Krishnamoorthi Presses Insurers Over Potentially Pocketing Funds Reserved for Reproductive Health Care
WASHINGTON — Congressman Raja Krishnamoorthi, Ranking Member of the House Oversight Subcommittee on Health Care and Financial Services, today pressed health insurers for answers over whether they are diverting premium funds that federal law expressly requires to be reserved for abortion coverage.
In a letter sent today to America’s Health Insurance Plans (AHIP), Krishnamoorthi warned:
“Recent guidance issued by the Centers for Medicare and Medicaid Services fundamentally misreads the Affordable Care Act and unlawfully permits insurers to divert these segregated funds for purposes unrelated to abortion care. This policy threatens to deny enrollees access to legally covered abortion services and enables insurers to convert funds dedicated to reproductive health care into profit.”
The letter goes on to warn that the new policy creates a direct financial incentive for insurers to retain funds that federal law requires be used exclusively for abortion services:
“Instead, it creates a perverse incentive for insurers to over-collect abortion premiums and then pocket the surplus. As abortion access is increasingly restricted nationwide, insurers have a legal and moral obligation to ensure affordable, accessible reproductive health care within their provider networks.”
Krishnamoorthi also underscored the stakes for patients’ access to care, writing:
“In the midst of a reproductive health crisis, funds explicitly set aside to ensure access to abortion care must not be diverted into insurance company revenue streams. Allowing insurers to siphon off funds reserved for abortion care, particularly in this moment, is indefensible.”
The letter requests that AHIP provide the following information by April 14, 2026:
Since the issuance of the December 9, 2025, CMS guidance, how many of your members have converted Section 1303 segregated funds that have been segregated for more than one year into revenue, or used the funds for a purpose other than abortion? What purposes have the funds been used for?
Prior to the December 9, 2025, CMS guidance, have any of your members ever converted Section 1303 segregated funds into revenue, or used the funds for a purpose other than abortion?
What amount of funding has been maintained in the segregated accounts of each relevant member over the last 10 years?
Federal law requires that plans that cover non-Hyde abortions charge a minimum of one dollar, per member, per month. In your calculation, what is the actual cost to your members of providing non-Hyde abortion coverage to enrollees?
The letter is available here.