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ObamaCareanditsMandatesFactSheet

ObamaCare(PatientProtectionandAffordableCareAct-ObamaCare)
x SignedintolawbyPresidentBarackObamaonMarch23,2010
x PlannedParenthoodtakescreditforhelpingtoshapetheAct(PlannedParenthoodAnnualReport)

HHSMandate
x FinalizedonFebruary10,2012byHHSSecretaryKathleenSebeliusrequiring"preventiveservices"
forwomenthatmustbeincludedwithoutco-paysordeductiblesinnearlyeveryhealthinsurance
planinthecountry(Womens Pieventive Seivices uuiuelinesandHHSMandate)
x Providesfreecoverageforearly-abortionpills,contraceptives,sterilizations anu euucation anu
counseling about choosingandusingthosethings(Womens Pieventive Seivices uuiuelinesand
HHSMandatePg.2)
x Whiletheseitemsarefree,nearlyallothermedications(heartpills,insulin,etc.)stillcostthe
same
x PlannedParenthoodexecutiveshelpedtocraftthemandateandapplaudeditsprovisions(Institute
ofMedicine,AULHRSAGuidelinesNoteii,victoiy foi Womens Bealth)
x This coveiage must be pioviueu at the beginning of a companys fiscal yeai that staits onorafter
August1,2012.(HHSMandatePg.2)

EmployerMandate
x Requiresthat,beginningin2014,largeemployersprovidetheiremployeeswithObamaCare-
compliantinsuranceplansorpayaheavyfine(26U.S.C.4980HPg.1;ObamaCareSec.1562(f),Pg.
152),andemployersofanysizewhoprovidetheiremployeeswithinsurancemustofferonly
ObamaCare-compliantplansorfacesimilarlyburdensomefinesandlawsuits(26USC4980DPg.
1;ObamaCareSec.1562(e)-(f),Pg.152;29U.S.C.1132Pg.1;ObamaCareSec.1562(e)-(f),Pg.152)
(seeFinesbelow)
x Religiousorganizationsarenotexemptunlesstheymeetverystrictandnarrowparametersthat
includeonlysomechurchesandreligiousorders(seeExemptionsbelow)(HHSMandatePg.2)
x TheEmployerMandatewillstillrequireorganizationstoexclusivelyprovideObamaCare-compliant
planstoemployees,eveniftheIndividualMandateisruledunconstitutional,becausethemandates
areindependentunlesstheSupremeCourtdecidestheymustbestruckdowntogether

IndividualMandate(ObamaCareSec.5000A(a),Pg.126)
x WasupheldbytheSupremeCourtasataxonJune28,2012
x Requiresthat,beginningin2014,nearlyallAmericanspurchaseObamaCare-compliantinsurance
plansorpayaheavyfine(seeFinesbelow)(ObamaCareamend.toSec.5000A(c)(1)&(2),Pg.791)
x IndividualswhoareforcedtopurchaseinsuranceplansthroughStateExchanges(seebelow)in
ordertobecompliantwiththeIndividualMandate,inmanycases,willbepurchasingplansthat
imposetheAbortionPremiumMandate(seebelow)
x TheIndividualMandaterequirespeopletopayforwhattheHHSmandatecovers(becausetheHHS
Mandateappliestoallplans)andalsorequiresallindividualsincertainplanstopaytheAbortion
Premium

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AbortionPremiumMandate
x IsconcealedintheIndividualMandateandrequiresallpersonsenrolledininsuranceplansinState
Exchanges(seebelow)thatincludeelectiveabortioncoveragetopayaseparatepremiumstraight
fromtheirpaycheckstofundalltypesofelectiveabortion(ObamaCareSec.1303(b)(1)&(2),Pg.
77980)
x ObamaCaresaysthisseparatepremiumwillnotcostlessthan$1permonthperenrollee,butdoes
notsayhowmuchmoreitcouldcost(ObamaCareSec.1303(D)(ii)(III),Pg.780)
x Thisseparatechargewillgodirectlyintoanabortion-on-demandfundestablishedbyObamaCare
tocoveralltypesofelectiveabortions-surgical,chemical,lateterm,etc.(ObamaCareSec.1303(C)
(ii),Pg.780)
x Becausethispremiumistakendirectlyfromapaycheckandputdirectlyintoanabortion-on-
demandfund,bypassingthetaxprocess,itattemptstocircumventfederallawsthatprohibit
taxpayerfundingofabortion(seeConsolidatedAppropriationsActof2012,Pub.L.No.112-74,div.
F,tit.V.,506(b),125Stat786,Pg.1111)
x Electiveabortionsofalltypes(surgical,chemical,lateterm,etc.)willbecoveredsimilarlyto
medicalprocedures,whichmayhaveaco-payormaybesubsidizedcompletely
x TheU.S.DepartmentofLaborreportsthatthereareapproximately154,000,000peopleintheU.S.
laborforce.IfonlyhalfofplansincludetheAbortionPremium,atonly$1permonth,theyearly
incomeintothisfundwouldbe$924,000,000.(BureauofLaborStatisticsMay2012Pg.5)
x Onaverage,anabortioncosts$450.Attheaboverate,thisfundcouldcompletelysubsidize
2millionabortionsperyear.Currently,thereare1.2millionabortionsperyearintheU.S.
(GuttmacherAbortionCosts,GuttmacherAbortionStatistics)

