Many state legislatures are considering insurance reform proposals that restrict abortion coverage this year – and not surprisingly, pro-abortion organizations are unleashing numerous tactics to defeat these widely-supported bills. In 2010, five states enacted “opt-outs,” or bills that prohibit abortion coverage through state exchanges created by the Patient Protection and Affordable Care Act (PPACA).
This year, more states are moving to enact opt-outs, and several states are pursuing legislation that combines an opt-out and a prohibition on abortion coverage by all private insurance plans within the state, except through a separate, optional rider. Five states have enacted this type of ban.
We are monitoring and responding to objections wielded by pro-abortion groups, including the following:
Allegation: These bills create an “undue burden” on the right to abortion, particularly for lower income women.
Response: The Supreme Court has repeatedly and unequivocally held that the federal government does not hamper a woman’s “right” to abortion when it withholds funding for abortions or abortion coverage (See, for instance, Maher v. Roe, 432 U.S. 464 (1977)). Further, the 8th Circuit Court of Appeals upheld the constitutionality of a state prohibition on private insurance coverage of abortion in Coe v. Melahn, 958 F.2d 223 (8th Cir. 1992).
Allegation: A prohibition on private insurance coverage could lead to widespread “back-alley” abortions.
Response: Medicaid recipients – those in the most financial need – are already prohibited from receiving abortion coverage through Medicaid under the Hyde Amendment (with limited exceptions), a law that was held constitutionally sound by the US Supreme Court in Harris v. McRae, 448 U.S. 297 (1980). Further, a 2008 Guttmacher Institute study found that “in all, 12% of abortions were paid for with private insurance.” If only 12% of abortions are currently paid for with private insurance, prohibiting private insurance coverage of abortion will clearly not lead to the widespread procurement of illegal abortions.
Allegation: These bills could lead to women being unable to obtain abortions for pregnancies caused through rape/incest.
Response: These bills do nothing to prohibit any woman from obtaining an abortion; they simply prohibit a woman (unless her life is in danger) from receiving insurance coverage for abortions unless she purchases a separate rider specifically for that coverage.
Allegation: The option to buy a separate rider for abortion is a “false promise,” as nobody plans to have an abortion and would thus never think of purchasing a rider. Requiring individuals to anticipate all future medical needs is unreasonable.
Response: Insurance companies require individuals to “think ahead” all of the time. There are numerous supplemental policies on the market (like supplemental cancer insurance). Just as an individual with a family history of cancer may choose to purchase a cancer policy, an individual who thinks she may want an abortion at some point in her life can purchase an abortion rider.
Not surprisingly, pro-abortion legislators are also offering amendments in committee and on the floor that would either gut the bills or add poisonous provisions. Nonetheless, restrictions on abortion funding and coverage have widespread public support. A December 2009 Quinnipiac poll showed that 7 in 10 Americans were opposed to provisions in federal health care reform that use federal funds to pay for abortions and abortion coverage. With these strong numbers behind them, watch for more states to enact these reforms this year.