In the negotiations leading to the passage of the Affordable Care Act (ACA), abortion coverage was one of the thorniest and most controversial of many controversial issues. Along with immigrant coverage, it was one of the final issues negotiated before the House vote. Initially, the House passed the Stupak-Pitts Amendment, which would have prohibited any plans in the Marketplaces from receiving federal subsidies if they covered abortion. The final law, however, included a compromise proposed by former Senator Ben Nelson of Nebraska which allows states to ban abortion coverage on their ACA Health Insurance Marketplace and requires plans that offer abortion coverage to segregate funds, assuring that no federal funds are used for abortion coverage. After the ACA was passed, President Obama also signed an executive order to emphasize that no federal funds can be used to pay for abortion beyond the Hyde limitations.
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