Repro-Briefs: States Banning Coverage for Abortion Care

Robin Marty

We wanted reform.  Instead, we got a loophole that may take away abortion coverage all together as states move to ban insurance coverage of abortion care.

A funny thing happened on the way to healthcare reform.  Not only did a woman’s right to choose get thrown under the bus in an effort to woo anti-choice democrats to vote yay, but a funny little loophole showed up in the final bill. 

[A]bortion opponents are not satisfied with the restrictions on abortion already in the measure, particularly those on abortion coverage in private plans that will be sold in the new marketplaces known as health “exchanges.” So they are pushing one particular aspect of the new law. It lets states ban all abortion coverage in the exchanges.

Charmaine Yoest, president and CEO of anti-abortion group Americans United for Life, said her group wasted no time drawing up a model state law to that effect. They sent it out the day after Congress approved the health bill.

“It was a part of the legislation that states could opt out, and so we had a heads-up that this would be a window for us,” she said. “So we moved right in to make sure that we could equip states with the tools that they need to have the most effective opt-out possible.”

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It happened more quickly than we could have imagined.

The first drumbeat started in Kansas in February, when the state legislature tried to pass a ban on abortion coverage for all insurance providers in the state, regardless of whether the coverage was public or private.  That bill was defeated when pro-choice advocates attached amendments declaring the need for supplemental insurance for smokers or people who use erectile dysfunction drugs.

Unfortunately, that appears to have set the stage for our current batch of states, all anxious to jump on the bandwagon and eliminate insurance coverage for abortion. 

Louisiana’s House Insurance Panel met recently and voted to ban all elective abortion coverage from any new policies written in the state

The new law allows states to prohibit abortion coverage in the plans that are offered as part of insurance exchanges established to allow consumers to buy policies from private companies. The exchanges will not be online until Jan. 1, 2014. Hoffman’s bill goes beyond the abortion opt-out provision by extending the prohibition to all insurance companies in Louisiana as soon as the bill becomes law.

Those who are fighting the policy note that extending the ban to all policies is a moot point, since insurers are unlikely to want to deal with the logistical nightmare of having different policies for those who are on the exchange versus those who are just purchasing private plans, meaning essentially eliminating it from the exchange means eliminating it all together.

Even worse, the Insurance Committee has yet to define what they consider to be an “non-elective” abortion, stating that mental health and a mother’s health may not actually qualify as exceptions.  The bill’s sponsor says he is willing to possibly look at other considerations but he’s “…not going to open doors that we don’t need to open.”

Of course, it comes as little shock that this move is mostly about political face, and little else.  It turns out private insurance plans in Louisiana already don’t cover elective abortion.

Rep. Chuck Kleckley, committee chairman, says he doesn’t know of any private insurance plan in Louisiana that covers abortion, except when a mother’s life is in danger. That exception remains in the bill.

Tennessee has also begun passing legislation to eliminate abortion coverage from the public exchange, claiming that Obama’s executive order is nice, but it’s not binding.

The state House of Representatives passed the bill Monday, banning any use of state government funds to pay for an abortion.

Now the Senate companion bill has cleared the Senate Commerce Committee on a unanimous vote.

One argument against the state bill has been that President Barack Obama signed an executive order barring abortion funding under the federal health care reform.

But Gallatin Republican Diane Black, who’s sponsoring the state measure, says the executive order is just a statement, not a law.

“That’s what people think, that that is the case, that if the president writes an executive order that, that will be the same as having something in statute, and we all know that that is not so.”

Unlike the Louisiana legislation, this does not yet go the additional step to mandate separate coverage in all private insurance plans.  But, as opponents in Tennessee noted, once it occurs in one insurance plan, the additional administrative headaches would make it easier to streamline all plans to match.

In Virgina, meanwhile, Governor Bob McDonnell is also using an abortion funding ban as an attempt to woo social conservatives, in this case without actually creating much change in funding at all.

Gov. Bob McDonnell proposed Wednesday to bar state funding for abortion services — except as required by federal law — a gesture to social conservatives that likely will have limited effect. Neither the governor’s office nor Planned Parenthood said they believed the measure would restrict state Medicaid dollars for the top abortion provider, which religious leaders are pushing to be defunded.

McDonnell, a long-time abortion foe, proposed the broadly written restriction as part of a larger set of amendments to Virginia’s two-year budget. Lawmakers will have a week to consider the governor’s alterations before returning Wednesday for a one-day reconvened session in which they can override the amendments or write them into law.

Under the federal Hyde Amendment, federal dollars can be used to end a pregnancy only in the case of rape, incest, or when the mother’s life is at risk.

As more states wrap up their legislative seasons, will we see more Americans United For Life’s “model state law” popping up across the country? 

We’ll definitely be watching.

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