Abortion Coverage in the Maryland Health Exchange

Posted: Dec 19, 2013 12:01 AM

Editor's Note: This column was co-authored by Elizabeth Morrison.

As the Family Research Council (FRC) discovered while reviewing healthcare plans in the D.C. health exchange, it is almost impossible for consumers to get accurate information regarding which plans cover elective abortion. The Maryland Health Exchange is turning out to be no different.

There are 27 states that allow abortion coverage to be included in healthcare plans on the state exchanges. Due to the abortion secrecy clause in the Affordable Care Act, health care plans on the exchanges do not have to disclose until the time of enrollment whether a purchased plan covers elective abortion.

As a native Marylander, FRC’s Elizabeth Morrison, co-author of this piece, set out to discover if she could accurately find information on which plans under the Maryland exchange covered elective abortion. Numerous phone calls to the Maryland exchange, follow-up conversations with supervisors and reviewing content on the website revealed that Maryland’s health exchange employees do not know or understand the ACA’s exchange rules and how the law is to be applied regarding abortion coverage.

She first visited the Maryland Health Exchange (MHE) website. She asked an MHE representative if elective abortion was covered in the exchange. The Maryland representative, who did not know the answer, asked her supervisor who explained that elective abortion is only an essential benefit if the plan a person applies for covers “contraceptive care.” That answer is particularly alarming because the Affordable Care Act (ACA) requires all plans to cover FDA-approved contraceptive drugs and devices. Thus, by default, if that answer were correct, elective abortion would be covered in all plans offered under the Maryland exchange, a violation of the law because the ACA requires that at least one Multi-State Plan (MSP) must be pro-life. The representative then informed Elizabeth that she would first need to apply for the health insurance plan before she could discover whether or not it covered elective abortion. This would mean that Elizabeth would have no way of discovering which plans would violate her most fundamentally held beliefs before actually applying for them.

On a subsequent call to MHE a few days later, Elizabeth spoke to a different representative who told her elective abortion was covered under “family planning,” and that benefits change depending on the insurance company. Under the law, however, there is a list of required benefits, and elective abortion is expressly excluded from that list. Thus, it seems that among exchange representatives there is no consistent knowledge of what the law requires or which plans cover elective abortion.

Elizabeth then called the Maryland exchange insurance companies directly.

The first call to Blue Cross and Blue Shield revealed that all plans covered by Blue Cross under the MHE cover elective abortion. During a second call however, Elizabeth was informed that there are two plans offered by Blue Cross on the exchange that do not cover elective abortion. Both those plans qualify as MSPs, plans offered under the exchange that are subsidized and administered by the federal government. Under the ACA, at least one of the MSPs offered in each state exchange must exclude elective abortion coverage.

The representative for Evergreen Health Co-op informed Elizabeth that only the “specialists” know which plans cover elective abortion and that she was not eligible to speak with them because her income disqualified her. There is no income requirement to enroll in a health care plan on the state exchange, so this response was confusing. Likewise, the representative for Kaiser Permanente was not able to answer the elective abortion question because he was not a “licensed assistor.” He also noted that Kaiser did not have any plan available on the exchange for Maryland, even though MHE listed them as a provider.

United Health Care also informed Elizabeth that, although their company is listed under the exchange, they are not actually offering plans under the Maryland exchange. When Elizabeth expressed her confusion, the representative responded by saying that she felt the same way, noting that they are “finding out new pieces of information [about the exchanges] every day.”

Elizabeth’s difficulty finding accurate information about abortion coverage in the health plans offered on the Maryland exchange is surely not unique. Americans should not be forced to compromise their deeply held moral beliefs and convictions by inadvertently purchasing a health plan that covers elective abortion. Due to the secrecy clause of the ACA and the general lack of knowledge about essential benefits and coverage, it is virtually impossible for people to discover which health plans will not violate their beliefs.

Congress must act to protect the religious liberty and conscience rights of Americans by passing the Abortion Insurance Full Disclosure Act sponsored by Rep. Chris Smith (R-N.J.), which would require insurance companies to clearly state whether their plans cover elective abortion before a consumer signs up for the plan and how much of their premium contributes to abortion coverage. Finally, Congress must pass the No Taxpayer Funding for Abortion Act, so that laws are no longer able to circumvent important conscience protections such as the Hyde Amendment, which, when applied, prevents tax dollars from being spent on elective abortions.

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