Abor­tion coverage rule eyed

Ad­min­is­tra­tion pro­poses sep­a­rate pre­mium bills

Connecticut Post - - FRONT PAGE - By Macken­zie Rigg

The Trump ad­min­is­tra­tion wants in­sur­ers that of­fer plans through Ac­cess Health CT, Con­necti­cut’s Af­ford­able Care Act ex­change, and other ex­changes na­tion­wide, to send peo­ple sep­a­rate monthly bills for the cost of their abor­tion coverage — in ad­di­tion to the bill they get for their reg­u­lar pre­mium costs.

This means peo­ple would re­ceive two sep­a­rate bills in the mail or elec­tron­i­cally — one to cover the pre­mium costs for ser­vices such as pri­mary care, men­tal health, maternity, etc. — and an­other one solely for the cost of their abor­tion coverage pre­mium.

Peo­ple on the ex­change would also have to make two sep­a­rate pay­ments for th­ese bills, ac­cord­ing to a pro­posed rule re­cently re­leased by the Cen­ters for Medi­care and Med­ic­aid Ser­vices (CMS).

Since the ACA was passed, in­sur­ers of­fer­ing Qual­i­fied Health Plans have been re­quired to break out the cost of the abor­tion coverage in monthly pre­mium bills, but in­sur­ers don’t typ­i­cally send out a sep­a­rate bill for that cost, said Alina Sal­gan­i­coff, vice pres­i­dent of women’s health pol­icy at the Kaiser Fam­ily Foun­da­tion.

Start­ing in 1977, the Hyde Amend­ment banned the use of any fed­eral funds for abor­tion, al­low­ing ex­cep­tions only for preg­nan­cies that en­dan­ger the woman’s life or that re­sult from rape or in­cest. This rule is not a per­ma­nent law; rather it has been at­tached an­nu­ally to Con­gres­sional ap­pro­pri­a­tions bills, and has been ap­proved every year by Congress, ac­cord­ing to the Kaiser Fam­ily Foun­da­tion.

Cur­rently, about 100,000 Con­necti­cut res­i­dents are en­rolled in health in­sur­ance through Ac­cess Health CT. This year, 19

out of the 20 plans avail­able in the in­di­vid­ual mar­ket in­clude elec­tive abor­tion coverage. Next year, 16 out of the 17 plans in­clude elec­tive abor­tion coverage, ac­cord­ing to Ac­cess Health CT on Thurs­day.

The ex­change’s pol­icy team was still eval­u­at­ing how the pro­posed rule would im­pact its cus­tomers on Thurs­day.

The two in­sur­ers that of­fer in­di­vid­ual plans through the state’s ACA ex­change are An­them and Con­nec­tiCare. An­them de­clined to comment on the pro­posed rule Thurs­day, and Con­nec­tiCare said all of its plans on the in­di­vid­ual mar­ket plans cover abor­tion.

Planned Par­ent­hood said in a state­ment that the pro­posed rule is “de­signed to make it im­pos­si­ble for health in­sur­ance plans to cover abor­tion un­der the ACA.”

“If fi­nal­ized, women across the coun­try could lose ac­cess to coverage that in­cludes abor­tion. By the ad­min­is­tra­tion’s own ac­count, nearly 1.3 mil­lion con­sumers would be sub­ject to th­ese oner­ous re­stric­tions,” the Planned Par­ent­hood state­ment said. “Not only would some plans drop coverage of abor­tion al­to­gether so as to avoid the ad­min­is­tra­tive bur­dens and the re­lated con­sumer con­fu­sion, con- sumers could lose coverage al­to­gether if they failed to fol­low the new re­quire­ments.”

Peter Wolf­gang, the ex­ec­u­tive di­rec­tor of the Fam­ily In­sti­tute of Con­necti­cut, a non­profit or­ga­ni­za­tion that op­poses abor­tion, ap­plauded the CMS pro­posed rule.

“It will lead to greater trans­parency,” he said. “Peo­ple will at least know what their money is and isn’t pay­ing for, and it’s a step in the right di­rec­tion of hav­ing no abor­tion fund­ing in Oba­macare.”

CMS be­lieves “that re­quir­ing is­suers to sep­a­rately bill the por­tion of the con­sumer’s pre­mium at­trib­ut­able to abor­tion ser­vices and in­struct con­sumers to make a sep­a­rate pay­ment for this amount as pro­posed in the pro­posed rule is a bet­ter in­ter­pre­ta­tion of the statu­tory re­quire­ment for is­suers to col­lect a sep­a­rate pay­ment for th­ese ser­vices,” ac­cord­ing to a fact sheet re­leased by the agency about sev­eral pro­pos­als.

Twenty-six states ban abor­tion coverage through their ex­changes, so this pro­posed rule wouldn’t af­fect them, ac­cord­ing to the Kaiser Fam­ily Foun­da­tion.

If fi­nal­ized, this rule would ap­ply to the in­sur­ance year be­gin­ning on Jan. 1.

For coverage in 2019, open en­roll­ment for Ac­cess Health CT be­gan on Nov. 1 and ends on Dec. 15.

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