Vt. Man Files Federal Lawsuit Over Concerns About Marketplace Abortion Coverage

February 26, 2015 — A Vermont man last month filed a lawsuit in federal court against the state's health insurance marketplace for not including any plans that do not include a fee for abortion coverage beyond cases of rape, incest and life endangerment, the Burlington Free Press reports.

According to the Free Press, similar cases have been filed in Rhode Island and in Connecticut (Murray, Burlington Free Press, 2/24). The Connecticut suit was dropped after the marketplace during the 2015 open enrollment period began including plans that do not include abortion coverage beyond cases of rape, incest and life endangerment.


The Affordable Care Act (PL 111-148) does not prohibit abortion coverage and lets insurers determine whether they will offer it. However, the law requires health plans to segregate money collected for abortion coverage from other premiums. Insurers are not required to segregate the money for abortion coverage in cases of rape, incest or endangerment to the life of the woman.

The ACA requires marketplaces in all states by 2017 to include at least one multistate plan that does not cover abortion services beyond cases of rape, incest and endangerment to a woman's life (Women's Health Policy Report, 1/20). Vermont is one of a few states that did not have such a marketplace plan available during the second open enrollment period, which ended on Feb. 15.

Lawsuit Details

The Alliance Defending Freedom filed the lawsuit in U.S. District Court on behalf of Alan Lyle Howe.

The defendants named in the suit include the Vermont marketplace, known as Vermont Health Connect; HHS; the Department of Labor; the Department of Treasury; and the Office of Personnel Management.

According to the suit, Howe opposes abortion because of his religious beliefs, and paying a fee for elective abortion coverage would "undermine his public opposition to abortion." He enrolled in a marketplace plan during the initial open enrollment period. However, he declined to sign up for coverage during the second open enrollment period and is currently uninsured, according to the Free Press.

The suit states, "Mr. Howe holds a sincere religious belief that he should responsibly steward his resources to provide for his own healthcare. Going without health insurance could have devastating consequences for his own physical and financial health. Thus, it is essential that he continue to have health insurance."

The suit alleges that the defendants in the case are in violation of the Religious Freedom Restoration Act (PL 103-141), the Vermont Constitution and the First Amendment's free speech and free exercise clauses under the U.S. Constitution.

ADF and the plaintiff are asking that Howe to receive relief from potential fines for not enrolling in health insurance, funds to cover expert costs and attorney fees, and other relief. They are also seeking for insurers selling marketplace plans to provide more information about abortion coverage and funds allocated to pay for abortion.

According to the Free Press, the parties have begun to discuss a settlement (Burlington Free Press, 2/24).