News Law and Policy

Trump Administration Wants New Restriction on Abortion Coverage

Ally Boguhn

The administration acknowledges the rule could increase the out-of-pocket cost of abortion care.

The Trump administration proposed a rule Thursday that includes a provision restricting insurance coverage for abortion care. Health-care experts said the rule is meant to steer insurers away from covering abortion services.

The abortion restriction was included in a proposed “2020 Payment Notice” from the Centers for Medicare & Medicaid Services (CMS), a division of the U.S. Department of Health and Human Services (HHS). If finalized, it would “require that insurance companies that offer [Affordable Care Act] plans covering abortions of pregnancies that do not threaten the life of the mother or result from rape or incest must also offer at least one identical plan in the same geographic area that does not cover these abortions,” according to a press release Friday touting the administration’s recent anti-choice policies.

“The rule would not apply in states with abortion coverage mandates,” the press release noted.

Megan Donovan, senior policy manager at the Guttmacher Institute, told Rewire.News Friday that the administration’s proposed rule was “another attempt to disincentivize insurers from offering abortion coverage—to restrict abortion coverage to the full extent that they can and just make it that much harder for insurers to include coverage in their plans by putting on another requirement.”

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“Under the ACA, insurers can choose whether to cover abortion in the plans that they offer in the marketplaces subject to state law—and of course, there are 26 states that restrict abortion coverage in the exchanges and four states that require plans to cover abortion,” she said. “But in the absence of a state law with a requirement or a ban … insurers can choose whether or not to include abortion in the coverage that they provide in the plans offered on the exchanges.”

“This proposed rule would require insurers who offer plans in the marketplaces that include abortion coverage—of course beyond the limited exceptions of the life endangerment, rape, and incest—to offer a …  ‘mirror plan’ in the same area that includes all the same benefits without the abortion coverage,” Donovan said.

The proposal acknowledges that the change could “potentially reduce the availability of non-Hyde abortion coverage in insurance, thereby increasing out-of-pocket costs for some women seeking those services.” Donovan pointed to that language and said this could “possibly make it difficult for people to obtain the care entirely because if they can’t meet that out-of-pocket cost there is significant financial barriers to getting the care that they need.”

The new Trump administration proposal “piles on top of the proposed rule from [November] that would create an onerous requirement that insurers offering insurance coverage in the marketplaces try to collect separate payment for that coverage,” Donovan said.

That rule, proposed by the Trump administration in November, would require insurers to bill customers and collect payments separately “for the portion of the consumer’s premium attributable to certain abortion services.” The comment period on that rule closed last week.

“This is part of what is clearly an ongoing effort to restrict private insurance coverage of abortion in the marketplaces,” Donovan continued.

“It is really telling that in the midst of a government shutdown the administration is pushing out new proposed restrictions on abortion coverage and the Senate was taking a vote on extreme anti-abortion coverage language yesterday while federal employees and contractors and the service-industry workers who rely on their business are … turning to nonprofits and community members to meet basic needs for food, housing, and diapers,” she said.

This is a developing story. Rewire.News will continue to report as more information emerges.

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