The Georgia state legislature passed a bill on Tuesday to prohibit abortion coverage from being included in insurance sold under Obamacare within its borders. It is now the 22nd state, almost all of them with statehouses controlled by Republicans, to pass such a bill since the federal law took effect in March 2010.
GOP lawmakers are taking advantage of the Affordable Care Act’s approach to abortion coverage, a hotly contested issue when the bill was being debated, but pro-choice advocates have no illusions about what’s happening: Conservatives are using the hated health care reform law to further the effort to restrict abortion coverage.
“This has been a big trend in state legislatures since as soon as the ink was dry on the ACA,” Elizabeth Nash, state issues manager at the Guttmacher Institute, a pro-choice advocacy organization, told TPM.
But the federal law passed by a Democratic Congress and signed by a Democratic president could also be to blame, Nash said. Obamacare included the following passage, which Nash argued effectively encouraged these states to prohibit abortion coverage from being sold through the law.
A State may elect to prohibit abortion coverage in qualified health plans offered through an Exchange in such State if such State enacts a law to provide for such prohibition.
Abortion opponents tout the Georgia legislation, which also restricted abortion coverage for state employees, and others like it as preventing taxpayer dollars from being used to fund abortion as well as filling their broader goal of thwarting “the inherent evil of killing the unborn.”
“It’s not about what is permissible or what it is not. It’s not about who can do what and who can not. It’s simply about who’s going to pay for it,” Georgia state Sen. Mike Crane (R) said on the Senate floor. “The state of Georgia has gone into the homes of Georgians, and taken of their property and dispersed it, some of which paid for the destruction of human life.”
The state laws could have a significant impact on abortion access and how women who choose to have an abortion pay for them, according to Guttmacher. A 2008 study found that 30 percent of abortion patients had private insurance, which suggests many patients are the uninsured who Obamacare is attempting to cover. Even among those who had insurance, 63 percent paid out of pocket, a trend unlikely to change with such widespread restrictions on what the insurance plans sold under Obamacare can cover.
The Georgia bill, which formalized a policy already instituted administratively by Republican Gov. Nathan Deal, allows for extremely limited exceptions for certain medical emergencies. The allowances of laws passed in other states range from none at all (Louisiana and Tennessee) to rape and incest, severe health risk and certain fetal impairments.
Because two states — Kentucky and North Dakota — had existing laws on the books that will apply to Obamacare coverage, 24 states in total have some kind of restriction on plans sold through HealthCare.gov or its state counterparts.
“Given the debate around the ACA, given the encouragement in the ACA to adopt abortion restrictions, it’s not surprising to see all of these states adopt these restrictions,” Nash said, “and this is just part of the huge wave of restrictions we’ve been seeing since 2011.”