Abortion, Health Insurance, and the States

There’s been a bit of confusion over what, exactly, health care reform has allowed states to do in terms of regulating health insurance coverage. Over at Wonk Room, Igor Volsky notes that the law “gives states the option of banning private insurers from providing abortion coverage to women within the exchange.” It’s true that states have the power to ban abortion coverage, and some states are taking advantage of it—Tennessee is moving to ban abortion coverage on its exchanges—but it’s nothing new.

Since 1945, the states have had the right to pass laws regulating insurance, including banning abortion. Some of them even did it: according to the Guttmacher Institute, which supports abortion rights, Idaho, Kentucky, Missouri, North Dakota, and Oklahoma have bills on the books limiting health insurance coverage of abortion. Oklahoma lets insurers cover abortions in cases of rape, incest, and when the life of the mother is endangered; the other four states only allow insurers to cover abortions if the life of the mother is endangered.

When it comes to abortion and insurance regulation, the health care bill as signed by President Obama essentially restates the provisions of the 1945 McCarran-Ferguson Act. States used to have the power to ban abortion coverage, and they still do. Health care reform may have made conservative states more likely to prohibit abortion coverage by drawing attention to the issue, but it didn’t enhance their powers to do so. Nothing to see here; move along, please.


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