Determining A Health Plan’s Abortion Coverage Remains A Challenge

As the third open enrollment period winds down on the health insurance marketplaces, one thing hasn’t changed much since the online exchanges opened: It’s still often hard to find out whether a plan covers abortion services.

The health law requires insurers to say one way or the other, and they have gotten better about reporting abortion coverage details this year, advocates on both sides agree.

But the federal government has yet to put out final instructions on how insurers should handle the issue on their Summary of Benefits and Coverage overview. Lacking specific instructions about what to say and where to say it, many insurers have simply left the information out of the summary, advocates said.

That leaves consumers in a bind. “It’s not easy to figure out whether a plan covers abortion and if it does, to what extent,” says Kinsey Hasstedt, a public policy associate at the Guttmacher Institute, a reproductive health research organization that supports abortion rights.

The health law lets states decide whether marketplace plans can cover abortion services. Half of states ban abortion coverage to some extent, often limiting it to cases of rape, incest or if the mother’s life is endangered, the standard the federal government uses for coverage in its employees’ plans and for health care programs, such as Medicaid.

However, even in states that permit insurers to cover abortion beyond the limited exceptions, marketplace plans may not have that benefit.

The lack of easily accessible information makes it hard to know whether the number of plans that provide abortion services on the exchanges is increasing or decreasing.

Advocates on both sides of the issue have their eyes on multistate plans. To encourage competition, the health law called for at least two multistate plans to be offered on every state marketplace by 2017, at least one of which excluded abortion services. In subsequent guidance, the Office of Personnel Management, which administers the multistate program, said that multistate insurers had to offer at least one silver and one gold level plan that exclude abortion coverage starting this year.

But the number of states offering multistate plans dropped to 32

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