Originally posted Tuesday at 5:08 pm. Updated with comments from Group Health and more from Planned parenthood. See below for details.
A breaking announcement from Planned Parenthood Votes Northwest and Legal Voice:
According to the State Office of the Insurance Commissioner, of the four carriers seeking to provide coverage through the State Health Benefits Exchange, all are covering elective abortion in their plans, with one unexpected exception – Group Health. NARAL Pro-Choice Washington and Planned Parenthood Votes Northwest have received confirmation that Group Health will not be including abortion care as part of its State Health Benefits Exchange coverage for low-income Washingtonians.
Group Health asserts that abortion care will be made available to patients in Group Health clinics, but the lack of coverage in the plan creates confusion and presents a barrier to access, while showing an alarming disregard for Washington women. It’s also inconsistent with Group Health’s own record on reproductive rights, which Group Health leadership and consumer members have twice affirmed through the cooperative’s democratic governing process. In 1969, Group Health’s Board of Trustees voted to endorse abortion reform, and in 1985, Group Health members voted down a proposal to ban abortion in Group Health facilities by a margin of 4 to 1.
The press release—which blames the bipartisan state senate caucus for failing to pass the Reproductive Parity Act, thereby letting Group Health squirrel out of abortion coverage—continues after the jump.
“It’s particularly galling to see one of the most progressive, pro-woman healthcare providers in our state placing limits on abortion coverage,” said Rachel Berkson, Executive Director of NARAL Pro-Choice Washington. “What we’re seeing now is a direct result of the legislature’s failure to pass the Reproductive Parity Act (RPA).”
“Insurance carriers are businesses. Because of the barriers to abortion coverage that were put into the Affordable Care Act by anti-women’s health extremists, insurance carriers are making business decisions about abortion,” said Elaine Rose, CEO of Planned Parenthood Votes Northwest. “The need for the RPA has never been more apparent. Women can’t trust insurance carriers to protect all of their pregnancy options.”
With the passage of the Affordable Care Act, more than 300,000 women of reproductive age in Washington are gaining insurance coverage. The promise of health care reform was that women would have more access to health care, not less. But administrative burdens put in place when the Affordable Care Act was passed give insurance carriers incentive to drop coverage for abortion. The Reproductive Parity Act would ensure every insurance plan that covers maternity care also covers abortion. Families are counting on their new healthcare coverage to help in tough economic times, and abortion coverage is no exception, say advocates.
“Despite having enough votes to pass this important issue and give millions of Washington women the freedom to determine their own reproductive destiny, the Republican majority caved to the far-right wing of their caucus, and now the results of their inaction are beginning to have real-world consequences,” said State Senator Steve Hobbs (D-44), one of the RPA’s sponsors.
Without the RPA in place to ensure comprehensive coverage for all Washington women, carriers like Group Health can make decisions likely to disproportionately affect the low-income women in our state who will apply for healthcare coverage through the exchange. Barring low-income women from comprehensive reproductive healthcare is part of a nationwide anti-choice strategy to disempower women and limit abortion: it has no place in Washington, it has no place at Group Health, and it shows just how crucial legislation like the RPA is in protecting women’s access to reproductive healthcare.
I have a call and e-mail in to Group Health.
UPDATE: Group Health spokesman Ed Boyle got back to me. He writes:
In response to a news release NARAL issued this afternoon, there may be some confusion around Group Health providing pregnancy termination services to our members.
For our members who enroll through the exchange and seek pregnancy termination services, Group Health (GH) will ensure they receive the care they need through GH medical centers.
Earlier this year, federal and state regulators specified that pregnancy termination could not be covered as one of the 10 Essential Health Benefits required of insurance plans under the Affordable Care Act, and that federal dollars could not be spent to support these services through funding tools such as the premium tax credit or cost-sharing subsidies for enrollees in the Washington Health Benefit Exchange.
At the time Group Health filed our products, we lacked further regulatory guidance. Group Health determined that in order to ensure full compliance with all requirements, it was advisable to not include pregnancy termination services in our individual products offered through the exchange for 2014. We are able to have made this determination and yet ensure access to care because of an integrated system in which our members can access services at Group Health medical centers. As we have been across our history – as the NARAL news release itself highlights – Group Health is committed to ensuring that women have access to pregnancy termination services that are safe, accessible, and affordable.
Federal and state regulators have now provided clarity about how we would be required to track the provision of these services and the financial separation and reconciliation of tax credits and cost-sharing subsidies, and Group Health fully intends to add this benefit to our products sold through the exchange in 2015.
Group Health places a great deal of importance on the exchange’s successful launch in 2014, and know we are accountable to our members, our patients, and to the government to uphold the highest standard of compliance with all new requirements.
