In February our friends at the Family Policy Institute of Washington, in Washington State, tried to access non-abortion plans on the Washington Exchange. What they found has been mirrored in many other states as well.
Washington State Insurance Exchange Report
I approached the Washington state health insurance exchange as a consumer, starting with healthcare.gov and speaking with sales associates over the phone. It took hours of research to find 1) how many insurance companies operate in the state exchange 2) how many plans exist in the state exchange, and 3) which of those plans cover abortion.
In order to find all of the information I needed, I had to visit the state exchange website (www.wahealthplanfinder.org), the state commissioner’s website (www.insurance.wa.gov/your-insurance/health-insurance/individuals-families/contact-companies/.) and the federal Office of Personnel Management website (www.opm.gov/healthcare-insurance/multi-state-plan-program/ – WA).
The setup of wahealthplanfinder.org allowed me to see the insurance companies of only one county at a time. I found 7 insurance companies1 in the state exchange by means of the state commissioner’s website. I searched the websites of each insurance company to find a total of 78 plans2. Within the Summary of Benefits Covered, 23 of the plans explicitly mentioned abortion coverage, while the other 55 plans made no mention of abortion. When I called each insurance company, I discovered that all of the state exchange plans cover abortion, except for Premera’s multistate plans. It was unclear until visiting the federal OPM website that Premera is the only company offering multistate plans, and they offer 8 multistate plans. Out of 78 plans in the state exchange, 8 plans exclude abortion coverage.
The concreteness of the information I was provided over the phone varied based on insurance company. Group Health, Community Health Plan of WA, Bridgespan, Molina and Kaiser Permanente mentioned that while all their plans cover abortion, the amount of coverage (deductible, out-of-pocket, cost-shares, co-insurance) depends on the plan. Community Health Plan of WA mentioned that one would get the best benefit with in-network providers. Coordinated Care was reluctant to discuss details and said abortion coverage is subject to pre-approval, while related aspects (prescriptions, hospital stays) under the 10 Essential Benefits would be covered.
A consumer wondering which insurance plans in the Washington state exchange cover abortion has the choice of remaining uninformed, or spending hours researching to find clarity. Consumers would benefit from a requirement that insurance companies disclose whether their plans include abortion coverage.
1 I considered Premera and Lifewise one company, with different plans under each name.
2I used a definition of “plan” that considers plans with the same name, but different deductible amounts as distinct plans.
Join us tomorrow when Rep. Chris Smith (R-NJ) talks about his efforts to make the Obamacare state exchanges more transparent for pro-lifers in the market place and Joseph Backholm, the Executive Director of FPIW talks about his team’s efforts to discover the problems in their state.