December 19, 2013 — A Michigan law banning most abortion coverage could affect about one in three state residents with group or public health plans, the Detroit News reports (Heinlein/Livengood, Detroit News, 12/17).
The state Legislature approved the legislation last week, with most Republicans supporting it and most Democrats voting against it. Under the state constitution, the measure will become law without the governor's signature.
The legislation does not apply when a woman's life is in danger or to Medicaid, which must cover abortions in cases of rape, incest and life endangerment. Individuals and employers will be able to purchase separate riders to cover abortion. However, the bill prohibits the purchase of the riders if a woman already is pregnant, even if the pregnancy resulted from incest or rape. Further, employers will be able to choose whether to offer the riders in their policies, which might leave some women without the option of purchasing one (Women's Health Policy Report, 12/16).
The law is scheduled to take effect on March 13, 2014, and likely will affect 2015 health insurance policies, according to the News.
Impact on Policyholders
The law should not affect the estimated two million state residents who have employer-sponsored, self-insured health plans, the News reports. Self-insured employers, who pay directly for their employees' medical care, are regulated by the U.S. Department of Labor and, thus, are not subject to the new rules, according to Michigan Association of Health Plans Executive Director Rick Murdock, the office of Michigan House Speaker Jase Bolger (R) and other state officials.
However, people who purchase their own health plans, companies with fewer than 200 employees and companies that do not self-insure are "fully exposed" to the rules, Murdock said, adding that those groups encompass about three million individuals.
Supporters of the law have framed it as a way to ensure abortion coverage will not be available in health plans offered through the state's insurance marketplace under the Affordable Care Act (PL 111-148). However, only one insurer offering health plans to small businesses through the marketplace includes the coverage and will have to make changes under the new law, according to Caleb Buhs, a spokesperson for the Michigan Department of Insurance and Financial Services.
In an attempt to correct misinformation about the law, state House Republicans have posted a "Questions & Answers" article on their website. The article said that women who have been raped and do not have health plans that cover abortion can obtain "the morning after pill or insertion of an [intrauterine device], to prevent an unwanted pregnancy with full coverage from their insurance company."
Guttmacher Institute policy analyst Elizabeth Nash said, "It seems interesting to me that the people who oppose access to family planning measures ... are now turning around and saying 'Oh, you can just go and get emergency contracept[ion] or an IUD.'"
Although state House Republicans said purchasing a separate rider for abortion coverage would present a "nominal cost to individuals," Nash noted that in states with similar laws, insurers often do not offer the riders. "They don't seem to exist," she explained (Detroit News, 12/17).