In Washington State, requiring health insurers to cover abortion

Washington State may soon become the first to require insurance companies to cover abortion.Washington State has tended to be ahead of the rest of the country when it comes to abortion rights. Prior to Roe v. Wade, it was one of four states with sweeping legal protections to terminate a pregnancy. Now, the state is looking to set new precedent: It could soon become the first state to require all health plans to cover abortion.

House Bill 2330 would require all health plans that offer maternity care to also provide coverage for terminating a pregnancy, with a conscience exemption for those that may have a religious objection to such coverage. The law, currently pending in the Washington State Senate, would kick in this summer. And it’s a notable counterpoint to the eight states that have recently passed legislation that bars insurers from covering abortions.

I spoke Tuesday afternoon with the bill’s sponsor, Rep. Eileen Cody, who explained that the legislation grew out of concerns over the structure of the federal health reform law. In order to ensure no federal funds get spent on abortion, the Affordable Care Act set up special accounting rules for insurance plans that cover the procedure and receive federal insurance subsidies.

Here’s how it works: Under the Affordable Care Act, an insurer will have to collect two payments from every enrollee. One would go to the general fund, the other to a fund exclusively covering abortion. Every enrollee - male, female, regardless of whether they wanted an abortion - will have to pay into both funds, the idea there being that the separate payment is not a rider but a standard part of premiums that must be paid separately.

The worry, for reproductive health advocates, is that the new accounting system will be too burdensome: Health insurance companies, they fear, will drop abortion coverage to dodge another level of bureaucracy. “We weren’t sure that abortion would be offered in the exchanges because the federal law sets up a lot of barriers to that,” says Cody. “We wanted to make sure that choice would be available.”

Cody’s legislation passed out of the Washington State House on a 52-46 vote in its favor. The business community and health insurers have been relatively quiet on the issue, she said. “The insurance industry has pretty stayed out of it, since all of our carriers tend to offer abortion services already,” says Cody. “They joked they weren’t even in the building during our hearing.”

The Catholic Church has come out in opposition to the bill. But, over all, Cody reports receiving less blowback than she initially expected. “Any time you mention abortion, you get somewhat of a reaction,” she says. Compared to the volume of e-mail she got on the gay marriage law the state passed in early February, “e-mail on this law has not been nearly as bad.”