President Barack Obama signed an executive order banning the use of federal money to pay for abortion in the health care reform law on March 24, 2010.
The legislation, a companion piece to the federal Patient Protection and Affordable Care Act, was designed to appease anti-abortion activists and win enough votes to pass the president's signature campaign promise.
But it took less than four months for anti-abortion activists and politicians to accuse the president of trying to quietly slip in funding for all legal forms of the procedure, for the first time, in Pennsylvania.
"The Obama Administration will give Pennsylvania $160 million in federal tax funds, which we've discovered will pay for insurance plans that cover any legal abortion," Douglas Johnson, legislative director for the National Right to Life Committee, said in a widely circulated statement in July 2010.
"This is just the first proof of the phoniness of President Obama's assurances that federal funds would not subsidize abortion - but it will not be the last," Johnson said.
House Minority Leader John Boehner, a Republican from Ohio, said in a statement that the move to fund Pennsylvania's high-risk pool "is the boldest admission yet from the Obama administration that the President's Executive Order on taxpayer-funded abortion was a sham.
"The fact that the high-risk pool insurance program in Pennsylvania will use federal taxpayer dollars to fund abortions is unconscionable," Boehner said.
But there's a little more to the story than that.
Provisions of Pennsylvania's High-Risk Insurance Pool
As About.com's U.S. Government Info Guide, Robert Longley, pointed out, the health care reform law bans health insurance companies from refusing to cover children due to pre-existing medical conditions.
The ban will also apply to adults, but not until 2014 when the state-run health insurance exchanges are in operation. In the interim, the law required all states to create high-risk insurance pools to offer coverage to individuals with pre-existing medical conditions who have not had insurance for at least six months.
Pennsylvania was quick to submit its plan for a high-risk pool to the federal government. The plan, however, raised a red flag among anti-abortion advocates because of the following provision:
Abortions: Includes only abortions and contraceptives that satisfy the requirements of 18 Pa.C.S. § 3204-3206 and 35 P.S. §§10101, 10103-10105.
The reference to the high-risk pool's compliance with Pennsylvania's abortion laws raised red flags with opponents because the procedure is legal there in most cases, with the exception, for example, of when it is "sought solely because of the sex of the unborn child."
As the National Right to Life correctly pointed out, Pennsylvania's law allows abortion when a single physician believes that it is "necessary" based on "all factors (physical, emotional, psychological, familial and the woman's age) relevant to the well-being of the woman."
However, the state's high-risk pool proposal also included the following statement: "Elective abortions are not covered."
So the plan was contradictory, at best. At least until state and federal officials clarified their plans.
Pennsylvania Says Elective Abortions Won't Be Covered
The Pennsylvania Insurance Department, responding to claims that federal money would fund abortions, issued a stern rebuttal to anti-abortion groups.
"Pennsylvania will - and has always intended to - comply with the federal ban on abortion funding in the coverage provided through our federally funded high risk pool," the Insurance Department said in a statement.
"This program will provide much-needed assistance for the sickest of the sick. The likelihood that any of those covered will seek abortion services is remote, but if they do need such services, they will have to pay for them out their own pocket."
A spokeswoman for the U.S. Department of Health and Human Services, Jenny Backus, supported Pennsylvania's stance.
"... In Pennsylvania and in all other states abortions will not be covered in the Pre-existing Condition Insurance Plan (PCIP) except in the cases of rape or incest, or where the life of the woman would be endangered," she said.
"Our policy is the same for both state and federally-run PCIP programs. We will reiterate this policy in guidance to those running the Pre-existing Condition Insurance Plan at both the state and federal levels," Backus said. "The contracts to operate the Pre-existing Condition Insurance Plan include a requirement to follow all federal laws and guidance."
If the state and federal governments stick to their words, it does not appear taxpayer money will pay any part of abortions in Pennsylvania or any other state.