One State With Its Head On Straight

Lucky citizens of Washington State: Olympic National Park, civilized Seattle, and a legislature of sentient, rational human beings.

Tara Culp-Ressler at Think Progress:

Across the country, about 21 states have restricted access to abortion by preventing insurance companies from covering the cost of the legal medical procedure. But lawmakers in Washington State are currently considering the opposite approach: legislation to mandate that insurance companies pay for abortion services as part of their plans’ maternity care. 

Washington has traditionally been a trailblazer when it comes to reproductive rights. In 1970, the state become the first to legalize abortion by a popular vote. Now, under the proposed Reproductive Parity Act, it may become the first to ensure that insurance companies aren’t permitted to segregate abortion care from the rest of the women’s health services covered under their plans:

The bill passed the state House earlier this month by a vote of 53-43, though it faces an uncertain future in the Senate. A similar bill in the New York state Assembly has been introduced each session for over a decade but has never received a public hearing.

“This is a core value for Washingtonians,” said Melanie Smith, a lobbyist for NARAL Pro-Choice Washington. “We should protect it while we still have it and not leave access to basic health care up to an insurance company.” [...]

Supporters of Washington state’s proposed abortion insurance mandate are careful to stress that it wouldn’t lead to a dramatic uptick in abortions or require carriers with a religious bent to cover the procedure. They also note that a pair of federal plans that will be sold on all 50 state exchanges will be barred from covering elective abortions.

“It’s not expanding abortion coverage,” said Democratic Rep. Eileen Cody of West Seattle, the bill’s primary sponsor. “It’s ensuring the rights of women to get what they’re paying for now and to continue their freedom of choice.”

The bill has been hotly contested, particularly as conservatives have argued it represents an affront to the religious liberty of individuals who oppose abortion and don’t want to purchase plans that cover it. But Obamacare already requires at least some plans in the state-level insurance marketplaces to exclude abortion coverage. And, as Rep. Cody notes, the legislation wouldn’t actually significantly change the current landscape in Washington because all of the state’s major insurers already cover abortion.

But it would prevent new insurers entering Washington’s insurance marketplace from adopting the same kind of anti-abortion policies that have been sweeping the nation over the past two years, as states across the country have rushed to block access to abortion coverage. Elizabeth Nash, the state issues manager for the Guttmacher Institute, told the New York Times that the bill’s passage would be a “watershed event” regardless of its immediate impact on the insurance market. “It would be a model for other states to follow,” Nash explained.

According to the Guttmacher Institute, only about 12 percent of the abortions across the country are paid for by insurance providers. But in states that have enacted roadblocks to abortion coverage, women who seek abortions are often forced to pay large out-of-pocket costs in order to make their own medical decisions. The average cost of a first-trimester abortion is about $470, and an estimated 42 percent of the women who seek abortions have incomes that fall below the federal poverty line.