[Federal Register Volume 75, Number 59 (Monday, March 29, 2010)]
[Presidential Documents]
[Pages 15597-15600]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2010-7154]



[[Page 15597]]

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Part IV





The President





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Executive Order 13535--Ensuring Enforcement and Implementation of 
Abortion Restrictions in the Patient Protection and Affordable Care Act


                        Presidential Documents 



Federal Register / Vol. 75, No. 59 / Monday, March 29, 2010 / 
Presidential Documents

___________________________________________________________________

Title3--
The President

[[Page 15599]]

                Executive Order 13535 of March 24, 2010

                
Ensuring Enforcement and Implementation of 
                Abortion Restrictions in the Patient Protection and 
                Affordable Care Act

                By the authority vested in me as President by the 
                Constitution and the laws of the United States of 
                America, including the ``Patient Protection and 
                Affordable Care Act'' (Public Law 111-148), I hereby 
                order as follows:

                Section. 1. Policy. Following the recent enactment of 
                the Patient Protection and Affordable Care Act (the 
                ``Act''), it is necessary to establish an adequate 
                enforcement mechanism to ensure that Federal funds are 
                not used for abortion services (except in cases of rape 
                or incest, or when the life of the woman would be 
                endangered), consistent with a longstanding Federal 
                statutory restriction that is commonly known as the 
                Hyde Amendment. The purpose of this order is to 
                establish a comprehensive, Government-wide set of 
                policies and procedures to achieve this goal and to 
                make certain that all relevant actors--Federal 
                officials, State officials (including insurance 
                regulators) and health care providers--are aware of 
                their responsibilities, new and old.

                The Act maintains current Hyde Amendment restrictions 
                governing abortion policy and extends those 
                restrictions to the newly created health insurance 
                exchanges. Under the Act, longstanding Federal laws to 
                protect conscience (such as the Church Amendment, 42 
                U.S.C. 300a-7, and the Weldon Amendment, section 
                508(d)(1) of Public Law 111-8) remain intact and new 
                protections prohibit discrimination against health care 
                facilities and health care providers because of an 
                unwillingness to provide, pay for, provide coverage of, 
                or refer for abortions.

                Numerous executive agencies have a role in ensuring 
                that these restrictions are enforced, including the 
                Department of Health and Human Services (HHS), the 
                Office of Management and Budget (OMB), and the Office 
                of Personnel Management.

                Sec. 2.  Strict Compliance with Prohibitions on 
                Abortion Funding in Health Insurance Exchanges. The Act 
                specifically prohibits the use of tax credits and cost-
                sharing reduction payments to pay for abortion services 
                (except in cases of rape or incest, or when the life of 
                the woman would be endangered) in the health insurance 
                exchanges that will be operational in 2014. The Act 
                also imposes strict payment and accounting requirements 
                to ensure that Federal funds are not used for abortion 
                services in exchange plans (except in cases of rape or 
                incest, or when the life of the woman would be 
                endangered) and requires State health insurance 
                commissioners to ensure that exchange plan funds are 
                segregated by insurance companies in accordance with 
                generally accepted accounting principles, OMB funds 
                management circulars, and accounting guidance provided 
                by the Government Accountability Office.

                I hereby direct the Director of the OMB and the 
                Secretary of HHS to develop, within 180 days of the 
                date of this order, a model set of segregation 
                guidelines for State health insurance commissioners to 
                use when determining whether exchange plans are 
                complying with the Act's segregation requirements, 
                established in section 1303 of the Act, for enrollees 
                receiving Federal financial assistance. The guidelines 
                shall also offer technical information that States 
                should follow to conduct independent regular audits of 
                insurance companies that participate in the health 
                insurance exchanges. In developing these model 
                guidelines, the Director of the OMB and the Secretary 
                of HHS shall consult with executive agencies and 
                offices that have relevant expertise in accounting

[[Page 15600]]

                principles, including, but not limited to, the 
                Department of the Treasury, and with the Government 
                Accountability Office. Upon completion of those model 
                guidelines, the Secretary of HHS should promptly 
                initiate a rulemaking to issue regulations, which will 
                have the force of law, to interpret the Act's 
                segregation requirements, and shall provide guidance to 
                State health insurance commissioners on how to comply 
                with the model guidelines.

                Sec. 3. Community Health Center Program. The Act 
                establishes a new Community Health Center (CHC) Fund 
                within HHS, which provides additional Federal funds for 
                the community health center program. Existing law 
                prohibits these centers from using Federal funds to 
                provide abortion services (except in cases of rape or 
                incest, or when the life of the woman would be 
                endangered), as a result of both the Hyde Amendment and 
                longstanding regulations containing the Hyde language. 
                Under the Act, the Hyde language shall apply to the 
                authorization and appropriations of funds for Community 
                Health Centers under section 10503 and all other 
                relevant provisions. I hereby direct the Secretary of 
                HHS to ensure that program administrators and 
                recipients of Federal funds are aware of and comply 
                with the limitations on abortion services imposed on 
                CHCs by existing law. Such actions should include, but 
                are not limited to, updating Grant Policy Statements 
                that accompany CHC grants and issuing new interpretive 
                rules.

                Sec. 4. General Provisions. (a) Nothing in this order 
                shall be construed to impair or otherwise affect: (i) 
                authority granted by law or Presidential directive to 
                an agency, or the head thereof; or (ii) functions of 
                the Director of the OMB relating to budgetary, 
                administrative, or legislative proposals.

                    (b) This order shall be implemented consistent with 
                applicable law and subject to the availability of 
                appropriations.
                    (c) This order is not intended to, and does not, 
                create any right or benefit, substantive or procedural, 
                enforceable at law or in equity by any party against 
                the United States, its departments, agencies, or 
                entities, its officers, employees or agents, or any 
                other person.
                
                
                    (Presidential Sig.)

                THE WHITE HOUSE,

                    Washington, March 24, 2010.

[FR Doc. 2010-7154
Filed 3-26-10; 1:00 pm]