Committee Considers Ban on Abortion Coverage in Obamacare Health Plans

State Rep. Marsha Farney (R-Georgetown)
State Rep. Marsha Farney (R-Georgetown)

The House State Affairs Committee considered a bill late Wednesday night that would ban coverage for abortion in health plans offered through the Affordable Care Act’s health insurance exchange.

State Rep. Marsha Farney (R-Georgetown) said her bill “will ensure that insurance plans offered in Texas under the health benefit exchange would not cover elective abortions.”

Opponents, however, argued that Farney’s House Bill 3130 would create yet another hurdle for women.

HB 3130 “is effectively a ban on abortion for anyone purchasing insurance through the Affordable Care Act exchange,” said Heather Busby, executive director of NARAL Pro-Choice Texas. “If you ban insurance coverage for abortion from the exchange, a pregnant person may not be able to access a licensed, quality health provider in a timely manner.”

The Affordable Care Act allows states to enact policies that specifically ban abortion coverage in health plans offered through the health insurance exchange. According to the Guttmacher Institute, a national research organization that tracks abortion and reproductive health policies, 25 states already prohibit abortion coverage in their exchanges. Some policies, including the Texas legislation considered by the House committee, include an exemption for life-endangering situations and when a “serious risk of substantial and irreversible physical impairment of a major bodily function.”

State Rep. Jessica Farrar (D-Houston) took issue with the bill’s lack of exceptions for cases of rape, incest, fetal anomalies and ectopic pregnancies. Under Farney’s plan, if a woman purchasing insurance in the exchange wants abortion coverage, she would be required to buy a supplemental plan, a provision that also concerned Farrar.

“I don’t see the purpose of the bill, and I understand that you have a philosophical purpose, but I’m just being pragmatic,” Farrar told Farney during many exchanges between the two during the hearing. “No one anticipates having to have an abortion. … Unsuspecting women are not going to know to get that extra policy.”

Supporters of the bill, including Texas Alliance for Life, Texans for Life Coalition and the Texas Catholic Conference of Bishops, argued that allowing insurers to include abortion coverage in the exchange’s health plans is equivalent to taxpayer-subsidized abortions.

“It forces taxpayers to contribute to ending unborn life,” said Jennifer Allmon with the Texas Catholic Conference of Bishops. “This bill protects the conscience of individuals who do not wish to contribute to premiums that cover abortion.”

Farrar pointed out multiples times during the discussion that the federal health law already addresses this concern. According to health care research group Kaiser Family Foundation, the Affordable Care Act requires insurance companies that offer abortion coverage to “segregate funds, assuring that no federal funds are used for abortion coverage.” Allmon said clarity is needed on the separation of funds.

Abortion rights organizations nationwide argue that bans on insurance coverage for abortion disproportionately affect poor women, who are five times more likely to have an unintended pregnancy. Poor women on Medicaid must pay out-of-pocket for their abortions. In 1976, Congress passed the Hyde Amendment, which bars the public health insurance program from covering abortion. The Guttmacher Institute estimates that one in four women on Medicaid who want an abortion can’t get one.

Amanda Jean Stevenson, researcher with the University of Texas at Austin’s Texas Policy Evaluation Project, told the committee that a study her group conducted in 2013 found that 40 percent of women seeking abortions in Texas live at or below the federal poverty line, and women purchasing insurance in the health insurance exchange have lower median income than the rest of the population. Stevenson warned that Farney’s ban may force women to wait to have their abortions until later in their  pregnancies, or keep them from getting the procedure at all.

Discussion of Farney’s bill Wednesday night also illuminated a divide between Texas Right to Life and Texas Alliance for Life, two major statewide pro-life groups. Texas Alliance for Life backs Farney’s legislation. John Seago with Texas Right to Life, however, told the committee that he agrees with the goal of the bill, but suggested it doesn’t go far enough.

“This bill only provides protections for those who do end up going to (the Affordable Care Act exchange)” for insurance plans, Seago said. “Our position is we need to cover the rest of the market.”

Texas Right to Life is supporting another bill by state Rep. John Smithee (R-Amarillo), but it hasn’t been scheduled for a hearing.

The committee left Farney’s proposal pending, though she told committee members to expect another version of the bill soon. She also said she’d be willing to consider expanding the ban to include all private insurance plans offered in Texas, as well as language that includes exceptions for rape, incest and ectopic pregnancies.

Alexa Garcia-Ditta is a staff writer (and former intern) covering women's health, reproductive health and health care access.

Published at 10:32 am CST