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Is abortion covered under healthcare?

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The lowdown...
  • Abortion coverage is considered to be an elective procedure under existing health insurance law, so states are free to determine whether or not it is covered
  • Currently, 25 states in America have opted out of elective abortion coverage
  • Some health insurance plans on the marketplace do offer benefits for abortion on demand, while others do not
  • If you are looking for abortion coverage, you will want to see if your state even allows this to be a benefit under your policy
For many, abortion is viewed as a basic medical service. As such, it should be covered under the provisions of the Affordable Care Act. That is not necessarily the case, however, as the following points will highlight.

As abortion remains one of the most controversial and divisive topics in American society today, it is not surprising that determining if it is covered under existing health insurance plans is rather difficult.

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Abortion Coverage is Not Currently Guaranteed

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We are still in the era of the Affordable Care Act.

While there are provisions under this latest attempt at health care reform to ensure that all based medical services are covered under insurance, abortion is specifically left out of this provision.

In effect, one of the primary components of the law specifically excluded abortion as a basic medical service. In fact, special rules were created just for the sake of determining who would and would not receive abortion benefits under their health insurance plan.

Existing components of the Affordable Care Act leave it to the states to determine their own rules when it comes to abortion coverage.

Under the provisions of the Affordable Care Act, health insurance plans sold in the marketplace are free to offer abortion-related services.

They are required, however, to prove that no federal funds whatsoever were used to support the procedure.

The Affordable Care Act leaves it up to the states as to whether or not they will ban abortion coverage altogether from being offered in their own health insurance marketplace.

Exactly half of the states in the Union have since banned abortion coverage altogether, while the other half do permit it to be listed as an elective benefit.

If you believe that this is a benefit that you may need at some point, you will want to consider this as a part of your decision-making process as you begin to compare policies in your area.

At the present time, transparency in terms of abortion coverage is lacking, and this ambiguity has made it difficult to determine if it is actually a covered benefit under many plans or not.

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What This Means for Women

With the passing of the Affordable Care Act in 2010, all U.S. citizens and legal residents are required to have a minimum level of insurance coverage.

The benefits offered by each insurance policy in America, as a result, is to contain a minimum level of basic health services.

Since abortion has been specifically excluded from the essential health benefits mandated by law, there is no protection under federal law for women to receive abortion-related coverage under their existing health insurance plan.

In fact, it has been a long-standing policy since 1977 that no federal money can be used for abortion procedures except in cases of rape or incest.

This policy has not changed under the Affordable Care Act.

What has happened, however, is that some states have permitted private insurance plans to offer abortion as an elective procedure, which essentially means that it can be claimed under such policies.

The only caveat is that the insurance company must prove that no federal tax dollars are used to pay for the procedure.

Women today still have the same access to abortion that they previously had, based on geographical location, but most must pay for it out of pocket. Critics do contend that this is disadvantageous to women who live in poverty.

Availability of Abortion Coverage Under the ACA

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One of the primary purposes of the Affordable Care Act was to make insurance more affordable and to bring basic medical services closer to a reality for individuals living in poverty.

Medicaid recipients have skyrocketed since the passing of the law. Here are some interesting statistics to note in relation to abortion coverage since 2012.

  • Roughly 50 percent of the 11.8 million women currently uninsured are eligible to enroll in Medicaid insurance plan that has no limitation on the scope of abortion services if they so desire.
  • Some 4.3 million uninsured women currently live in a state that limits the availability of abortion coverage to a pregnancy that is the result of rape or incest, or in cases where the life of the women is in danger.
  • Women who desire an abortion, but lack the coverage to do so, must pay the out of pocket costs associated with the procedure. This ranges from a low of $400 early in the pregnancy to as high at $1,650 later in the term.

These figures indicate the lack of availability of abortion coverage under many existing health insurance plans. The question of whether or not the procedure is listed as a benefit under any given policy remains a bit nebulous at best.

In Conclusion…

While it is true that many more women today are insured than before recent health care reforms were enacted, many still live in a location where abortion procedures are strictly limited or outright prohibited.

States have the final say as to whether or not the health insurance programs participating in their marketplace will off abortion as a benefit or not.

At the current time, abortion remains an elective procedure and, as such, is not required to be covered under any health insurance plan, be it a private policy of Medicaid.

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