Attorney General Kris Mayes of Arizona has joined 20 other states in sending a letter to congressional leaders, urging them not to impose restrictions on reproductive health care coverage as part of ongoing negotiations over the extension of Enhanced Premium Tax Credits under the Affordable Care Act (ACA). The coalition contends that linking the extension of these tax credits to a ban on abortion coverage in state ACA insurance plans would undermine state authority, contradict existing laws, and threaten residents’ access to essential health services.
“Donald Trump and Republican politicians are so determined to control abortion and reproductive health choices that they’re willing to drive up health care premiums for Arizonans by sabotaging subsidy negotiations,” said Attorney General Kris Mayes. “Arizonans have made it clear: we do not want politicians interfering with access to reproductive care.”
The Enhanced Premium Tax Credits are scheduled to expire at the end of this year. Without renewal, many families could face higher healthcare costs starting next year. Recent reports indicate that some Republican lawmakers are seeking to condition their support for extending these subsidies on excluding abortion coverage from all ACA plans receiving federal tax credits.
All 21 states in the coalition currently permit abortion coverage through their ACA insurance plans. The proposed restriction would impact hundreds of thousands who rely on such coverage. In their letter, Mayes and her counterparts argue that removing the ability for people to use tax credits for comprehensive reproductive care would create additional barriers and increase out-of-pocket costs.
Republican proponents claim that federal funds are being used for abortion services, but according to current law in Arizona, federal money does not pay for abortions. State insurance plans covering abortions require enrollees to pay separate fees specifically allocated for those services.
The coalition emphasizes that states should retain autonomy over healthcare policy decisions affecting their populations, aligning with both the structure of the ACA and established principles granting states authority over health regulation.
Statistics suggest that one in four women will have an abortion during their lifetime; access is considered critical by advocates who point out increases in adverse outcomes—such as sepsis, infant death, and pregnancy-related deaths—in states with more restrictive laws following Roe v. Wade’s overturning.
The letter from Attorney General Mayes also references previous efforts by the Trump Administration aimed at restricting abortion access at Veterans Affairs medical centers—a move opposed by Arizona—which sought to eliminate exceptions even in cases involving rape, incest, or risks to pregnant veterans’ lives.
Mayes and her colleagues urge Congress not only to uphold state sovereignty but also preserve affordable healthcare options that include reproductive services. Attorneys general from California, Colorado, Connecticut, District of Columbia, Hawaiʻi, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, North Carolina, Oregon, Rhode Island, Vermont and Washington co-signed the letter alongside Arizona.
