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Some group health plans on state health exchange will cover 'elective' abortions; individual plans will cover only if "medically necessary"
Christopher Dugan, senior director of public relations for Anthem in New Hampshire, said small-group plans offered in the exchange also will cover "elective" abortion services. But not the plans that individuals will be able to purchase, he said.
Previously, individual customers could purchase a rider from Anthem for maternity coverage, and elective abortion was included in that, Dugan said. But in the new plans, he said, "Our decision was to exclude elective abortions because federal funds could not be used, under the new (health reform) law, for that."
The Affordable Care Act allows the states to decide whether to include abortion coverage in their exchanges, but it specifically prohibits use of federal funds for abortion services except in cases of rape or incest, or when the life of the woman is endangered.
According to the coverage certificate for the new plans provided by Dugan, that is defined as "health care services or products provided to an enrollee for the purposes of preventing, stabilizing, diagnosing, or treating an illness, injury or disease, or the symptoms of an illness, injury or disease."
New Hampshire law is silent on the issue.
The state's Joint Healthcare Reform Oversight Committee met a year ago to decide on the "essential health benefits" that will be offered in exchange plans.
And even when the joint committee chose as its benchmark an Anthem plan, Matthew Thornton Blue, that does provide abortion coverage, Patterson advised lawmakers that does not mean carriers that participate in the exchange have to offer such coverage. "That's one thing the committee was really concerned about: If we choose this and it has the coverage, does that become part of the package?" she said. "And it does not."
Because lawmakers here did not address the issue of abortion coverage in legislation, Patterson said, "It's up to the carriers to decide what services are covered by any particular plan."
The Legislature still could act on the issue, and Patterson said insurers that offer plans through the exchange would have to abide by what lawmakers decide.
And under Section 1303 of the Affordable Care Act, Patterson said, "If the state chooses to make a law with respect to abortion, then that law won't be preempted by the ACA."
Last year, the Legislature passed a law (RSA 420-N:7) that prohibits creating a state-based health exchange. Instead, the law allows state agencies to "interact with the federal government with respect to the creation of a federally facilitated exchange."
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