Insurers covering maternity care required to cover abortions under new Washington law

Washington Gov. Jay Inslee signed a bill into law on Wednesday that requires health insurers covering maternity care to also cover abortion services.

While most insurers already provide that coverage, some Washington leaders and activists wanted to mandate it -- especially in the time of President Donald Trump's administration.

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Hobbs, along with Rep. Eileen Cody (D-Seattle) in the House, have pushed this bill in the upper chamber for years, but it hasn't passed despite some bipartisan support. When it was first discussed in 2012, it failed 26-23. With Democrats recently taking control of the Washington state Senate, Hobbs trusted that the shift in power would lead to swift passage.

The Washington State Legislature voted in favor of the measure in early March, and after some changes, the bill was sent to Inslee for his approval.

Before Inslee's approval, Washington state already had laws in place that protected reproductive health rights. Voters passed an initiative in 1991 that would keep protections in place for women in the event that Roe v. Wade is overturned. What SB 6219 focuses on is affordability of coverage.

The average cost for an abortion is around $650, and the monthly income of a full-time, low-wage worker in the Puget Sound region is $1,400, according to The Northwest Abortion Access Fund, an organization that helps women pay for care.

Activists say that this bill is a step forward to help alleviate the cost of an abortion for many women so they don't have to seek additional financial help. It would also set up a type of reimbursement program for women, including non-citizens, without insurance or who are on Medicaid.

But some families will still be left with high deductibles. Also, when a woman passes a certain point of pregnancy, the cost increases.

"I think [this bill is] a step in the right direction, but there's more work to be done. We need to push for cover for all folks: gender, sexual orientation, identify ethnicity and income levels -- where we can be furthering protection and expand that care," said Planned Parenthood communications manager Katie Rogers, who gave recommendations for the bill.

But right now, Rogers said with facing potentially harmful federal restrictions under the Trump administration on funding for legal abortion, the RPA would make sure that state law applies as broadly as possible without violating those restrictions.

Human Life of Washington, a right to life group, strongly opposes RPA. Its government relations expert Sarah Davenport-Smith says it forces taxpayers who are against contraception and abortion to pay for something they don't support.

"People who oppose abortion at any stage do so because it violates their conscience," she said. "Every citizen is guaranteed absolute freedom of conscience in all matters of religious sentiment, belief and worship. SB 6219 forces Washingtonians to go against their conscience and pay for abortions."

According to Davenport-Smith, while abortions and abortifacient drugs are legal, there is no requirement for taxpayers to fund them.

The political climate is also why the bill covers several rules for birth control access, said Tiffany Hankins, executive director of NARAL Pro-Choice Washington, a chapter of a national organization that supports women making personal decisions about their reproductive health.

Many of these rules ensuring contraceptive equity and affordability already existed through the Washington state insurance commissioner's office. Under their rules, most health plans currently must cover Food and Drug Administration-approved contraceptive methods prescribed by their in-network medical provider, and this is without people having to deal with copays, deductibles and coinsurance.

But having these rules in a bill strengthens those rules.

"You don't have reproductive rights if you don't access to health care," Hankins said. "We are looking the federal government casting doubt over the stability (of rules through the) insurance commissioners office. It's really important to regulate through state law to show what protections are in place at the state level, guarantees we can have a more advanced protections."

Now that the bill's passed, people could see changes as soon as 2019. It specifically applies to a health plan issued or renewed on Jan. 1, 2019.

Last year, the Trump administration proposed rules that would allow any company to deny coverage for contraceptive services to female employees based on religious grounds. Other types of organizations would also be able to deny coverage on moral grounds.

KIRO 7 talked to Sara Ainsworth of Legal Voice in the wake of the Trump administration's decision in October. She said that a Washington state insurance commisoner's office rule possibly protects women from it.
"We have a contraceptive equity rule through our insurance office that requires employers who do have religious objection to make sure that their women employees still have access to birth control coverage," she said.

That’s one rule that the RPA would not strengthen, according to Hankins, but it’s something lawmakers are looking into whether to pursue.

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