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Now

In 2017, the U.S. abortion rate reached a historic low since abortion was legalized in 1973. Find out more in our fact sheet.
As of December 1, 2019 State Laws and Policies

Restricting Insurance Coverage of Abortion

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

  • 11 states have laws in effect restricting insurance coverage of abortion in all private insurance plans written in the state, including those that are offered through the health insurance exchanges were established under the federal health care reform law.
    • 8 states limit coverage to life endangerment.
    • 1 state limits coverage to life, rape, incest, fetal impairment and “substantial and irreversible impairment of a major bodily function.”
    • 1 state limits coverage to life endangerment and “substantial and irreversible impairment of a major bodily function.”
    • 1 state limits coverage to life endangerment, “substantial and irreversible impairment of a major bodily function,” rape or incest.
    • 9 states permit additional abortion coverage through purchase of a separate rider and payment of an additional premium.
  • 26 states restrict abortion coverage in plans offered through the insurance exchanges.
    • 7 states limit coverage to life endangerment.
    • 4 states limit coverage to life endangerment and “substantial and irreversible impairment of a major bodily function.”
    • 1 state limits coverage to life endangerment, “substantial and irreversible impairment of a major bodily function,” rape or incest.
    • 10 states limit coverage to life endangerment, rape and incest.
    • 1 state limits coverage to life endangerment, rape and incest, fetal impairment and “substantial and irreversible impairment of a major bodily function.”
    • 1 state limits coverage to life endangerment, rape, incest and cases of “grave long-lasting physical health damage.”
    • 2 states prohibit any abortion coverage.
  • 22 states restrict abortion coverage in insurance plans for public employees.
    • 8 states limit coverage to life endangerment.
    • 12 states limit coverage to some combination of life endangerment, threat to the woman’s health, rape, incest or fetal abnormality.
    • 2 states prohibit any abortion coverage.
  • 20 states have more than one of the above restrictions.

     

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For more information

  • Public Policy Office

    202 296-4012
    [email protected]

Topic

United States

  • Abortion: Insurance Coverage, State Policies on Abortion

Geography

  • United States: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming

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Women's Health Issues

Monthly State Policy Updates

Get an overview of state legislative and policy activity in all topics of sexual and reproductive health.

Learn More

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‡​

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

 

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‡,Ω

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

 

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

Wisconsin

 

Life, Rape, Incest, Severe Physical HealthФ​

Life, Rape, Incest, Severe Physical HealthФ​ 

TOTAL

11

26

22


†   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."

 

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