Insurance Coverage

Last updated: March 18, 2016

Insurance coverage bans restrict insurance coverage of abortion in order to eliminate access to safe abortion care. The Affordable Care Act (ACA), which President Obama signed into law in 2010, calls for each state to set up a health insurance exchange or “marketplace” so that people who do not have health insurance coverage through their employers can shop for health insurance at competitive rates. The ACA expressly permits states to opt out of providing abortion coverage by enacting “opt-out” laws. By passing such “opt-out” legislation, states can prohibit insurance plans available through the state’s health insurance marketplace from covering elective abortions. Some states offered varying exceptions within these coverage bans for rape, incest, or life endangerment, and some states permit women to purchase abortion coverage outside the health insurance exchange if they pay a separate premium for that coverage.

Anti-choice activists view these insurance coverage bans as a way to push back on what they claim are federal subsidies of abortion through the health-care law. As the White House has noted, however, such claims have no merit: The Hyde Amendment prohibits federal dollars from being used to pay for abortions except in cases of rape, incest, or when the life of the woman is endangered.

The push to excise abortion from health insurance coverage is part of a significant strategy of the anti-choice movement, which has realized in recent years that activists do not have to topple Roe v. Wade to eliminate access to safe abortion. Rather, anti-choice proponents understand that making abortion unobtainable, even though it is legal, can in some cases have the same effect. One effective strategy to reduce access to abortion is to make it unaffordable by ensuring that women have no option but to pay for procedures without coverage.

Examples of Insurance Coverage Bans (last updated January 25, 2016)

According to the Guttmacher Institute, ten states restrict insurance coverage of abortion in all private insurance plans written in the state, including plans that will be offered through the health insurance exchanges. Twenty-five states restrict abortion coverage in plans to be offered through the health insurance exchanges, with some of these states offering exceptions in cases of rape, incest, or life-endangerment. Twenty-one states and the federal government restrict abortion coverage in insurance plans for public employees.

Some states permit women to obtain insurance coverage for abortion by alternative means. Pennsylvania, for example, permits the purchase of abortion coverage outside the health insurance exchange if a separate premium is paid for that coverage. And in Michigan, pursuant to a bill colloquially known as the “Rape Insurance” bill, women are required to purchase a separate rider for abortion coverage even in cases of rape and incest. (Pennsylvania’s law permits insurance coverage for abortion in cases of rape and incest and is therefore not as stringent as Michigan’s law.)

Many state opt-out insurance coverage bans are based upon model legislation called “The Federal Abortion Mandate Opt-Out Act” drafted by Americans United for Life (AUL). Eight states have passed opt-out bills based on AUL model legislation, and four additional states passed similar bills with assistance from AUL, according to AUL’s spokesperson Kristi Hamrick. In some cases, the legislation was sponsored by state legislators with significant ties to the American Legislative Exchange Council (ALEC). For example, insurance coverage bans in Indiana, Louisiana, Mississippi, Missouri, South Carolina, Utah, Virginia, and Wisconsin were sponsored by state legislators who served on various ALEC task forces and committees.

