What Are The Effects of Restrictive Abortion Laws on Health Insurance

Abortion insurance coverage in the United States can be complicated. Federal regulations and the laws of the state you live in affect insurance coverage for pregnancy terminations.

Does insurance cover abortions under Medicaid, the Affordable Care Act, or private insurance? The likely answer in most cases is that abortion coverage, if any, is very limited. That’s why it’s important to look into your state’s insurance laws regarding coverage for pregnancy and pregnancy termination.

Does Medicaid cover abortions? Without insurance coverage, you’ll have to pay any medical expenses relating to the termination of a pregnancy out-of-pocket.

For a better understanding of abortion coverage under Medicaid, the ACA, and private insurance, enter your ZIP code here. You’ll be connected with a knowledgeable insurance provider who can discuss coverage in your area.

What is private versus public health insurance?

Private health insurance is coverage that a private company provides. Many people can enroll in private health insurance through an employer plan. People can also obtain private insurance without going through an employer plan, but the costs tend to be significantly higher.

Public health insurance is provided and sponsored by the government. The cost of public insurance to the consumer is subsidized, in whole or in part, by federal and state public funds. Private health insurance, by contrast, is paid for out of the consumer’s pocket.

What is Medicaid?

The Medicaid program, which became law under President Lyndon B. Johnson in 1965, is a government-run program that provides health coverage to people in need of financial assistance. It aids low-income families, children, pregnant women, elderly adults, people of all ages with disabilities, and people needing long-term care. 

Medicaid is a federal program, but it’s administered by the states. And both states and the federal government pay subsidies for Medicaid.

If Medicaid limits coverage for certain care, states have to rely solely on state funds to subsidize medical costs relating to that care. On top of Medicaid restrictions, states have their own insurance laws that can limit or restrict insurance coverage for certain medical care.

Over the years, Medicaid benefits have been expanded to widen the scope of coverage to include disabled people and people aged 65 or older. The most recent Medicaid expansion is the Affordable Care Act in 2010, which was passed into law under President Barack Obama.

What is the Affordable Care Act?

The Affordable Care Act (ACA or Obamacare) created a health insurance Marketplace where people can obtain government-subsidized private health insurance for themselves and their families. The Obamacare expansions to Medicaid affords millions of low-income Americans the opportunity to qualify for and obtain private health insurance coverage.

Insurance companies that offer plans on the Marketplace are required to cover Obamacare’s 10 Essential Health Benefits (EHB), which are as follows:

• Ambulatory patient services
• Emergency services
• Hospitalizations
• Laboratory services
• Mental health and substance abuse services
• Pediatric services
• Pregnancy, maternity, and newborn care
• Prescription drugs
• Preventive and wellness services and chronic disease management
• Rehabilitative services and devices

Although maternity care and prescription drugs are included in the 10 EHBs, pregnancy termination services are expressly excluded from the list.

Does Medicaid cover abortions?

Many low-income women needing pregnancy termination services ask, are abortions covered by Medicaid? Unfortunately, the answer is only under very limited circumstances.

Medicaid only covers abortion in the case of rape, incest, or life endangerment.

In 1976, the House of Representatives passed the Hyde Amendment, sponsored by Republican Congressman Henry Hyde of Illinois. The law prohibits the use of federal funding for abortion.

Since the original Hyde Amendment, carve-outs have been made to allow federal funding for abortion to prevent life endangerment of the woman, and for pregnancy by rape or incest.

New Link Destination day, only 16 states have expanded Medicaid using their own funding to cover abortion. People relying on Medicaid assistance in the remaining 34 states have health insurance that does not cover abortion services.

The Hyde Amendment’s restrictions on access to abortion coverage predominantly impact low-income recipients of Medicaid and other state-funded programs. It prevents people in need of financial assistance from using their healthcare benefits to cover pregnancy terminations.

Does Obamacare cover abortions?

Under Obamacare, no Marketplace plan is required to provide abortion coverage. The ACA includes a provision incorporating the Hyde Amendment’s restrictions into Marketplace plans. As such, subsidized coverage for pregnancy termination is permitted under Obamacare only for rape, incest, or when the life of the woman is in danger.

Does private insurance cover abortions?

Private insurance can cover abortions depending on state laws. Four states, namely California, New York, Oregon, and Washington, have mandates requiring abortion coverage for all private health insurance plans that are regulated by the state, including Marketplace plans. Maine recently started requiring abortion coverage for all private health plans that cover maternity care costs.

Do military benefits cover abortions?

If you’re wondering, does the government fund abortions in ways other than Medicaid and Obamacare, the answer is yes. The government provides military health care benefits for active and retired military service members, and their dependents and survivors.

Prior to 2013, military health insurance limited coverage for abortion to life endangerment. The National Defense Authorization Act expanded abortion coverage in 2013 to also allow servicewomen and military dependents to terminate pregnancies in the instances of rape or incest or as permitted in other federal programs. All military abortions are required to be performed at military medical facilities.

The Bottom Line

The bottom line is that it can be challenging to find insurance that will cover the costs of an abortion. If you can’t find insurance coverage for a pregnancy termination procedure, you’ll have to pay those expenses out-of-pocket.

Knowing the answer to the question: “does insurance cover abortions?” can provide peace of mind. Enter your ZIP code here to talk with a knowledgeable insurance provider about abortion coverage options in your state.