In a nutshell, under their proposed plan, people couldn't use their tax credits to purchase insurance plans that cover abortion. This could compel insurance companies to drop abortion coverage from all their plans, since people purchasing insurance plans will want to use their tax credits. This would also create a problem for liberal states such as CA, which require insurance plans to provide abortion coverage.
Note that the ACA already offered a compromise measure that allowed individual states to bar plans that provide for abortion via the ACA marketplace, and 25 states have done so. Ten of these states go even further and ban privately purchased insurance plans from covering abortion as well.The law, if passed, would all but make it impossible for Californians to use the new tax credits to buy health insurance.
“States would be faced with this choice: Do we get rid of our abortion coverage requirement, or deny state residents all the tax credits?” said Gretchen Borchelt, the vice president for reproductive rights and health at the National Women’s Law Center. “It’s putting states in a really terrible position.”
I'm guessing that more court cases will ensue if the GOP health care plan passes in its current form.
This is yet another frustrating example of how the GOP, without overturning Roe, is seeking to make life more difficult for women who do not wish to carry their pregnancies to term. Even early abortions cost hundreds of dollars, which is beyond the means of many women. Add to the difficulty the fact that contraceptives have gotten more expensive in recent years and that the GOP also champions the right of employers and insurers to deny contraceptive coverage.
I personally don't think access to a service that has such potential impact on a woman's health, life, and well being should be left up to the vagaries of a state's internal politics, but this certainly belies the claim that the GOP is the party of small government and state rights.