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Information on Abortion Coverage Hard To Find for Marketplace Plans

Information on Abortion Coverage Hard To Find for Marketplace Plans

April 15, 2014 — There is a lack of information available to consumers on whether private health plans sold through the Affordable Care Act's (PL 111-148) health insurance marketplaces cover abortion services, according to a new report from the Guttmacher Institute, Kaiser Health News reports.

The ACA allows states to decide whether marketplace plans sold in their state may include abortion coverage. Currently, 26 states and Washington, D.C., allow marketplace plans to cover abortion, while 24 states do not, although some allow exceptions for pregnancies resulting from rape or incest or if a woman's life is in danger, KHN reports. In 22 of the states that prohibit or restrict abortion coverage, the federal government operates the marketplace, meaning consumers use the federal website, according to KHN.

Report Details

For the report, researchers at Guttmacher examined the online coverage descriptions for 12 states that permit abortion coverage. The researchers focused on plans' "summary of benefits and coverage" overview -- which the ACA requires all plans to include -- but they also scanned for other coverage details if available.

Under the ACA, health plans that offer abortion coverage beyond cases of rape, incest and life endangerment are required to disclose that information in their SBCs. However, the template that the federal government issued to insurers to help guide them in developing their SBCs did not include abortion information, according to KHN.

In states that permit abortion coverage, a few plans in four states clearly specified that they include it, while at least one plan in six states specified that it did not cover abortions. In states that do not allow most abortion coverage, no plans included a general statement explaining that fact.


Both supporters and opponents of abortion rights said information about abortion coverage should be included in plans' SBCs.

Kinsey Hasstedt, a public policy associate at Guttmacher and a report co-author, said, "Abortion should be considered basic health care and consumers should know whether it's covered or not."

Gretchen Borchelt, senior counsel at the National Women's Law Center, said, "It's not in the [federal government's SBC] template, and plans are just following that." She added, "I think it's a lack of awareness on their part, a lack of familiarity with what should be included."

Meanwhile, Chuck Donovan, president of the antiabortion-rights Charlotte Lozier Institute, said, "The people we communicate with are looking for [the information]," adding, "We're hearing complaints about it."

According to KHN, HHS did not respond to a request for comment (Andrews, Kaiser Health News, 4/15).