A coalition of 21 Democratic attorneys general sent a letter to congressional leaders this week, calling for the extension of enhanced premium tax credits under the Affordable Care Act without new restrictions on abortion coverage in marketplace plans.
The letter, dated early December 2025, was addressed to House Speaker Mike Johnson, House Minority Leader Hakeem Jeffries, Senate Majority Leader John Thune, and Senate Minority Leader Chuck Schumer. Signers included attorneys general from Arizona, California, Colorado, Connecticut, the District of Columbia, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, North Carolina, Oregon, Rhode Island, Vermont, and Washington.
The enhanced premium tax credits, introduced in 2021 and extended through 2025, help lower health insurance costs for millions enrolled in ACA marketplace plans. These credits are scheduled to expire December 31, 2025, potentially leading to higher premiums for enrollees.
Negotiations in Congress involve Republican proposals to condition any extension on prohibiting marketplace plans from covering abortions, even in states where such coverage is permitted or required under state law. Current ACA rules already prevent federal funds, including tax credits, from directly paying for abortions except in cases of rape, incest, or life endangerment, consistent with the Hyde Amendment.
The coalition argued that adding broader restrictions would override state authority over health policy. “The ACA was crafted with state sovereignty at its core, allowing for flexibility and innovation across states, including when it comes to abortion,” the letter stated. “This structure is consistent with states’ traditional rights and powers to protect the health and safety of our residents.”
Colorado Attorney General Phil Weiser, one of the signers, described the potential restrictions as an attempt to override state laws. “This latest effort to tie ACA tax credits to abortion restrictions is an unacceptable attempt to override state laws and the individual rights of our residents,” Weiser said. “We will continue to fight for the health, dignity and autonomy of every Coloradan.”
Arizona Attorney General Kris Mayes stated that residents “do not want politicians interfering with access to reproductive care.” California Attorney General Rob Bonta noted that such restrictions would infringe on state sovereignty.
All signing jurisdictions permit abortion coverage in their ACA marketplace plans, often requiring separate funding mechanisms to ensure no federal dollars are used for non-Hyde exceptions.
Pro-life groups supported the Republican position. In an exclusive interview with The Center Square, Jamie Dangers, director of federal affairs at Susan B. Anthony Pro-Life America, said the letter reflected Democratic concerns over the issue.
“Obamacare was the largest expansion of taxpayer-funded abortion on demand since Roe v. Wade,” Dangers said. “It was intentionally crafted to circumvent the Hyde Amendment’s pro-life protections.”
The Hyde Amendment, enacted in 1976 and renewed annually, prohibits federal funds from paying for most abortions. Dangers emphasized that federal policy since the 1970s has avoided funding abortion coverage with tax dollars.
“To this day, at least 12 states mandate abortion coverage in Obamacare plans,” Dangers said. “We are thankful to all our pro-life Republican allies, and we’re confident they will win this fight if they continue to stay united and show leadership. Abortion isn’t health care, and taxpayers should never be forced to pay a dime to further the destruction of countless innocent lives.”
Background on ACA Abortion Coverage
The Affordable Care Act, enacted in 2010, incorporates Hyde Amendment restrictions for marketplace plans receiving federal premium tax credits. Insurers offering broader abortion coverage must segregate funds, typically collecting a separate premium from enrollees to cover non-excepted services.
Twenty-five states prohibit abortion coverage in marketplace plans beyond Hyde exceptions. Twelve states require coverage in private and marketplace plans, using state mechanisms to comply with federal funding limits.
The ongoing debate ties into broader congressional efforts to address expiring credits amid concerns over rising premiums. Without extension, average enrollee costs could increase significantly in 2026.
The coalition’s letter highlighted that federal tax credits subsidize overall plan premiums, not specific services like abortion, which are funded separately in permitting states. “In Colorado, we believe people should be able to make their own personal health care decisions free from political interference and without being priced out of essential care,” Weiser said. “Protecting access to reproductive health care, including abortion care, is central to safeguarding individual freedom and the wellbeing of our communities.”
As negotiations continue, the outcome remains uncertain, with partisan differences over conditions for extending the credits.
