Obamacare's Abortion Coverage Mandate Has Been Gutted By 23 States — And Counting

There are plenty of reasons for women to be happy about Obamacare, including its subsidies for preventive care and contraceptive coverage, but many states are using a little-known provision in the law to drastically scale back access to affordable abortions. While the law requires that insurance plans on the health exchanges cover abortion, a compromise inserted during the bill’s crafting also allows states to opt out of this requirement. So far, 23 states have done so, and one more — Michigan — is on the verge of doing so. Meanwhile, eight states have passed laws that ban abortion coverage on both private and public plans, which will effectively require all women in the state to pay for the procedure out-of-pocket.

Today, Michigan’s board of elections approved a petition, launched by Michigan Right-To-Life, that would ban insurance companies on the state’s health care exchanges from covering abortion, even in cases of rape and incest. In defending the legislation, Right To Life’s Barbara Listing compared getting raped to “a car accident,” or having home flooding, explaining that “you have to buy extra insurance for those things, too.” Lister’s comments, in addition to being offensive and intellectually-vapid, ignore the fact that many Michigan women won’t be able to afford private plans that offer abortion coverage, which is the whole reason Obamacare required companies to cover it in the firest place.

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Republican Governor Rick Snyder had already vetoed legislation that would have banned insurance companies from covering abortion, but Michigan Right To Life found a way around this. Per the state constitution, if a mere eight percent of people who voted in the state’s last gubernatorial election sign a petition urging the state legislature to vote on a bill, that bill can be enacted into law without the governor’s approval. Michigan Right To Life has used this tactic to push anti-abortion laws in the past, including a requirement that minors obtain parental consent and a ban on partial-birth abortions.

Those who followed Obamacare’s long, arduous journey from Congress to President Obama’s desk will remember Bart Stupak, a now-former Congressman from Michigan who threatened to derail the bill unless it contained an amendment banning federal funds from covering abortions. The amendment wasn’t added, but in order to get the votes of Stupak and his followers — votes that were needed to pass the bill — Democrats accepted a compromise, one that allowed states to pass laws opting out of the federal mandate that health care plans cover abortions. Anti-abortion legislators in 23 states have used that provision to prohibit insurance plans on state exchanges from offering abortion coverage. Women in those states who want abortion coverage have to either find a private plan that offers it — which is often prohibitively expensive or doesn’t exist — pay $500+ for the procedure, should they ever end up needing it.

The Michigan legislation, should it pass the state legislature, won’t apply to women on Medicaid. Federal law requires state Medicaid providers to cover abortion in cases of rape and incest — although South Dakota has passed a law banning even this. The South Dakota legislation is in flat violation of federal law, but has yet to be challenged in court.