Removing Choice in Washington State: Mandating Abortion in Health Insurance

[Update: While Washington state HB 1647 passed the House on March 10, 2015, the Senate companion bill SB 5574 was not given a hearing before the legislative deadline, so the abortion insurance mandate will once again not advance this session. For more information about the original bill, please see: http://app.leg.wa.gov/billinfo/summary.aspx?bill=1647&year=2015.] 

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On February 10, the Washington state House of Representatives held a public hearing on a bill that would mandate coverage of elective abortion in health insurance plans for 2016. House Bill 1647 states that any plan in the state that covers maternity services must also provide “substantially equivalent coverage to permit the voluntary termination of pregnancy.”

The bill asserts that it seeks to “improve access to reproductive health,” yet there is no evidence of statewide lack of access to a health plan covering elective abortion. The mandate would affect plans sold on the state exchange or privately from insurance companies and through employers, meaning that most, if not all, insurance consumers in the state would be forced to subsidize abortion on demand. According to the CDC’s latest figures, Washington state’s abortion rate has fallen more than 20% from 2006 to 2011.

Since almost all health plans are required by federal law to cover maternity services, the Washington mandate would have a significant impact. As for current access to abortion coverage in the Evergreen State, the Charlotte Lozier Institute found that for the 90 state marketplace plans that are eligible for federal subsidies, all plans already cover elective abortion except for the eight multi-state plans (MSPs) which are under the jurisdiction of the federal Office of Personnel Management. According to the Affordable Care Act, at least one MSP must exclude elective abortion, allowing for the others to include it in the future.

During the February 10 committee hearing (video here at 14:15), one witness testifying was Jim Mischel, CEO of Electric Mirrors, a successful pro-life family-owned small business. Mischel shared a personal story attesting to his family’s firmly held belief in the protection of human life at its earliest stages. He began:

39 years ago, a 14-year-old girl was raped. When she discovered she was pregnant she went to a clinic to have an abortion, but then changed her mind. She courageously carried her child to term and a couple adopted the baby. That baby is my brother Aaron and that couple is our parents… Today, Aaron is our vice president and a great husband and father of four. My brother is a face of the almost aborted child. My family’s faith and personal experience lay the foundation for how we run our business and support our employees.

Mischel continued by highlighting the coercive effect the Washington abortion mandate would have on his family:

Unfortunately for most life affirming businesses, access to pro-life insurance policies simply doesn’t exist. Instead of creating more market options for these business owners and pro-life employees, this law attempts to remove choice when it comes to life affirming health care policies…. My family would be forced to pay for the very means that would have taken my brother’s life.

When the Washington House was considering the mandate last year, Aaron Mischel himself testified in opposition.

The abortion mandate is not new in Washington state. Called the “Reproductive Parity Act” by proponents, the mandate was originally introduced in 2012 by Rep. Eileen Cody, who has reintroduced it every year since in various forms upon its continued failure to pass the state Senate.

Concerning conscience protection for insurance companies and healthcare workers, it is notable that this year’s iteration of the coercive abortion-coverage mandate does not contain any language respecting workers’ conscience, though versions of the mandate in years past were amended to include additional conscience language. Even then, the provision in last year’s proposed mandate proved confusing and even seemingly nullified by other statements in the same bill.

Carrie Anderson, another witness who testified in opposition to the mandate, referred to the push for elective abortion coverage in health plans as a “movement in the insurance industry.” And so it seems in her state. When the abortion mandate passed the House last year, the Washington State Office of the Insurance Commissioner (OIC) issued a press release commending the House and urging the Senate to do the same.

In another instance, OIC spokeswoman Stephanie Marquis called out one insurance company who dropped abortion coverage due to confusion on how to file the separate abortion surcharge. Marquis said, “Unfortunately, [Group Health] made the change to take away that benefit from women, and we can’t require them to include it. It’s an unfortunate decision for consumers.” The OIC is a state agency founded to “protect insurance consumers and oversee the insurance industry.”  Apparently some occupants of that agency are not interested in protecting all of the state consumers.

The bill’s condition that elective abortion be required if a health plan covers maternity services spells out its intention: to make abortion and maternity care coequal choices for a pregnant woman. The chosen phrase in the bill – “medical abortion care” – reflects that curiously twisted view. But abortion, no matter how common it is – and it is becoming less so in Washington as it is in the United States overall – is not health care. May healthcare reform in this country provide for true choice among health plans and better reflect the purpose of practicing medicine – to heal, not “terminate,” people.

*Washingtonians may submit comments on the abortion insurance mandate here, which will then be emailed directly to the district legislators according to one’s residential address.

Genevieve Plaster is a Research Assistant at Charlotte Lozier Institute.