The Trump Administration Just Finalized a New Rule That Could Wreck Health Insurance Coverage of Abortion

By Marian Manapsal | Dec. 20, 2019, 4:31 p.m.

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The Trump administration just finalized a new rule that could undermine private health insurance coverage of abortion for millions of people across the country. How so? By requiring insurers to jump through unnecessary administrative hoops that have nothing to do with health care and everything to do with restricting access to abortion. 

What This Rule Does, and What It Means for Patients

This rule requires companies in the health insurance marketplace for individuals to send two separate insurance premium bills — either by mail in separate paper bills or separate emails — to a patient: one for abortion care and one for all other health services. Patients would also be required to pay two separate premiums: one for abortion coverage and one for coverage of all other health care. Confused yet? That’s part of the Trump’s administration's whole MO. 

This new rule could make abortion cost-prohibitive and put access to abortion out of reach. By the Trump administration’s own account, more than 3 million people would be subject to these onerous restrictions. The administrative costs to enforce this rule could be staggering. 

Some health insurance plans could drop abortion coverage altogether to avoid these administrative burdens or raise premiums, and patients might not understand the requirements and could be discouraged from buying a health care plan that includes abortion coverage. 

Furthermore, if a patient forgets to pay the separate bills or doesn’t understand why they’re receiving two separate bills, they could potentially lose their health insurance altogether. For many people, paying medical bills is already confusing and stressful enough. Now, there’s an added risk of losing your insurance entirely. 

Without insurance coverage, those who are seeking to end their pregnancy could pay up to $1,500 or more in out-of-pocket costs for abortions. This could lead many to forgo the procedure altogether. This rule is especially alarming for people who need an abortion later in pregnancy. Such abortions involve more time and medical attention and are often more expensive.

The new rule also makes it easier for anti-abortion consumers to pick and choose only those parts of a plan with abortion coverage that they want to pay for. It tells insurers the Trump administration will do nothing to stop them from letting consumers opt out of paying their fair share of the abortion coverage premium, after buying a plan that includes abortion coverage. This is not how health insurance works. 

The End Goal? To Make Abortion As Expensive and Hard to Get As Possible

This new Trump administration rule comes on the heels of relentless state and federal attacks on abortion: 

• The Hyde Amendment, which blocks federal funds for abortion, creating a financial barrier for people with low incomes and others who use government health insurance and who want an abortion.

• In state after state in 2019, anti-abortion politicians have rushed to ban abortion outright or to limit it to the first few weeks of pregnancy before most people know they’re 

• The U.S. Senate, with a majority hostile to abortion rights, continues to greenlight Trump’s extreme anti-abortion judicial nominees, like Sarah Pitlyk and Lawrence VanDyke, for lifetime positions on the federal bench. 

• The Supreme Court is set to hear arguments for the first time in an abortion case since Justice Brett Kavanaugh’s confirmation — a case which could make the protections of Roe v. Wade virtually meaningless and take the country one step closer to making abortion impossible to access.

This rule is scheduled to officially take effect on February 25, 2020, but the actual implementation date for health plans will be later in 2020. All of us deserve health care that meets our needs — regardless of our gender, sexual orientation, citizenship status, or decisions about whether or when to have children.

Tags: Abortion, Insurance, health insurance