers from providing abortion coverage. As such, the Proposed Rule violates women’s fundamental rights under the US Constitution and international human rights law. For these reasons, GJC urges HHS to withdraw the Proposed Rule.