Obamacare Needs Transparency on Abortion Coverage

Arina O. Grossu | Family Research Council | Monday, September 15, 2014

Obamacare Needs Transparency on Abortion Coverage

Open enrollment for Obamacare is right around the corner.  With a November 15 start date, Americans deserve to know whether the plans they’re considering on the insurance exchange cover elective abortion and if so, how much they are paying for the abortion coverage, and how the abortion surcharge will be billed.  Obamacare’s abortion subsidy section contains a secrecy clause and it requires a person who signs up for a plan that covers elective abortion to pay an abortion surcharge of at least $12 per year.  We investigated Colorado, for example, and discovered that it was very difficult to obtain accurate information.


The Colorado state exchange website lists seven insurers, but two additional insurers have insurance plans also linked to the exchange website (Colorado Choice and Denver Health Medical Plan are not listed as carriers).  There are a total of 97 plans that we could find, even though only 85 are listed in the main search.  


Anthem Blue Cross Blue Shield HMO Colorado (14 exchange plans, 

Colorado Choice (12 exchange plans), and Denver Health Medical Plan (four exchange plans), and Access Health Colorado (six exchange plans) seem to only have pro-life plans according to the representatives and the website.  But that’s where the clarity ends.  


Things became more perplexing with Kaiser Permanente and its nine exchange plans (all of which seem to cover elective abortion) when we asked about the abortion surcharge.  On one occasion a representative said that, “Yes, elective abortions are covered…you are only excluded if you are a federal employee, an employee of the state of Colorado or the University of Colorado.”  The second representative said that she did not know, it was not stated, and “there is no way to know.”  After checking, she came back and said that all of their plans cover voluntary abortions and the website confirmed it.  Confusion ensued in regard to the abortion surcharge.  When asked she said that “you wouldn’t know because you are not a member” and that there is “not a way to know until you select a plan.”  We commented that it is really important to know that information about a plan before enrolling, and she didn’t respond.  Instead she offered information that “Kaiser does not perform abortions, but that Planned Parenthood does and that you should call them to see how much they charge.”  We were not asking about the cost of abortion, but about the abortion surcharge which is included in every one of their plans.


Colorado HealthOP has eight exchange plans and we were given a lot of contradictory information. The first representative said that two of their plans cover elective abortion.  She said PPO Bison covers “pregnancy termination” at 40% co-insurance after the deductible and PPO Bighorn covers at 35% co-insurance.  The second representative said that all of their plans cover elective abortion.  However, the website lists that none of their plans cover elective abortion.  So, which is it?  When we asked about the abortion surcharge, the representative confused the difference between it and deductible costs.  She said, “Once you meet the deductible it is covered, depending on the coinsurance…there is no way of really knowing the specific amount, that each plan has a different amount, and that will not be visible on future bills because they will have to wait for the claim to come in.”  This was a nonsense answer to a straightforward question.  


Cigna has 11 exchange plans and while both representatives and the website were in agreement that they don’t cover elective abortions, the representatives were confused about which abortions they do cover.  The first representative said that they cover abortions that a doctor deems “medically necessary”, including but not limited to rape, incest, or life of the mother cases.  The second representative said that “there was no detailed information on those cases [life of the mother] but that it looked like they would not be covered either.”  Again, there is no transparency or clear guidance.


Two different representatives from Humana, that has seven exchange plans, vouched that none of their plans cover elective abortion, but according to the plan details, they all do.  So which information is correct?


Last, Rocky Mountain Health Plans HMO has 26 exchange plans.  On the same call with two different representatives, they contradicted each other.  One “thought that most of their plans do cover it.”  The second representative said that voluntary abortion is not covered and is not a benefit on any of their plans.  This seemed like the more authoritative answer because it was checked with a “specialist” and because the website details back this information, but your average customer is not going to speak with multiple representatives and will generally trust the information he or she is getting the first time around.


As you can see, navigating the Colorado insurance market was a very confusing experience.  It is unacceptable that for about half of the companies we called, we received conflicting or inaccurate information about elective abortion coverage and the abortion surcharge.


We have seen similar stories coming out of Maryland, D.C., and New York.   Americans deserve clear answers about abortion coverage when they purchase healthcare plans on the Obamacare exchange. Please urge Congress to pass Rep. Chris Smith’s “H.R.7, the No Taxpayer Funding for Abortion and Abortion Insurance Full Disclosure Act of 2014.”



Arina O. Grossu, M.A. is the director for the Center for Human Dignity at the Family Research Council where she focuses on sanctity of human life issues, ranging from conception to end of life care.


Publication date: September 15, 2014