SecrecyClause
x WhilemanyoftheObamaCare-compliantinsuranceplansincludecoverageanabortionpremium,
notalldo.(ObamaCareSec.1303(b)(1)(A)(i),Pg.779)
x Butinsurancecompaniesarenotallowedtocommunicateinadvancetoemployeeswhichplans
includethisabortionpremium.Itmayonly be uiscloseuinthefineprintofthesummaiy of
benefits anu coveiage explanation at the time of eniollment (ObamaCareSec.1303(b)(3)(A),Pg.
781)
x Theemployeewilldiscoverthattheirplancontainsanabortionpremiumeitherbyseekingitoutin
thefineprintoncetheyhaveenrolled,ornoticingtheseparatesurchargetakenfromtheir
paycheck.(ObamaCareSec.1303(b)(1)&(2),Pg.780)

AutomaticEnrollmentofMinorsinHHSMandate
x Children/Dependents(ages026) as beneficiaiiesareautomaticallyandmandatorily
enrolledintotheHHSMandatecoverage(77Fed.Reg.at16505Pg.3;76Fed.Reg.at46624Pg.4)
x Childrenwillreceivecoverageoffreecontraceptioncounselingandeducation,contraception,
sterilizationandearly-abortionpillsasstatedintheHHSMandate(seeabove)(Womens
PreventiveServicesGuidelines)
x Healthcareserviceprovidersarenotrequiredtoinformparentsofservicesprovidedtotheir
childrenbecauseofPrivacyProvisions(HIPPA164.502Pg.17and164.510Pg.25-26)
x Whilethelawrequiresthatchildren/dependentsreceivetotalcoverageforcontraception,
abortionpillsandsterilizations,itdoesnotrequirethattheyreceiveanycoverageforlivebirth.
(Title29:LaborPart1604GuidelinesOnDiscriminationBecauseOfSex)
x InFebruary,2012theObamaAdministrationsaidthatforreligiousorganizations,thecoverage
wouldonlygotoemployeesandtheirdependentswho uesiie it(77Fed.Reg.at8728Pg.4)

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InMarchtheadministrationchangedtheirpositionandannouncedthatthiscoveragewould
automaticallygotoallemployeesandtheirchildren(77Fed.Reg.at16505Pg.3)
x Planneu Paienthoous researchinstitutespecificallyadvocatedforcontraceptioncounseling,
contraception,andabortionpillstobecoveredininsurancetotallyfree,astheHHSMandate
directs,sothatchildrencouldgetitconfidentially,withoutparentsreceivingabillforaco-pay
oranExplanationofBenefits(Guttmacher:UnintendedConsequences)

Subsidies
x ObamaCaresubsidizeshealthplansinStateExchangespurchasedbyfamilies(offour)whomake
$92,000peryearorless,or400%orlessofthepovertylevel(Reconciliation Act Pg.3)
x Allaspectsoftheplanaresubsidizedwithtaxpayerdollars,necessarilyincludingelectiveabortions
(forplansthatincludeit),abortionpills,contraception,sterilization,etc.(NRLNewsToday)
x TheAbortionPremiumMandate(seeabove)issimplyanaccountingdesignationcreatedtogivethe
impressionthatabortionsarenotsubsidizedwithtaxpayerdollars
x TheObamaCaresubsidizationofexchangeplanswhichcoverabortionviolatesexistingfederallaw
knownastheHydeAmendment,whichspecificallyprohibitsfederalfundingforanypartofahealth
insurancepackagethatcoverselectiveabortions(seeConsolidatedAppropriationsActof2012,
Pub.L.No.112-74,div.F,tit.V.,506(b),125Stat786,Pg.1111)

FinesandLawsuits
x Employeeswhorefusecoveragewillbefinedthegreaterofeitherthecostoftheplan(averagecost
ofthebronzelevelplan)or1%oftheirsalarythefirstyear,2%thesecondyear,and2.5%each
yearafterthat(ObamaCareamendmenttoSec.5000A(c)(1)&(2),Pg.791)
x Finestoemployeeswillbeincludedintheirtaxreturns(ObamaCareSec.5000A(b)(2),Pg.126)
x EmployerswhoofferinsuranceplansthatarenotHHSMandate-compliantbycoveringearly-
abortionpillswillbefined$100peremployeeperday(26USC4980DPg.1;ObamaCareSec.
1562(e)-(f),Pg.152;42U.S.C.300gg-13)
x EmployerswhoofferinsuranceplansnotcompliantwiththeHHSMandatemaybesuedbytheU.S.
DepartmentofLaborandbyitsplanparticipants,forcingtheemployertoofferthecoverageby
courtorder(29U.S.C.1132Pg.1;ObamaCareSec.1562(e)-(f),Pg.152)
x Employerswhohaveover50employeesanddropinsurancecoveragealtogethertoavoid
facilitatingtheHHSMandatewillbefinedapproximately$2,000peremployeeperyear(26U.S.C.
4980HPg.1;ObamaCareSec.1562(f),Pg.152)

