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As the third open enrollment period draws to a close in the health insurance markets, one thing hasn’t changed much since trading opened online: It’s still often unclear whether a plan covers abortion services.
The health law requires a plan to say one way or another, and anti-abortion advocates and abortion right supporters say insurers have improved in communicating details. But the federal government has yet to issue final instructions on how insurers should deal with the problem in their benefit summary and coverage overview. Without specific instructions on what to say and where to say it, many insurers have simply omitted information from the summary, advocates on both sides of the matter have said.
This leaves consumers who have a preference – because of their views on abortion or concerns about the need for the service – at a standstill. “It’s not easy to determine if a plan covers abortion and, if so, to what extent,” says Kinsey Hasstedt, public policy associate at the Guttmacher Institute, a health research organization. reproductive system that supports the right to abortion.
The health law allows states to decide whether market plans can cover abortion services. Half of the states ban abortion coverage to some extent, often limiting it to cases of rape or incest or when the mother’s life is in danger. (The federal government uses this standard in employee plans and for health care programs such as Medicaid.)
However, even in states that allow insurers to cover abortion beyond limited exceptions, market plans may not offer this benefit.
The lack of readily available information makes it difficult to know whether the number of plans that provide abortion services on scholarships is increasing or decreasing.
Advocates on both sides of the issue have their eyes on multi-state plans. The health law provided for multi-state plans that would be offered in each state by certain insurers. Each state market was supposed to have two multi-state plans by 2017, at least one of which excluded abortion services. In subsequent guidelines, the Office of Personnel Management, which administers the multi-state program, said multi-state insurers must offer at least one silver-level plan and one gold-level plan that excludes coverage of the abortion from this year.
But the multistate program is in trouble. The number of states where multi-state plans were proposed fell to 32 plus the district in 2016, from 35 last year.
In these states, most multi-state plans do not cover abortion. Of the 261 multi-state plans available in 2016, only four plans in two states – Connecticut and Alaska – provide abortion services, according to the OPM.
However, opponents of abortion have said that since multi-state plans are not yet available in all states, there is no guarantee that consumers can find a plan that does not cover abortion.
Advocates of abortion rights have a different problem with the multistate program. They say it’s not fair to require the market to come up with plans that exclude abortion without also requiring plans that include coverage for abortion. They are also challenging the OPM’s decision that insurers should offer two multi-state plans that exclude abortion coverage, instead of the one that the law requires.
OPM is not considering any changes to the program at this time, a spokesperson said.
Advocates on both sides hope the final instructions for the coverage summaries will make it easier for consumers to find out if the plans cover abortion.
Advocates of all stripes agree that the language describing abortion services should be clear and consistent rather than the mishmash of descriptions that appear in current documents, where it may be called “termination of pregnancy” or “voluntary termination of pregnancy”. ‘a normal pregnancy’, among other terms.
This column is produced through a collaboration between The Post and Kaiser Health News.
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