Laws

Title Number State Proposed Status
Indiana Omnibus Abortion Bill (HEA 1210) HEA 1210 Indiana January 12, 2011 Current
North Carolina Motorcycle Abortion Bill (SB 353) SB 353 North Carolina March 19, 2013 Current
Texas Insurance Coverage for Abortion Ban HB 997 Texas February 5, 2013 Failed to Pass
Pennsylvania Health Insurance Exchange Abortion Ban (HB 818) HB 818 Pennsylvania February 25, 2013 Current
Pennsylvania Health Insurance Exchange Abortion Ban (SB 3) SB 3 Pennsylvania February 8, 2013 Failed to Pass
Pennsylvania Health Insurance Exchange Abortion Ban (HB 742) HB 742 Pennsylvania February 14, 2013 Failed to Pass
Pennsylvania Bill Prohibiting Use of Public Funds for Abortion (SB 275) SB 275 Pennsylvania February 26, 2013 Failed to Pass
Michigan Abortion Insurance Opt-Out Bill (HB 4597) HB 4597 Michigan April 18, 2013 Failed to Pass
Michigan Health Insurance Exchange Abortion Ban (HB 4065) HB 4065 Michigan January 22, 2013 Failed to Pass
Michigan Abortion Insurance Opt-Out Bill (SB 139) SB 139 Michigan February 5, 2013 Failed to Pass
Michigan Nonprofit Health Care Corporation Reform Act (HB 4066) HB 4066 Michigan January 22, 2013 Failed to Pass
Michigan Health Insurance Exchange Abortion Ban (SB 137) SB 137 Michigan February 5, 2013 Failed to Pass
Michigan Nonprofit Health Care Corporation Reform Act (SB 138) SB 138 Michigan February 5, 2013 Failed to Pass
Michigan Abortion Insurance Opt-Out Act Public Act 182 of 2013 Michigan Current
Wisconsin Abortion and Contraceptive Coverage Opt-Out Bill (SB 202) SB 202 Wisconsin May 30, 2013 Failed to Pass
Wisconsin Abortion and Contraceptive Coverage Opt-Out Bill (AB 216) AB 216 Wisconsin June 13, 2013 Failed to Pass
Florida Unborn Viability Act (HB 551) HB 551 Florida January 16, 2014 Failed to Pass
Florida for Life Act 2014 (HB 545) HB 545 Florida January 9, 2014 Failed to Pass
Florida for Life Act 2013 (SB 1056) SB 1056 Florida February 20, 2013 Failed to Pass
Florida for Life Act 2013 (HB 395) HB 395 Florida January 22, 2013 Failed to Pass
Florida Unborn Viability Act (SB 1602) SB 1602 Florida February 28, 2014 Failed to Pass
Florida for Life Act 2014 (SB 1510) SB 1510 Florida February 28, 2014 Failed to Pass
Oklahoma Contraception and Abortion Opt-Out Bill (SB 452) SB 452 Oklahoma February 4, 2013 Failed to Pass
Oklahoma Joint Resolution Regarding Freedom of Conscience in Health Insurance Coverage (SJR 31) SJR 31 Oklahoma January 17, 2013 Failed to Pass
Alabama Abortion Coverage Prohibition Act (SB 321) HB 321 Alabama March 12, 2013 Failed to Pass
Arkansas Health Insurance Exchange Abortion Ban (HB 1100) HB 1100 Arkansas January 22, 2013 Current
Michigan Bill to Repeal Abortion Insurance Opt-Out Act (HB 5697) HB 5697 Michigan June 12, 2014 Failed to Pass
Georgia Federal Abortion Mandate Opt-Out Act (SB 98) SB 98 Georgia February 1, 2013 Current
Bill to Amend Georgia Federal Abortion Mandate Opt-Out Act (SB 427) SB 427 Georgia March 7, 2014 Failed to Pass
Georgia Insurance Coverage for Abortion Ban (SB 164) SB 164 Georgia February 13, 2013 Failed to Pass
Georgia Insurance Coverage for Abortion Ban (HB 1066) HB 1066 Georgia February 24, 2014 Failed to Pass
South Carolina Bill Regarding Abortion Coverage in State Insurance Plans (S 618) S 618 South Carolina April 16, 2013 Failed to Pass
South Dakota Insurance Coverage for Abortion Ban (HB 1185) HB 1185 South Dakota January 23, 2012 Current
North Carolina Family, Faith, and Freedom Protection Act (HB 695) HB 695 North Carolina April 9, 2013 Failed to Pass
North Carolina Health Care Conscience Protection (HB 730) HB 730 North Carolina April 10, 2013 Failed to Pass
North Carolina Act to Modify Religious Employer Exception for Contraceptive Coverage (SB 498) SB 498 North Carolina March 27, 2013 Failed to Pass
Ohio Insurance Coverage for Abortion Ban (HB 351) HB 351 Ohio November 13, 2013 Failed to Pass
