Maine’s Largest Obamacare Health Provider Cuts Costs By Nixing Abortion Coverage

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Maine’s Largest Obamacare Health Provider Cuts Costs By Nixing Abortion Coverage

Michelle D. Anderson

The Affordable Care Act allows states to ban abortion coverage by insurance plans in the marketplace. Twenty-five states have adopted this policy, though Maine is not one of them.

Pregnant people seeking abortion care in Maine will no longer have access to coverage for the procedure through the largest insurance provider in the state’s Affordable Care Act (ACA) marketplace.

The insurance co-op Community Health Options announced it will drop coverage for the health service in an attempt to make up for the $31 million loss it posted in 2015, NPR and Kaiser Health News reported. The insurance co-op lost more than $17 million in the first nine months of 2015, after making $10.9 million in the same period the previous year, the Insurance Journal reported.

The company is reportedly one of only six member-run co-ops remaining, out of the 23 that were created for the ACA marketplace. Community Health Options recently gained approval to withdraw from the New Hampshire insurance market in 2017 to address its financial losses, the Portland Press Herald reported.

Community Health Options CEO Kevin Lewis told reporters that the decision to do away with abortion care coverage was driven by “economic considerations,” in addition to “the construction of the Affordable Care Act and how it regards essential health benefits in the individual marketplace.”

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The change is accompanied by a 25 percent increase in insurance premiums. The average increase would have been 33 percent without the recent cuts in coverage, Lewis told NPR.

Community Health Options will also drop adult vision care, which, like abortion, is not considered an essential health benefit under the ACA.

Eighty-one percent of Maine counties had no abortion clinic as of 2011, according to Guttmacher Institute data, and 55 percent of the state’s women lived in these counties.

The ACA allows states to ban abortion coverage by insurance plans in the marketplace. Twenty-five states have adopted this policy, though Maine is not one of them.

California is the only state that requires private insurance plans to treat abortion coverage the same as other maternity coverage. Washington state legislators have tried and failed to pass a similar measure in recent years.

Andrea Irwin, executive director of the Mabel Wadsworth Health Center in Bangor, one of Maine’s three main providers of abortion services, told NPR that Community Health Options’ decision “further stigmatizes a normal procedure [that is] part of the comprehensive experience of women’s health care.”

Pro-choice advocates, like Planned Parenthood of Northern New England spokesperson Nicole Clegg and Kaiser Family Foundation senior policy analyst Laurie Sobel, said the co-op’s recent decision is indicative of how some lawmakers have worked to restrict access to abortions, NPR reported.