The Trump administration is trying to discourage private insurance companies from offering coverage for abortions.
Abortion coverage bills in the mail
Under a new rule finalized by the Department of Health and Human Services in December, insurers who sell plans through the Marketplaces will be required to issue two separate bills to consumers if their plans include coverage for abortions: one for their regular premium and one for a special abortion coverage premium.
♦ September 17, 2021 — CMS issued new rule changes that scrapped the Trump administration's 2019 rule.
If you’re one of the 3 million Americans who bought health insurance on an Affordable Care Act state exchange, you may be surprised to open up the mail this summer. You will also be surprised to learn you may need to send in two separate payments.
♦ Most consumers don’t even know if their plan includes abortion coverage. People whose plans cover abortion will be required to pay two separate bills. The bill for abortion coverage is expected to be small, possibly only a dollar a month.
The problem is that many people will think they can choose to not pay the bill for abortion coverage. That is not an option. Insurance companies have been given the green light to cancel a person’s coverage if they fail to pay both bills.
Why two bills?
The administration says this rule change is to prevent taxpayer funding of abortion coverage. But their story is a bit bent for political reasons.
The administration seems more intent on trying to discourage coverage for abortions by creating confusion and putting up more administrative obstacles.
♦ In truth, federal funding for abortions has been illegal since 1976, when Congress passed a measure now known as the Hyde Amendment.
The Hyde Amendment already blocks federal funds from being used to pay for abortions outside of the exceptions for rape, incest, or if the pregnancy is determined to endanger the woman’s life.
• The Hyde Amendment has resulted in dramatically limiting coverage for abortions under Medicaid and other federal programs.
♦ Insurance providers will still be allowed to provide abortion coverage under the new rules. The rule changes are really intended to dissuade many providers from covering abortions.
The insurance industry has said the changes would create huge burdens for them, including changing their billing software, managing twice as many payments and dealing with confusion from customers.
Those costs will inevitably get passed on to consumers in some form, be it an increase in premiums, deductibles, co-pays or changes to coverage and doctor networks.
♦ The Kaiser Family Foundation estimates that roughly 3.1 million individuals may now be required to pay separate bills. Meaning millions could be at risk of losing abortion coverage.
• The total cost will not change under the new rule — that is, the abortion services coverage charges won’t be an add-on but will simply be broken out from the total bill.
Medical groups warn that the rule change could cause people to lose coverage if they get confused and don’t pay both bills.
Point of view
♦ “If they can’t make it illegal, they will make it as inaccessible as possible, and they’re pulling out every single stop in order to do that,” says Mary Alice Carter of Equity Forward, a watchdog organization focused on reproductive health.
Receiving two bills hardly makes anything inaccessible but it does add confusion when we should be trying to make things simpler.
♦ “Consumers have a right to know if they are paying for elective abortion. While the Affordable Care Act still allows government-subsidized plans to cover abortion, at least with this rule, Americans can now see and try to avoid complicity by choosing plans consistent with their consciences,” said Archbishop Joseph Naumann of Kansas City, Kansas.
This is a valid point. However, bills are not expected to start arriving in people’s mailboxes until around June. And no one will be able to change their plan mid-year because they are unhappy.
Open enrollment starts November 1st for plan year 2021. We don’t know yet if all insurers will show two charges during enrollment or simply provide a total. Insurers have never been all that concerned about anyone’s conscience.