New York is leading a coalition of 20 states pushing back against a new congressional proposal that could restrict abortion access by leveraging critical health care subsidies.
In a letter sent to congressional leadership, the group of attorneys general — led by New York Attorney General Letitia James — urged lawmakers to reject any attempt to condition the renewal of Affordable Care Act (ACA) premium tax credits on new restrictions around abortion coverage. The proposal, they said, would not only interfere with state authority but also put millions of Americans’ health care at risk.
States say federal overreach threatens access to care
At the center of the dispute are the ACA’s premium tax credits, which lower monthly health insurance costs for millions of low- and middle-income families. These subsidies are set to expire at the end of the year unless Congress extends them.
But recent reports show that some members of Congress are pushing to attach anti-abortion provisions to the renewal — a move that would ban abortion coverage in marketplace health plans, even in states where that coverage is legal and protected.
“This is a backdoor attempt at a national abortion ban,” the letter warns. “It would rob states of their authority and make it harder for families to afford necessary health care.”
Proposed restrictions could hit New Yorkers hard
Under current law, federal funds already cannot be used for abortion services. However, the ACA allows states to require or permit abortion coverage in marketplace plans — and more than a dozen states, including New York, do. To comply with existing law, enrollees in those states pay a separate $1 monthly premium to cover abortion care, with no federal money involved.
The coalition argues that new federal limits would have widespread consequences: pushing abortion care out of reach, especially for low-income patients, and burdening state health systems. People with complex pregnancies or those in regions with limited access to care could face delays, higher costs, or skipped treatment altogether.
Broad support for reproductive freedom
Public polling shows strong support for abortion access nationwide. Roughly 63% of Americans believe abortion should be legal in all or most cases, and nearly one in four people will have an abortion in their lifetime.
The attorneys general say any effort to sneak restrictions into ACA negotiations would go against the will of the public and deepen mistrust in federal health policy.
“This is not just about reproductive rights,” the letter states. “It’s about whether Americans can access the health care they need without political interference.”
In addition to New York, the letter was signed by attorneys general from Massachusetts, Arizona, California, Colorado, Connecticut, Hawaii, Illinois, Maine, Maryland, Michigan, Minnesota, Nevada, New Jersey, New Mexico, North Carolina, Oregon, Rhode Island, Vermont, Washington, and the District of Columbia.
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