The Trump Administration Just Made it Even Harder for Private Insurance Companies to Cover Abortion

It will affect millions of Americans covered under the Affordable Care Act.

A demonstrator shouts slogans during a rally in support of abortion rights, Tuesday, May 21st, in Los Angeles. Marcio Jose Sanchez/AP

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The Trump administration is adding an extra bureaucratic hassle for insurance companies providing coverage for abortions—a move critics say will discourage insurers from covering abortions and make it harder for people to obtain them.

The administration announced the new policy on Friday, after initially releasing a draft of the rule last year. It requires insurance providers on the Affordable Care Act marketplace to give two separate bills to consumers whose plans cover abortions: one for their regular premium and one for a special abortion coverage premium. The change is expected to affect millions of Americans currently receive coverage under the Affordable Care Act exchange and whose plans cover abortions. 

“The primary goal of this new rule is very clear,” says Megan Donovan of the Guttmacher Institute, a research organization focused on reproductive health care, “and that is to make it as difficult as possible for insurers to offer abortion coverage and for consumers to get it.” 

Although insurance providers are still allowed to provide abortion coverage under this new rule, experts worry that the extra financial and administrative burden will dissuade many providers from covering abortion at all. Insurers will now have to account for the extra printing, mailing, and staffing costs of complying with the rule, in addition to updating their accounting systems. The Kaiser Family Foundation estimates that roughly 3.1 million individuals may now be required to pay separate bills. Meaning millions could be at risk of losing abortion coverage. 

Some consumers, who may not even be aware that their plan includes abortion coverage, could also be at risk of losing their insurance entirely. Policyholders whose plans cover abortion will be required to pay two separate bills. If a person fails to pay the second bill for abortion coverage, insurers have discretion to cancel their plans, for failing to pay a bill that may amount to just a dollar. 

Onerous administrative regulations have been an effective tool for anti-abortion hardliners to reduce access to abortion. Targeted restrictions on abortion providers, also known as TRAP laws, have been used by conservative states to impose regulations on everything from the size of a clinic’s hallway to the layout of a janitor’s closet. Like the new rule on abortion coverage, these laws serve no medical or logistical purpose other than to limit access to abortion. In Louisiana, lawmakers passed a law requiring abortion providers to have admitting privileges at local hospitals, despite the fact that abortion is one of the safest outpatient surgeries. The law, which is currently before the Supreme Court, was so burdensome that it would leave the state with a single abortion provider for more than 1 million women of reproductive age. 

“If they can’t make it illegal, they will make it as inaccessible as possible, and they’re pulling out every single stop in order to do that,” says Mary Alice Carter of Equity Forward, a watchdog organization focused on reproductive health. 

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