The 2016 RI State Budget, approved by House Finance late Tuesday evening, included language on abortion coverage in its section on HealthSource RI funding that goes far beyond what is required under the Affordable Care Act (ACA). This part of the budget, inserted at the request of Governor Gina Raimondo on May 29, replaced article 28 of her original budget which the General Assembly changed to Article 18 in its final version.
The part that pertains to abortion coverage reads:
(3) Any health plan that delivers a benefit plan on the exchange that covers abortion services, as defined in 45 CFR section 156.280(d)(1), shall comply with segregation of funding requirements, as well as an annual assurance statement to the Office of the Health Insurance Commissioner, in accordance with 45 C.F.R. sections 156.280(e)(3) and (5).
(4) At least one plan variation for individual market plan designs offered on the exchange at each level of coverage, as defined by section 1302(d)(1) of the federal act, at which the carrier is offering a plan or plans, shall exclude coverage for abortion services as defined in 45 CFR section 156.280(d)(1). If the health plan proposes different rates for such plan variations, each listed plan design shall include the associated rate.
(5) Health plans that offer a plan variation that excludes coverage for abortion services as defined in 45 CFR section 156.280(d)(1) for a religious exception variation in the small group market shall treat such a plan as a separate plan offering with a corresponding rate.
The ACA requires, by 2017, that a Multi-State Plan not covering most abortions be offered on every state-based health exchange. The language above mandates that every insurer operating on HealthSource RI offer multiple plans that do not cover abortion. The budget in its current form does not require that insurers offer plans to cover abortion, so any insurer not interested in offering nearly identical plans may decide to drop such coverage altogether.
The federal mandate that requires at least one plan that does not cover abortion should more than adequately cover those with a well-founded religious objection to abortion so that they can find a health plan to cover their needs.
I have made two requests to the Governor’s office, asking for clarification of the amendment’s intent and the reasoning behind the language, but these have gone unanswered.
Gina Raimondo has always maintained that she is staunchly pro-choice. That she would be behind some of the most audacious anti-choice legislation in decades, and that the language should be inserted into the budget without any public debate or comment may come as a surprise to her supporters.
After receiving the endorsement from the Planned Parenthood Votes! Rhode Island PAC, Raimondo said, ‘The Catholic Church has a clear position and I have a clear position…I am clearly pro-choice.”
But Raimondo’s Budget Article 28, by mandating that every insurer offer multiple plans that do not cover abortion, undermines the accepted medical and legal standard that abortion is a safe and legal procedure. Just as individuals do not get a choice about whether their health insurance covers blood transfusions, erectile dysfunction, or vaccinations, abortion coverage should be treated as an essential health benefit, not an outlier “variation” for which every insurance plan must make an exception.