Background

State governments have found multiple ways to limit insurance coverage of abortion, including through bans on abortion coverage in public employees’ insurance policies. Several states have restricted abortion coverage in other private health insurance plans, especially following passage of the Affordable Care Act (ACA) in 2010, which provided for the establishment of state-level health insurance exchanges. While these coverage restrictions on private health plans are in place in half of the states, other states have taken steps to protect abortion access and affordability by requiring insurance plans to cover abortion. The laws in these states either require abortion coverage or require the coverage if a health plan includes coverage for prenatal care. Some states choose to use their own Medicaid funds to cover abortion, although the Hyde Amendment prohibits the use of federal funds for abortion except in cases of life endangerment, rape or incest.

Highlights

Insurance Coverage of Abortion

State

Coverage required

Coverage banned or restricted to specified exceptions

All private insurance plans

All private insurance plans

Specific to health exchanges

Insurance policies for public employees

Alabama

 

 

Life, rape, incest

 

Arizona

 

 

Life, severe health

Life, severe health

Arkansas

 

 

Life, rape, incest

 

California

X

 

 

 

Colorado

 

 

 

No coverage

Florida

 

 

Life, rape, incest

 

Georgia

 

 

Life, severe health

Life

Idaho

 

Life

Life, rape, incest

Life

Illinois

Xβ

 

 

 

Indiana

 

Life, rape, incest, severe health†‡

Life, rape, incest, severe health

Life, rape, incest, severe health†‡

Kansas

 

Life

Life

Life

Kentucky

 

Life

Life‡,Ω

No coverage

Louisiana

 

 

No coverage

 

Maine

X*

 

 

 

Massachusetts

 

 

 

ξ

Michigan

 

Life

Life

Life

Mississippi

 

 

Life, rape, incest

Life, rape, incest, fetal impairment

Missouri

 

Life

Life

Life

Nebraska

 

Life

Life

Life

New York

Xβ

 

 

 

North Carolina

 

 

Life, rape, incest

Life, rape, incest

North Dakota

 

Life

Life‡,Ω

Life

Ohio

 

 

Life, rape, incest

Life, rape, incest

Oregon

Xβ

 

 

 

Oklahoma

 

Life

Life

Life

Pennsylvania

 

 

Life, rape, incest

Life, rape, incest

Rhode Island

 

 

 

Life, rape, incest

South Carolina

 

 

Life, rape, incest

Life, rape, incest, severe health

South Dakota

 

 

Life, severe health

 

Tennessee

 

 

No coverage

 

Texas

 

Life, severe health

Life, severe health

Life, severe health

Utah

 

Life, rape, incest, severe health and fetal impairment

Life, rape, incest, severe health and fetal impairment

Life, rape, incest, severe health and fetal impairment

Virginia

 

 

Life, rape, incest

Life, rape, incest, fetal impairment

Washington

X*

 

 

 

Wisconsin

 

 

Life, rape, incest, severe physical healthФ

Life, rape, incest, severe physical healthФ

TOTAL

6

11

26

22

†   The health exception applies to a “substantial and irreversible impairment of a major bodily function.”

‡   Abortion coverage beyond exceptions specified is available only through the purchase of a separate rider at additional cost.

β  A plan must cover abortion with no copayments.

Ω  Although the law does not specifically refer to the ACA, the restriction applies to plans offered in the health care exchange.

*   A plan must cover abortion if it covers prenatal care.

ξ   State specifically prohibits coverage of postviability “partial-birth” abortions except in cases of life endangerment and “substantial risk of grave impairment of her [the patient’s] physical or mental health.”

Ф  Health exception applies when an abortion is necessary to “prevent grave, long-lasting physical health damage to the woman.”