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Multiple state and federal laws currently impose a variety of unfair limitations on insurance coverage. Since 1977, the federal government and a majority of states have banned insurance coverage for abortion care for women who qualify for public health insurance like Medicaid. Since 2010, when health care reform explicitly opened the door for states to restrict insurance coverage for abortion in health plans sold on a state’s health insurance exchange, many states have moved to pass such laws. The renewed focus on how abortions are paid for and whether they are covered by insurance has energized advocates seeking to protect and expand coverage for abortion no matter what type of insurance a woman has. Unfortunately, it has also energized those who oppose abortion and are seeking to cement and expand bans on coverage of abortion care.
In 2013, five states (Arkansas, Michigan, North Carolina, Pennsylvania, and Virginia) passed legislation banning insurance coverage of abortion in health plans sold on their state health care exchanges, with limited exceptions, bringing the total number of states with this policy to 24. North Carolina further prohibited insurance coverage for abortion for people employed by municipalities in the state. In an unprecedented move, Iowa enacted a law requiring the governor to review billing for each Medicaid-eligible abortion in the state to determine whether that abortion qualifies for insurance coverage under the small number of exceptions permitted in the Medicaid program. In December, Michigan legislators approved a ban on insurance coverage for abortion in all private plans in the state, using a complicated and controversial legislative maneuver brought forth by a small minority of voters. And finally, Kansas took aim at health savings accounts and imposed tax penalties on anyone who purchased a separate rider providing insurance coverage for abortion or used health savings account funds to pay for abortion care.
Restrictions on public insurance coverage of abortion force some women to continue unwanted pregnancies, cause other women to delay abortion care at potentially increased risk to their health, and impose additional financial strains on low-income and indigent women. Women eligible for Medicaid who cannot get insurance coverage for abortion report forgoing basic necessities, borrowing money, or selling or pawning personal belongings in order to pay for an abortion. Women unable to make up for the lack of insurance coverage for the procedure are often forced to carry their unwanted pregnancy to term. Research shows that these impacts of restrictions on public insurance coverage for abortion may also apply to women with private insurance, who cannot or do not use that insurance for abortion care.
Whether she has private or public health insurance, every woman should have coverage for a full range of pregnancy-related care, including abortion. Withholding insurance coverage for needed health care in order to make it more difficult or impossible for a woman to have an abortion is unconscionable.
The Center for Reproductive Rights is proud to be a partner of All* Above All, which unites organizations and individuals to build support for lifting the bans that deny abortion coverage. Our vision is to restore public insurance coverage so that every woman, however much she makes, can get affordable, safe abortion care when she needs it. Learn more and take action.
In 2012, the Center launched the Draw the Line campaign with the express purpose of putting the rampant attacks on women’s reproductive health care—like those described above—on the entire nation’s radar. Nearly 300,000 people have signed the Bill of Reproductive Rights at www.DrawtheLine.org, sending politicians a loud and clear message that reproductive rights are fundamental human rights, and must be protected from extremist politicians. Visit DrawtheLine.org to add your voice.