Virginia Bill to Repeal Insurance Coverage for Abortion Ban (HB 1186) HB 1186 Virginia January 16, 2014 Failed to Pass
Virginia Bill to Repeal Insurance Coverage for Abortion Ban (SB 618) SB 618 Virginia January 15, 2014 Failed to Pass
Virginia Bill to Repeal Insurance Coverage for Abortion Ban (SB 646) SB 646 Virginia January 17, 2014 Failed to Pass
Virginia Bill Regarding Right of Conscience Related to Contraceptive Coverage 2014 (HB 18) HB 18 Virginia November 21, 2013 Failed to Pass
Virginia Bill Regarding Right of Conscience Related to Contraceptive Coverage 2014 (HB 19) HB 19 Virginia November 21, 2013 Failed to Pass
Virginia Bill Regarding Right of Conscience Related to Contraceptive Coverage 2014 (HB 20) HB 20 Virginia November 21, 2013 Failed to Pass
Virginia Bill Regarding Right of Conscience Related to Contraceptive Coverage 2013 (HB 1314) HB 1314 Virginia October 3, 2012 Failed to Pass
Virginia Bill Regarding Right of Conscience Related to Contraceptive Coverage 2013 (HB 1315) HB 1315 Virginia October 3, 2012 Failed to Pass
West Virginia Insurance Coverage for Abortion Ban (HB 4489) HB 4489 West Virginia February 12, 2014 Failed to Pass
West Virginia Insurance Coverage for Abortion Ban (HB 4311) HB 4311 West Virginia January 24, 2014 Failed to Pass
West Virginia Insurance Coverage for Abortion Ban (HB 3081) HB 3081 West Virginia January 9, 2014 Failed to Pass
West Virginia Insurance Coverage for Abortion Ban (SB 272) SB 272 West Virginia January 8, 2014 Failed to Pass
West Virginia Insurance Coverage for Abortion Ban 2014 (HB 4471) HB 4471 West Virginia February 11, 2014 Failed to Pass
West Virginia Insurance Coverage for Abortion Ban (SB 496) SB 496 West Virginia February 5, 2014 Failed to Pass
West Virginia Insurance Coverage for Abortion Ban (SB 660) SB 660 West Virginia March 25, 2013 Failed to Pass
West Virginia Insurance Coverage for Abortion Ban 2013 (HB 3081) HB 3081 West Virginia March 25, 2013 Failed to Pass
West Virginia Insurance Coverage for Abortion Ban (HB 3136) HB 3136 West Virginia March 25, 2013 Failed to Pass
West Virginia Insurance Coverage for Abortion Ban (SB 405) SB 405 West Virginia March 1, 2013 Failed to Pass
Idaho Insurance Coverage for Abortion Ban (S 1115) S 1115 Idaho February 17, 2011 Current
Idaho Bill Regarding Freedom of Conscience (S 1353) S 1353 Idaho January 22, 2010 Current
Indiana Insurance Coverage for Abortion Ban (HB 1123) HB 1123 Indiana January 9, 2014 Current
Indiana Insurance Coverage for Abortion Ban (SB 335) SB 335 Indiana January 8, 2013 Failed to Pass
Indiana Law Regarding Refusal of Certain Health-Care Coverage (HB 1498) HB 1498 Indiana January 22, 2013 Failed to Pass
Iowa Insurance Coverage for Abortion Ban (HF 2096) HF 2096 Iowa February 3, 2014 Failed to Pass
Iowa Bill Restricting Use of Public Funds for Abortion (SF 29) SF 29 Iowa January 24, 2013 Failed to Pass
Iowa Bill Regarding Employer Religious Conscience Protection (SF 2153) SF 2153 Iowa February 11, 2014 Failed to Pass
Nebraska Bill Regarding Medicaid Expansion for Contraceptive Coverage (LB 452) LB 452 Nebraska January 22, 2013 Failed to Pass
South Carolina Bill Regarding Abortion Coverage in State Insurance Plans (S 122) S 122 South Carolina December 3, 2014 Proposed
Florida for Life Act 2015 (HB 247) HB 247 Florida January 13, 2015 Failed to Pass
Virginia Bill to Repeal Insurance Coverage for Abortion Ban (SB 769) SB 769 Virginia December 23, 2014 Failed to Pass
Virginia Bill Regarding Insurance Coverage for Contraception (SB 1277) SB 1277 Virginia January 14, 2015 Failed to Pass
No Taxpayer Funding for Abortion Act and Abortion Insurance Full Disclosure Act 2015 (HR 7) HR 7 Federal January 21, 2015 Proposed
Iowa Bill Restricting Use of Public Funds for Abortion 2015 (SF 55) SF 55 Iowa January 21, 2015 Failed to Pass
Alaska Restrict Medicaid Payment for Abortions (HB 173) HB 173 Alaska March 15, 2013 Failed to Pass
