Abortion Coverage Equity Act

Summary: The Abortion Coverage Equity Act would ensure that women, regardless of their economic status, are able to obtain insurance coverage for abortion care.

Background Summary

Insurance coverage for abortion is fundamental to women’s health care. When she has insurance coverage, a woman is better able to see a licensed, quality health care provider and make the best decisions for herself and her family.

It is common industry practice to cover abortion in the private, employer-sponsored insurance market. Yet, in many cases, states have interfered with and blocked insurers from including this coverage in private plans. Unfortunately, the same is true of health insurance provided by or through the federal or state governments.

On the federal level, the Hyde Amendment, enacted in 1976, bans the use of federal Medicaid funds from covering abortion except in cases of life endangerment, rape or incest. Congress has extended similar bans to several other health care programs.

Some states have stepped up to fill the gaps created by the Hyde Amendment and other discriminatory laws. Yet, thirty-three states and the District of Columbia prohibit the use of state Medicaid funds for abortion, except in limited cases. Twenty-five states restrict abortion coverage in their insurance exchanges. Twenty-one states restrict abortion coverage for state employee health plans. And ten states restrict abortion coverage in standard private insurance plans.

The lack of abortion insurance coverage hurts lower income women the most. At least one in six women of reproductive age (15-44) are enrolled in Medicaid. Studies show that when Medicaid doesn’t cover abortion, it forces one in four women who would otherwise seek an abortion to carry an unwanted pregnancy to term. Further, studies show that a woman who seeks an abortion but is denied is more likely to fall into poverty than a woman who is able to obtain an abortion.

The Abortion Coverage Equity Act ensures abortion is included in health insurance plans for every woman however much she earns, however she is insured, or wherever she lives. It respects the fact that, wherever she gets her insurance, every woman should be able to make her own decisions about pregnancy.


Model Legislation

SECTION 1. SHORT TITLE

This Act shall be called the “Abortion Coverage Equity Act.”

SECTION 2. FINDINGS AND PURPOSE

(A) FINDINGS—The legislature finds that:

1)      Affordable, comprehensive health insurance that includes coverage for a full range of pregnancy-related care, including abortion, is critical to the health of every woman.

2)      Neither a woman’s income level nor her type of insurance should prevent her from having access to a full range of pregnancy-related care, including abortion services.

3)      No woman should have the decision to have, or not to have, an abortion made for her based on her ability or inability to afford the procedure.

4)      Since 1976, the federal government has withheld funds for abortion coverage in most circumstances. These restrictions who are insured through the Medicaid program, as well as women who receive insurance or care through other federal health plans and programs.

5)      Other states provide coverage that [state] does not: Forty states permit abortion care in standard private insurance plans; Twenty-nine states permit abortion care in state employee insurance plans; Twenty-five states permit abortion care in their insurance exchanges; Seventeen states have policies that include abortion care in their Medicaid programs. [Include what is relevant to your state.]

6)      A report by the Center for Reproductive Rights details how restrictions on abortion coverage interfere with a woman’s personal decision-making, with her health and well-being, and with her constitutionally protected right to a safe and legal medical procedure.

7)      Restrictions on abortion coverage have a disproportionate impact on low-income women, women of color, immigrant women, and young women who are already disadvantaged in their access to the resources, information, and services necessary to prevent an unintended pregnancy or to carry a healthy pregnancy to term.

(B) PURPOSE—This law is enacted to ensure that women, regardless of their source of insurance or economic status, are able to obtain comprehensive and affordable insurance coverage for abortion care.

SECTION 3. POLICY TO COVER ABORTION CARE

After section XXX, the following new section XXX shall be inserted:

(A) POLICY TO COVER ABORTION

Abortion shall be covered in all types of health insurance offered, sold or purchased in this state, including all private plans, all state-funded plans, and all state-provided benefits.

(B) RESTRICTIONS REPEALED

1)      Section XXX [any provision of law that prohibits abortion care in private health insurance plans] is hereby repealed.

2)      Section XXX [any provision of law that prohibits abortion care in state employee insurance plans] is hereby repealed.

3)      Section XXX [any provision of law that prohibits abortion care in the state insurance exchange] is hereby repealed.

4)      Section XXX [any provision of law that prohibits abortion care in Medicaid coverage] is hereby repealed.

5)      Section XXX [any provision of law that prohibits abortion care in any other state-funded insurance program] is hereby repealed.

SECTION 4. SEVERABILITY

The provisions of this Act shall be severable, and if any phrase, clause, sentence or provision is declared to be invalid, is preempted by federal law or regulation, or results in noncompliance with federal requirements that are a condition to the allocation of federal funds to the state, those words are inapplicable and the validity of the remainder of this Act shall not be affected.

SECTION 5. EFFECTIVE DATE

This Act shall take effect on XXXX 1, 2016.

[Bill drafting note: States have different regulatory requirements for traditional health insurance carriers and their managed care plans. Therefore, some states may need separate provisions or separate bills to amend the different statutes that cover all health care plans.]

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