Many public exchange plan issuers may be failing to charge enrollees a separate fee for abortion benefits.
The Patient Protection and Affordable Care Act (PPACA) requires exchange qualified health plan (QHP) issuers that provide routine access to abortion benefits to charge separately for the benefits, to keep the plans from using PPACA subsidy money to pay for abortions.
Investigators from the U.S. Government Accountability Office (GAO) talked to 18 carriers that provide “non-excepted abortion benefits” through a total of 246 exchange QHPs. Only one was charging separately for abortion benefits, according to John Dicken, a GAO director.
The issuers said actual abortion claim costs ranged from about 10 cents per enrollee per month to $1.10 per enrollee per month.
Dicken summarized the investigators’ work in a QHP abortion benefits report sent to House Republican leaders.
PPACA includes an exception that lets QHP issuers use PPACA subsidy money to pay for abortions when a pregnancy is the result of rape or incest, or the life of the pregnant woman would be endangered if the abortion were not performed.
Twenty-three states limit QHPs’ ability to cover “non-excepted” abortions — elective abortions; 28 do not. In the 23 states with restrictions, 17 prohibit QHPs from covering any elective abortions, and six let QHPs cover elective abortions only in specified circumstances, such as circumstances in which continuing a pregnancy could cause irreversible harm to a pregnant woman’s body, Dicken says.