More States Moving To Restrict Abortion Coverage

February 1, 2013 — Federal fights over abortion coverage leading up to passage of the Affordable Care Act (PL 111-148) have raised state lawmakers' consciousness about their ability to restrict health insurers from covering the procedure, Politico reports.

The ACA maintains a ban on federal funding for abortion, except for cases of rape, incest or to save a woman's life. Additionally, private health plans offered through state health insurance exchanges can only offer abortion coverage that is segregated from other coverage and paid for with a separate payment. The law also permits states to enact additional limits on abortion coverage in the exchanges.

Elizabeth Nash of the Guttmacher Institute noted that before the ACA, abortion coverage restrictions "were a nonissue." The law's passage "really encouraged states to go in and pass these abortion coverage restrictions in their own health exchanges," she said.

To date, 18 states have enacted legislation banning or restricting abortion coverage in the exchanges, according to Guttmacher. Two additional states -- Kentucky and North Dakota -- already had laws in place banning all health plans from covering abortion.

The number of states opting to restrict abortion coverage in the exchanges is expected to grow, Politico reports. More states also are acting to prohibit abortion coverage in all private health plans, not just those in the exchanges.

Kentucky Rep. Stan Lee (R), who is sponsoring a bill banning abortion coverage in his state, said the ACA "raised the consciousness" of antiabortion-rights lawmakers about the opportunity to restrict abortion coverage (Smith, Politico, 1/31).

All States Except Ore. Restrict Abortion, Chart Shows

In related news, a new chart from Remapping Debate depicts how all states, with the exception of Oregon, have passed laws limiting access to abortion, the Washington Post's "Wonkblog" reports.

The chart, which details the types of restrictions in each state, is based on data from Guttmacher and NARAL Pro-Choice America. The most restrictive state is Oklahoma, with 22 antiabortion provisions (Kliff, "Wonkblog," Washington Post, 1/31).