U.S. can’t require separate abortion services invoices
A federal judge has barred the Trump administration from requiring insurers to send separate bills for abortion and nonabortion services, a mandate that could have led to cutoffs of health insurance coverage.
The rule was due to take effect Aug. 26 — by coincidence, the 100th anniversary of the constitutional amendment granting women the right to vote. It would have required insurers providing coverage under the Affordable Care Act, which covers 1.4 million Californians, to send bills showing coverage for the small amount of the premium that pays for abortion care and the amount that covers nonabortion care. The bills could have been sent in separate envelopes or in a single form.
Those who did not pay both bills, because of confusion, personal views or any other reason, could have lost their entire health insurance coverage until the next open enrollment period this fall. Cancellation would have been up to individual insurers.
In announcing the plan in November, U.S. Health and Human Services Secretary Alex Azar noted that the Hyde Amendment, passed by Congress in 1976 and renewed every year since then, prohibits most federal funding of abortions for poor women.
“The separate billing requirement fulfills Congress’ intent and reflects President Trump’s strong commitment to preventing taxpayer funding of abortion coverage,” Azar said.
But U.S. District Judge Catherine Blake of Baltimore said the proposed rule would have created an “unreasonable barrier” to obtaining medical care. Such barriers are expressly forbidden by the health care law signed in 2010 by President Barack Obama.
The requirement “makes it harder for consumers to pay for insurance, because they must now keep track of two separate bills,” Blake said. She said the billing “is likely to cause enrollee confusion and may lead to some enrollees losing health insurance.”
And those who are not confused “will still have to spend extra time reading, understanding and paying two separate bills each month,” she said, despite the 2010 law’s ban on rules that interfere with “timely access to health care services.”
The judge issued a nationwide injunction against the proposed rule Friday, in a lawsuit by Planned Parenthood and four individuals. A separate lawsuit by California, five other states and the District of Columbia is pending in federal court in San Francisco.
The ruling is “a huge victory for the people who need and deserve access to safe, legal abortion,” said Alexis McGill Johnson, president of the Planned Parenthood Federation of America.
The Health and Human Services Department declined to comment.
California is one of six states that require insurers to cover abortion and one of 16 states that provide their own funds to pay for poor women’s abortions that are denied federal funding by the Hyde Amendment.
The Trump administration’s Centers for Medicare and Medicaid Services has said the separatebilling rule would “alert customers” in insurance-optional states that their health plan covers abortion, “allowing them to make fully informed decisions” on whether to cancel that coverage. The rule, if it took effect, could also prompt some insurers in those states to drop abortion coverage because of the extra billing costs.