The non-partisan congressional watchdog agency, Government Accountability Office (GAO), released a new report late September 15 confirming that: 1,036 federally subsidized plans cover elective abortion; insurance consumers were frequently not informed of this coverage before enrolling; and plan issuers are not billing elective abortion coverage separately despite a legal requirement.
The report also makes public for the first time a complete list identifying every plan by name that covers elective abortion and those that do not in the states that permit coverage on the insurance exchanges. (This list may be accessed here by clicking “Abortion Services Interactive Map” on the right: http://www.gao.gov/products/GAO-14-742R.)
This valuable resource has been a long time coming. Former Department of Health and Human Services (HHS) Secretary Kathleen Sebelius promised and dodged requests for this very list three times under oath (here, here, and here) during Congressional hearings over the past 11 months. Her successor, Sylvia Burwell, apparently did little to follow up. The GAO, which reports working on this project for seven months, did what the giant of HHS could or would not do despite its $941 billion budget, which makes it wealthier than Indonesia, the 16th richest nation in the world.
The GAO report found:
- 28 states allow elective abortion in Qualified Health Plans (QHP) offered on health insurance exchanges.
- 15 states have no restrictions or limitations on the elective abortion coverage.
- Five states offer only elective abortion plans on the exchange. There are no “pro-life” plans in Connecticut, Hawaii, New Jersey Rhode Island, and Vermont. (Note: The Lozier Institute also found this to be the case when researching the first four states; however, Vermont proved particularly difficult as one insurance company provided conflicting responses via four different representatives and did not make available any abortion policy document upon request.)
- 1,036 QHPs cover elective abortion.
- 87 percent of the 5.4 million Americans who bought insurance via the exchanges used federal premium subsidies to pay for their coverage.
- 11 of the 18 plan issuers interviewed as a sample did not provide abortion information to consumers before they enrolled.
- None of the 18 plan issuers interviewed billed the abortion surcharge separately per the law or itemized the fee clearly as abortion.
- One plan issuer was not aware at all of the requirement to file an abortion segregation plan with its state department detailing its abortion accounting methods.
This, after almost one full year of individuals and families enrolling in and paying for their health insurance.
The present situation above – and Lozier’s latest findings – on the lack of segregation of abortion funds directly violates that provision in the Affordable Care Act. Even the author of this billing arrangement provision, Sen. Ben Nelson, explained clearly in 2009:
“If you are receiving Federal assistance to buy insurance, and if that plan has any abortion coverage, the insurance company must bill you separately… Now, let me say that again. You have to write two checks: one for the basic policy and one for the additional coverage for abortion.”
HHS has responded to the report by acknowledging that “additional clarification may be needed.” It promised that its Centers for Medicare & Medicaid Services (CMS) would “address issues of concern” and “speak directly with the QHPs or state Departments regarding the issues identified by GAO to determine whether additional guidance is necessary” for states and issuers to understand the laws. Regardless of any proposed technical or logistical “fixes,” however, the heart of the matter is the troubling issue that this “medical procedure” that intentionally takes a human life – unlike any other medical procedure – is being sold as “healthcare.”
Genevieve Plaster is a research assistant at the Charlotte Lozier Institute.