Alaska Law Regarding Medicaid Payment for Abortions (SB 49) SB 49 Alaska February 11, 2013 Current
Arizona Bill Amending Provision Regarding Birth Control Benefit (SB 1431) SB 1431 Arizona February 3, 2015 Failed to Pass
Arizona Omnibus Bill (SB 1318) SB 1318 Arizona February 2, 2015 Current
West Virginia Insurance Coverage for Abortion Ban 2015 (SB 236) SB 236 West Virginia January 15, 2015 Failed to Pass
West Virginia Insurance Coverage for Abortion Ban (HB 2440) HB 2440 West Virginia January 27, 2015 Failed to Pass
Texas Insurance Coverage for Abortion Ban (HB 1435) HB 1435 Texas February 13, 2015 Failed to Pass
Texas Insurance Coverage for Abortion Ban (SB 575) SB 575 Texas February 13, 2015 Failed to Pass
Iowa Bill Regarding Employer Religious Conscience Protection (SF 118) SF 118 Iowa January 29, 2015 Failed to Pass
Mississippi Federal Abortion Opt-Out Act (SB 2808) SB 2808 Mississippi February 19, 2015 Failed to Pass
Montana Bill Regarding Insurance Coverage for Abortion (SB 349) SB 349 Montana February 16, 2015 Failed to Pass
Minnesota Physician Fee for Abortion Services Prohibition (SF 1759) SF 1759 Minnesota February 25, 2014 Failed to Pass
Minnesota Bill Regarding Abortion State Health Programs Funding Limitation (SF 1567) SF 1567 Minnesota April 8, 2013 Failed to Pass
Washington Bill Regarding Medicaid Enrollee Contraceptive Access (SB 5884) SB 5884 Washington March 22, 2013 Failed to Pass
Washington Bill Regarding Medicaid Enrollee Contraceptive Access (HB 2022) HB 2022 Washington April 2, 2013 Failed to Pass
Iowa Bill Prohibiting Abortions at State-Funded Institutions (HF 422) HF 422 Iowa February 26, 2015 Failed to Pass
Florida For Life Act 2015 (SB 1502) S 1502 Florida February 26, 2015 Failed to Pass
Texas Insurance Coverage for Abortion Ban (HB 3130) HB 3130 Texas March 11, 2015 Failed to Pass
Texas Insurance Coverage for Abortion Ban (SB 1872) SB 1872 Texas March 13, 2015 Failed to Pass
Minnesota Bill Prohibiting Use of Public Funds for Abortion (SF 1934) SF 1934 Minnesota March 23, 2015 Failed to Pass
Rhode Island Bill Regarding Insurance Coverage for Abortion (H 5784) H 5784 Rhode Island March 5, 2015 Failed to Pass
Rhode Island Bill Regarding Insurance Coverage for Abortion (S 573) S 573 Rhode Island March 3, 2015 Failed to Pass
Montana Bill Allowing Gender Consideration in Setting Insurance Premiums (HB 600) HB 600 Montana March 15, 2013 Failed to Pass
West Virginia Bill Prohibiting State Funding of Abortions (HB 2256) HB 2256 West Virginia January 23, 2015 Failed to Pass
Washington Contraceptive Access for Medicaid Plans (SB 5806) SB 5806 Washington February 3, 2015 Proposed
Michigan Bill Regarding Optional Rider for Abortion Coverage (SB 214) SB 214 Michigan March 17, 2015 Proposed
Michigan Bill to Repeal Abortion Insurance Opt-Out Act (SB 63) SB 63 Michigan January 29, 2015 Proposed
Minnesota Contraceptive Health Equity and Employee Rights Act (SF 1278) SF 1278 Minnesota March 2, 2015 Failed to Pass
Minnesota Contraceptive Health Equity and Employee Rights Act (HF 1165) HF 1165 Minnesota February 23, 2015 Failed to Pass
Washington Reproductive Health Act (HB 1647) HB 1647 Washington January 26, 2015 Proposed
Washington Reproductive Health Act (SB 5574) SB 5574 Washington January 26, 2015 Proposed
Massachusetts Bill Requiring Contraceptive Coverage (H 948) H 948 Massachusetts January 20, 2015 Proposed
Maine Act to Expand Coverage of Family Planning Services (LD 1247) LD 1247 Maine March 27, 2013 Failed to Pass
Maine Bill Expanding Coverage of Reproductive Health Care (LD 319) LD 319 Maine February 10, 2015 Failed to Pass
Illinois Bill Allowing Use of Public Funds for Abortions (HB 4013) HB 4013 Illinois February 27, 2015 Proposed
Connecticut Act Improving Access to Contraceptives (HB 6159) HB 6159 Connecticut January 22, 2015 Failed to Pass
Arkansas “Contraception Incentive” for Medicaid Beneficiaries (HB 1868) HB 1868 Arkansas March 9, 2015 Failed to Pass
