By Rose Hoban
A bill that passed out of a state House judiciary committee Wednesday morning and then passed a vote on the House floor that night would remove abortion coverage from insurance plans offered in the health benefits exchanges created under the ACA, known as Obamacare.
The bill would also prohibit state, municipal and local governments from paying for abortions for their employees with taxpayer money. The provision brings those plans in line with the State Health Plan which currently restricts abortion coverage for state employees, except in the case of rape, incest or a risk to the mother’s life.
The bill also allows any health care worker, or health care facility, to refuse to perform an abortion or provide post-abortion care if they have any religious, moral or ethical objections to the procedure.
That extends what’s currently in the law from just doctors and nurses, to pharmacists, nurses’ aides, hospitals or anyone else who might be involved in providing reproductive health services to women.
Echoes of Affordable Care
Congress put a provision in the Affordable Care Act that allows states to make the decision about whether to include abortion coverage in their exchange plans, even if a state’s exchange is being run by the federal government.
Rep Paul Stam (R-Apex) cited that provision during the debate Wednesday evening.
“[There] is a provision in that act that gives this body the power to do what it’s just about to do,” Stam told the House, “and it’s signed by Nancy Pelosi, Joe Biden and Barak Obama. “And it says 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 enact a prohibition.”
“It’s right there,” he said.
Stam has been trying unsuccessfully for years to restrict municipalities from providing abortion benefits to employees. In 2009, he sent a letter to county boards of commissioners threatening to sue municipalities that provided the coverage.
“It is absolutely true that the state could pass this law,” said Rep. Deborah Ross (D-Raleigh). “Many states have done it; most have not. And the reason why… is because they understand that if women pay for their own insurance under the exchange, those women should be able to seek the kind of health care coverage that they want to get, rather than having the state choose it for them.”
Wednesday’s votes mean the provisions inserted into HB 730 would establish a state standard for the new health benefit exchanges that would exclude coverage for abortion in any of the exchanges.
Health policy experts expect most of the people who will buy insurance on the exchanges will be those low-middle-income families who are also eligible for federal subsidies to buy insurance.
“Banning abortion coverage in the health care exchange is yet another example of politicians imposing their own views on private medical decisions,” said Suzanne Buckley, executive director of NARAL Pro-Choice North Carolina. “Despite what the bill’s sponsors would have you believe, health insurance benefits are part of employee compensation, not government subsidies.”
In its earlier iteration Wednesday morning, language in the bill also restricted access to contraception. Currently, North Carolina law only extends the ability to restrict coverage to religious institutions such as churches, religious not-for-profits or organizations that primarily employ people who are all of the same religious beliefs.
Under the Affordable Care Act, religious institutions, churches and other religious not-for-profits can also limit their employees’ access to abortion and contraception.
“We spent a lot of time reading over and discussing language that is already in our statute,” said bill sponsor Rep. Jacqueline Schaffer (R-Charlotte) during the committee meeting. “We’re attempting to extend the conscience rights of employers to include anyone who has a religious, moral or ethical objection to providing this type of coverage.”
But members of the committee – including members of the Republican caucus – objected to the new language in the bill as going too far.
“There is probably no one in this room who is more pro-life than I am, but I’ve got to tell you, I’ve got a real problem with this portion of the bill as it relates to birth control,” said Rep. Bob Steinburg (R-Edenton). “Its almost like we’re stepping back in time.”
“To suggest in the 21st century that a woman could be prevented access to birth control pills, that’s going off the cliff,” Steinburg said.
That language was removed on the floor of the House that evening in the amendment offered by Stam.
Other abortion bills
The bill comes on the heels of several others that address abortion that have made their way through the General Assembly.
Earlier this week, a bill passed the Senate requiring teens to be taught in their health education curriculum that abortion can increase the risk of preterm birth.
Originally, only the abortion language was in that bill, but it was amended on the Senate floor to add other risk factors such as smoking, alcohol and drug abuse and poor prenatal care.
Another bill that passed through the Senate would forbid the practice of sex-selective abortion.
Wednesday’s bill would be the most sweeping of the three measures, restricting insurance coverage to abortion for potentially hundreds of thousands of women in the state.
“Taking away the coverage that does not reduce the need for abortion. It only creates a barrier for access for women to have a safe medical procedure that they need and of course it will force some women to resort to drastic measures” said Rep. Alma Adams (D-Greensboro). “It’s wrong for us to deny coverage for a legal, medical procedure just because some people are opposed to that procedure.”
Anti-abortion supporters said that women are free to pay for their own procedures.
The bill needs one more vote on the House floor Thursday to meet the legislative crossover deadline before it can head to the Senate.