Today's right-wing outrage concerns the discovery that contrary to public promises, federal money may indeed have ended up subsidizing coverage of abortions through health insurance policies that are purchased on exchanges. Having read the report from the Government Accountability Project, available here, here's how this situation came about:
1.) Nothing in federal law prohibits private insurance companies from covering abortion services. Nothing requires it either. That has been well-understood from the beginning and is not at issue. States can use their own regulatory power to ban coverage of abortion, and 23 states do so. In the 27 states and the District of Columbia that don't bar abortion coverage, the GAO found 1,036 policies that cover abortion, and 1,062 that do not.**
2.) However, federal law does attempt to ensure that taxpayer money is not used to buy abortion-related coverage. Medicaid, for example, does not fund abortion. To also ensure that taxpayer funds are not used to subsidize abortion in private coverage purchased through exchanges, the law requires an insurance company to make two calculations:
- a.) What is the cost of a policy that does NOT cover abortion?
- b.) What is the cost of the same policy that DOES cover abortion?
3.) If you subtract Cost A from Cost B, you get the additional cost of covering abortion services. By law, that is the amount that cannot be covered by taxpayers and must be paid individually by the person buying the policy.
And how much is that additional cost that has conservatives in an uproar? I'll let the GAO answer that question:
"All but one of the issuers from which we obtained information estimated the cost of the coverage of non-excepted abortion services to be less than $1 per enrollee, per month. For example, officials from one issuer told us that their actuaries estimated that the cost for non-excepted abortion services ranged between 10 cents and 20 cents per enrollee, per month, calculated across multiple states, while officials with another issuer said that the cost for these services ranged from 10 cents to 70 cents per enrollee, per month.... The highest cost estimated by the issuers we interviewed was $1.10 per enrollee, per month."
In effect, the GAO found that the additional cost of providing abortion coverage -- anywhere from 10 cents to $1.10 a month -- was so tiny that most insurance companies did not bother to break it out as an itemized, individual cost, even though that's what the law and federal regulations require. That's the extent of the scandal.
According to the GAO, the Department of Health and Human Services has responded to its findings by acknowledging that "additional clarification may be needed" and promising that the Centers for Medicare & Medicaid Services "will use our findings to address issues of concern to better ensure that stakeholders understand the laws and regulations governing the provision of non-excepted abortion services coverage."
In short, you'll soon begin to see a small little line item on some policies requiring an additional out-of-pocket payment of 10 cents to $1.10 a month. So is everybody happy now?
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** Georgia is among those states that do not bar coverage of abortion. Given the attention now being paid to this issue, I fully expect legislation to be filed or regulations promulgated that will outlaw such coverage in the future.
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