CommerceClause(U.S.ConstitutionArt.ISec.8Clause3,Pg.3)
x ProponentsofObamaCareclaimthattheCommerceClause,whichgivesthefederalgovernment
thepowertoregulateinterstatecommerce,authorizestheAct.
x OpponentsofObamaCarearguethatitexceedstheconstitutionallimitsoftheCommerce
Clause,whichonlyauthorizesCongresstoregulateinterstatecommercialactivitywhichis
alreadytakingplace.Notpurchasinghealthinsuranceisavoidingcommercialactivity,not
engaginginit.IfnotdoingsomethingcanberegulatedundertheCommerceClause,thatwould
openthedoorforthegovernmenttoforcethepurchaseofanything,ormandateanytypeof
health caie e.g.,everyonemustpurchaseagymmembership,buyhealthfood,buyAmerican
cars,etc.
x Foiceu puichase is typically calleu coeicion iathei than commeice

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SpendingClause(U.S.ConstitutionArt.ISec.8Clause1,Pg.2)
x TheSupremeCourtwillruleonwhetherCongressexceededitsenumeratedpowersunderthe
SpendingClausebyplacingheavyregulationsonstatesthatreceiveMedicaidfunding
x OpponentsofObamaCareurgethatitdoesnotmeettheconstitutionalrequirementsofthe
SpendingClausebecauseitmandatesamassiveincreaseofhealthcarebureaucracywithout
providinganadequatemeansofpayingforit
x Thisadditionalbureaucracyandexpenseisparticularlyevidentintherequirementofthecreation
ofStateExchanges(seebelow)

StateExchanges
x 0bamaCaie iequiies states to set up exchanges by }anuaiy government-operatedhealth
insurancemarkets,iftheywanttoreceivefederalsubsidies(ObamaCareSec.1321(b),Pg.68)
x Families(of4)whoearn$92,000orlesswillreceivefederaltaxcreditswhichsubsidizetheirplanif
theypurchasefromaStateExchange(ReconciliationActSec.1001(a),Pg.3)
x Statesarethereforeincentivizedtocreatetheseapprovedexchangesorforgoreceivingfederal
subsidizationfortheircitizens healthcare
x IfaStatedoesnotestablishanapprovedexchange,thefederalgovernmenthastheoptionofsetting
upanexchangeinthatstatewhichwillmostlikelyprovideforabortioneveninstateswhere
abortioncoverageisillegal.(ObamaCareSec.1321(b)&(c),Pg.68)
x ObamaCaresetsasthedefaultthatStateExchangeswillcoverabortioneveninstateswhere
abortioncoverageisillegal.ItgivestheStatetheoptiontopassalawtooptoutofthecoverage,
anditalsodetailshowthatlawcanbeterminatedorrepealed.(ObamaCareSec.1303(a)(1)and
(2),Pg.779)

ExemptionsforReligiousOrganizationstotheHHSMandate(GroupHealthPlansFinalRegulation)
x TheHHSMandateonlyallowsanorganizationtobeexemptifitmeetsallofthefollowing(1)has
theinculcationofreligiousvaluesasitspurpose;(2)primarilyemployspersonswhoshareits
religioustenets;(3)primarilyservespersonswhoshareitsreligioustenets;and(4)isachurch,
religiousorder,orintegratedauxiliarythereofunderspecificsectionsoftheInternalRevenueCode
(HHSMandatePg.2)
x Anyreligiousorganizationthatisnotformallyachurch,congregationorreligiousorderisdeemed
notreligiousatallunderthisexemption.(HHSMandatePg.2)
x Anyreligiousschoolorcharitythatservespeopleofotherfaithsisnotexemptbecauseitdoesnot
meettherequirements(aChristiansoupkitchen,aCatholicschool,etc.)Evensomechurchesare
notexemptiftheyaretoofocusedonservingpeoplebesidesthemselves.(HHSMandatePg.2)
x Anyorganizationmustrefusetosignificantlyhirepeopleofotherbeliefstomeetthisexemption.
Thisinvitesgovernmentbureaucratstobecomeentangledinreligiousmattersbydecidingwhether
employees aie sufficiently aligneu with a ieligious oiganizations tenets Foi example itisunclear
whethertheexemptionwouldapplytoadenominationalorganizationthathiresChristiansofother
denominations.(HHSMandatePg.2,4)
x Thepresidentfinalizedthisrule without change Bis public suggestions of a compiomise uo not
changethisrule,donotproposetorescindthenarrowdefinitionofreligiousentity,andwouldstill
requirereligiousgroupsandbusinessestodirectlyprovideaccesstoobjectionablecoverage.(HHS
MandatePg.1,5,6)