N.C. House, Senate Finalizing Legislation To Prohibit Abortion Coverage in State Health Insurance Marketplace

July 23, 2013 — North Carolina lawmakers are negotiating final language of legislation that would prohibit health plans participating in the health insurance marketplaces created under the Affordable Care Act from covering elective abortions, the AP/Charleston Post and Courier reports. The House and Senate approved separate measures on the issue earlier this year (Dalesio, AP/Charleston Post and Courier, 7/20).

The bill (HB 730) approved by the state House also would prohibit city and county governments' health plans from including abortion coverage that exceeds that offered through the state employee health plan. The state employee health plan covers abortion only in instances of rape, incest or when a woman's life is in danger.

In addition, the bill would allow health care professionals to refuse to participate in abortion care. Current law specifies only that nurses and physicians can refuse to provide such care (Women's Health Policy Report, 5/17).

North Carolina opted against establishing its own insurance marketplace, meaning that the federal government will administer one in the state.

The ACA allows states to prevent abortion coverage in health insurance plans offered through the marketplaces. Women can purchase separate abortion coverage outside of the marketplace.

Some of the seven individual and group policies that Blue Cross and Blue Shield of North Carolina submitted for potential inclusion in the marketplace included abortion coverage. BCBS, which controls more than 80% of the state's individual insurance market, does not cover abortion, pregnancy or delivery in its standard plans, company spokesperson Lew Borman said. Such coverage can be purchased through a separate maternity rider.

Neither of two marketplace plans submitted by Coventry Health Care of the Carolinas -- recently acquired by Aetna -- offer elective abortion coverage. One plan submitted by FirstCarolinaCare Insurance specifically excludes such coverage and one plan makes no mention of abortion coverage.

Adam Searing, a health care advocate for the North Carolina Justice Center, said of the legislation, "They're picking and choosing what women are able to buy health insurance for," adding, "This just shows a contempt for women and women's health" (AP/Charleston Post and Courier, 7/20).