In the meantime, members can continue to access coverage for these services through Group Health Cooperative and Group Health Options Individual products sold directly, outside of the exchange, as the exclusion for subsidies and associated tracking requirements are not applicable in this market.
BOTTOM LINE: Group Health is committed to ensuring access to pregnancy termination services for our exchange enrollees through Group Health medical centers. This is consistent with Group Health’s long history and present-day commitment to providing women access to the full spectrum of reproductive health services that are safe, affordable and accessible.
PS, Dominic – Just to clarify … In 2014 our members who enroll through the exchange can be assured they will have access to pregnancy termination services through Group Health medical centers, with no greater financial burden than as if this was a covered benefit. And as the statement clarified, in 2015 pregnancy termination services will be included as a covered benefit in the plans Group Health offers through the Washington Health Benefit Exchange.
Megan Burbank, spokeswoman for Pro-Choice Washington and Planned Parenthood, responds:
Our take on this is that while we know Group Health is an abortion provider—and they have a seriously good record on this issue, which is why we were surprised they weren’t covering it—this is not really an issue of provision so much as coverage and access. It doesn’t matter that Group Health provides abortions if women applying for coverage through the exchange don’t know how to access or afford the procedure. And 2015 is a long way off. It’s great that they’re committed to adding this as a benefit, but not including elective abortions under their plans creates confusion about coverage now, which in itself presents a barrier to access. Given that low-income women are more likely to apply for plans through the exchange, our concern is that they will be disproportionately affected. We’re also concerned that a lack of clear coverage may lead to administrative barriers for women seeking care, and additional financial burdens should they need inpatient care in hospitals outside of Group Health’s system.
So, if it's just about access, I asked, was the original Planned Parenthood press release misleading? Burbank says:
Unless they’ve said that their exchange plans now cover elective abortion, no. Essentially, what they’re saying is that it’s not a problem that they aren’t covering abortion in their plans, because they’re a provider. But that doesn’t change the scope of their exchange plans, and it basically means we have to take their word for it that they’ll make abortion accessible to women who sign up for plans through the exchange.
So, Group Health says people who buy Group Health insurance through the exchange will have abortion access at Group Health facilities (as Planned Parenthood noted in its original announcement). But the Group Health insurance plans don't explicitly cover the procedures. Further, Group Health claimed that "in order to ensure full compliance with all requirements, it was advisable to not include pregnancy termination services in our individual products offered through the exchange for 2014." But all the other insurance providers do provide it.
Yet Group Health say there is "some confusion" as a result of the press release from women's health advocates.
So I asked Group Health if they can confirm that members who buy their insurance through the exchange won't have abortion coverage in their insurance. And given that, why not? If women aren't covered by their insurance, how can they receive these procedures without paying a cent more? And why couldn't Group Health do this when all the other providers could?
Group Health's Ed Boyle again:
Q: Will members who buy Group Health insurance plans through the exchange have abortion coverage?
A: In 2014 our members who enroll through the exchange can be assured they will have access to pregnancy termination services through Group Health medical centers, with no greater financial burden than as if this was a covered benefit.
Q: If women aren't covered by their insurance, how can they receive these services without paying a cent more?
Again, in 2014 our members who enroll through the exchange can be assured they will have access to pregnancy termination services through Group Health medical centers, with no greater financial burden than as if this was a covered benefit. We are able to do this because Group Health is both an insurer and care provider.
Q: And why could Group Health not provide it when all the other providers could?
A: Group Health places a great deal of importance on the exchange’s successful launch in 2014, and know we are accountable to our members, our patients, and to the government to uphold the highest standard of compliance with all new requirements. Federal and state regulators have now provided clarity about how we would be required to track the provision of these services and the financial separation and reconciliation of tax credits and cost-sharing subsidies, and Group Health fully intends to add this benefit to our products sold through the exchange in 2015. Again though, in 2014 our members who enroll through the exchange can be assured they will have access to pregnancy termination services through Group Health medical centers, with no greater financial burden than as if this was a covered benefit.
Group Health seems to be doing a damage control for a decision not to include abortions under their plans—even going so far as to claim there is "confusion." But asked point blank—Do your insurance plans in the exchange cover abortion?—they still provide an evasive answer. Group Health will provide the services, they say, but not cover them. Uh, okay. Performing them for free, even if they aren't part of the plan, is better than nothing.
I'm glad these groups are turning the screws here, even if Group Health has a great record. I'm glad they are using this to illustrate the need for the Reproductive Parity Act. If this isn't law, insurers won't cover it. Progressive groups have been warning about this potential problem for years, and presto, now we have proof it's a real problem. In the meantime, as Burbank put it, "we have to take their word for it that they’ll make abortion accessible to women who sign up for plans through the exchange." There's no better way to help folks keep their word than forcing them make their promise in public.