Washington Reproductive Parity Act (SB 6359) SB 6359 Washington January 22, 2014 Failed to Pass
Washington Reproductive Parity Act (HB 2148) HB 2148 Washington January 6, 2014 Failed to Pass
Washington Reproductive Parity Act (SB 5576) SB 5576 Washington February 4, 2013 Failed to Pass
Washington Reproductive Parity Act (SB 5798) SB 5798 Washington February 15, 2013 Failed to Pass
Washington Reproductive Parity Act (HB 1044) HB 1044 Washington January 10, 2013 Failed to Pass
Washington Reproductive Parity Act (SB 5009) SB 5009 Washington January 14, 2013 Failed to Pass
New York Emergency Contraception Insurance Coverage (A 5178) A 5178 New York February 12, 2015 Proposed
Washington Employee Reproductive Choice Act (HB 1502) HB 1502 Washington Proposed
Washington Employee Reproductive Choice Act (SB 5026) SB 5026 Washington January 12, 2015 Proposed
Illinois Reproductive Health Coverage (HB 6299) HB 6299 Illinois September 15, 2014 Failed to Pass
Vermont Act Relating to Abortion & Insurance Coverage (H 717) H 717 Vermont January 28, 2014 Failed to Pass
Rhode Island Appropriations Bill For 2016 (H 5900) H 5900 Rhode Island March 13, 2015 Signed into Law
California Bill Relating to Abortion Coverage (AB 1254) AB 1254 California February 27, 2015 Proposed
Rhode Island Bill Regarding Insurance Coverage for Abortion (H 6301) H 6301 Rhode Island June 26, 2013 Failed to Pass
Rhode Island Bill Regarding Insurance Coverage for Abortion (H 6300) H 6300 Rhode Island June 26, 2013 Failed to Pass
Rhode Island Bill Regarding Insurance Coverage for Abortion (S 1038) S 1038 Rhode Island June 27, 2013 Failed to Pass
Rhode Island Bill Prohibiting Insurance Coverage for Induced Abortions (H 8045) H 8045 Rhode Island April 10, 2014 Failed to Pass
Rhode Island Bill Prohibiting Insurance Coverage for Induced Abortions (H 7403) H 7403 Rhode Island February 12, 2015 Failed to Pass
Florida Bill Regarding the Termination of Pregnancies (HB 1411) HB 1411 Florida January 12, 2016 Current
Florida Bill Regarding the Termination of Pregnancies (SB 1722) SB 1722 Florida January 11, 2016 Failed to Pass
Florida for Life Act 2016 (SB 1718) SB 1718 Florida January 11, 2016 Failed to Pass
Florida for Life Act 2016 (HB 865) HB 865 Florida January 12, 2016 Failed to Pass
West Virginia Insurance Coverage for Abortion Ban (SB 22) SB 22 West Virginia January 13, 2016 Failed to Pass
Tennessee Bill Regarding the Reporting of State-Funded Abortions (SB 2330) SB 2330 Tennessee January 21, 2016 Failed to Pass
Tennessee Bill Regarding the Reporting of State-Funded of Abortions (HB 2438) HB 2438 Tennessee January 21, 2016 Failed to Pass
Virginia Bill Defunding Abortion Facilities (HB 1090) HB 1090 Virginia January 13, 2016 Failed to Pass
Nebraska Bill Prohibiting Abortion Funding (LB 782) LB 782 Nebraska January 7, 2016 Failed to Pass
South Carolina “Defunding the Abortion Industry & Advancing Women’s Health Act” (H 4538) H 4538 South Carolina January 12, 2016 Failed to Pass
California Bill Repealing Abortion Insurance (AB 2081) AB 2081 California February 17, 2016 Failed to Pass
West Virginia Insurance Coverage for Abortion Ban (SB 571) SB 571 West Virginia Failed to Pass
Maryland State Funding of Abortion Ban (HB 1357) HB 1357 Maryland February 12, 2016 Failed to Pass
Rhode Island Bill Prohibiting Insurance Coverage for Induced Abortion (H 7760) H 7760 Rhode Island February 26, 2016 Failed to Pass
Rhode Island Bill Prohibiting Insurance Coverage for Induced Abortions (S 2512) S 2512 Rhode Island February 25, 2016 Failed to Pass
Mississippi Bill Banning Medicaid Funding for Abortion (SB 2116) SB 2116 Mississippi February 1, 2016 Failed to Pass
Mississippi Bill Defunding Planned Parenthood (SB 2238) SB 2238 Mississippi February 5, 2016 Current
Rhode Island Bill Regarding Insurance Coverage for Abortion (S 2098) S 2098 Rhode Island January 21, 2016 Failed to Pass