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Ariz. Bill Would Ban Abortion Coverage in Health Plans Sold Through ACA Marketplace

February 20, 2015 — The Arizona Senate on Thursday voted 17-12 to pass a bill (SB 1318) that would bar women in the state from purchasing health plans that include abortion coverage on the federal insurance marketplace, the AP/Sacramento Bee reports (Christie, AP/Sacramento Bee, 2/19).

The bill would also require abortion providers to submit proof to the state Department of Health Services that they have admitting privileges at hospitals close to their clinics (Hansen, Arizona Republic, 2/19).

Background

The Affordable Care Act (PL 111-148) requires insurers to keep funds for abortion coverage separate from those for other health services as a way to ensure that federal tax credits do not pay for abortion, according to the AP/Bee.

Many states have enacted additional restrictions on abortion coverage in health plans purchased through the health insurance marketplaces established under the ACA. According to Elizabeth Nash, senior state issues coordinator with the Guttmacher Institute, just two of those states use the federal marketplace, like Arizona, while the other states' restrictions apply to their own marketplaces (AP/Sacramento Bee, 2/19).

Under current Arizona law, insurers can sell private health plans that include abortion coverage. The state in 2010 passed a law that would bar insurers from including abortion coverage in plans sold through the state's exchange, were Arizona to establish one. The new bill would extend that ban to plans sold in Arizona through the federal marketplace (Arizona Republic, 2/19).

Amendment, Debate

The abortion coverage restrictions in the bill would not apply when a pregnancy threatens a woman's life. In addition, the Senate approved a Republican-backed amendment to include exemptions for pregnancies resulting from rape or incest.

Republican lawmakers blocked an amendment from Democrats that sought to ensure physicians' names were kept private on clinic license applications.

Regarding the amendment, state Sen. Katie Hobbs (D) said providers "have been targeted, harassed, stalked, and endangered and in some cases even killed," adding that the amendment would have been "a commonsense [measure] that protects these physicians that are doing nothing more than taking care of their patients."

Hobbs, who opposed the bill, noted that the bill would also eliminate abortion coverage for women who use the marketplace but are not eligible for tax credits to help them purchase insurance.

Hobbs said the bill is "yet another effort by politicians to insert themselves in women's health care decisions," adding that the measure "says the government gets to decide what coverage you get."

Supporters of the bill said that additional abortion coverage restrictions are necessary to ensure taxpayer money does not go toward abortion (AP/Sacramento Bee, 2/19).

State Sen. Steve Farley (D) urged colleagues to find areas on which they could agree. "I wish we could deal with this problem by figuring out what we have in common because I think everyone on this floor wants to reduce unwanted pregnancies," he said (Arizona Republic, 2/19).

Democrats expect that Gov. Doug Ducey (R) will sign the bill, although he has not publicly stated his intentions, according to the AP/Bee (AP/Sacramento Bee, 2/19).