Background

In 2010, President Obama signed into law the Patient Protection and Affordable Care Act, which, among many other things, provides for the establishment of state-level health care exchanges to assist individuals and small businesses in purchasing a private health insurance plan. Despite the fact that these exchanges were not operational until 2014, states began to enacted laws in 2010 that restrict the abortion coverage in plans purchased through the exchanges. But although federal health care reform may have renewed the debate around restricting insurance coverage of abortion, restrictive state abortion insurance policies are not a new phenomenon. Several states already restrict private insurance coverage of abortion; these restrictions also apply to plans sold on the exchanges. More often, states have banned abortion coverage in public employees’ insurance policies or in other cases where public funds are used to insure employees.

 

Highlights

Restricting Insurance Coverage of Abortion

STATE

PRIVATE INSURANCE POLICIES

INSURANCE POLICIES FOR PUBLIC EMPLOYEES

All Private Insurance Plans

Specific to Health Exchanges

Alabama

 

Life, Rape, Incest

 

Arizona

 

Life, Severe health

Life, Severe health

Arkansas

 

Life, Rape, Incest

 

Colorado

 

 

No coverage

Florida

 

Life, Rape, Incest

 

Georgia

 

Life, Severe Health†​

Life

Idaho

Life

Life, Rape, Incest

Life‡​

Illinois

 

 

Life‡​

Indiana

Life, Rape, Incest, Severe health 

Life, Rape, Incest, Severe health†​

Life, Rape, Incest, Severe health†‡​

Kansas

Life

Life

Life

Kentucky

Life

Life,

No coverage

Louisiana

 

No coverage

 

Massachusetts

 

 

ξ

Michigan

Life

Life

Life

Mississippi

 

Life, Rape, Incest

Life, Rape, Incest, Fetal impairment

Missouri

Life‡​

Life

Life

Nebraska

Life

Life

Life‡​

North Carolina

 

Life, Rape, Incest

Life, Rape, Incest

North Dakota

Life

Life,

Life

Ohio

 

Life, Rape, Incest

Life, Rape, Incest

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

 

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

Wisconsin

 

Life, Rape, Incest, Severe Physical HealthФ​

 

TOTAL

10

25

21

  Enforcement permanently enjoined by court order; policy not in effect.

†   The health exception applies to a "substantial and irreversible impairment of a major bodily function."
‡   Additional abortion coverage is available only through the purchase of a separate rider at an additional cost.
Ω  Although the law does not specifically refer to health reform, the restriction applies to health plans offered in the health exchange.
ξ   State specifically prohibits coverage of postviability "partial-birth" abortions except in cases of life endangerment and "substantial risk of grave impairment of her physical or mental health."
Ф  Health exception applies in cases when the abortion is necessary to "prevent grave, long-lasting physical health damage to the woman."