General Assembly votes to repeal ban on abortion coverage by plans on state insurance exchange

Virginia lawmakers voted Tuesday to repeal a state law that prohibits plans on the state’s health insurance exchange from covering abortions.

The measure, sponsored by Sen. Jennifer McClellan, D-Richmond, and Del. Sally Hudson, D-Charlottesville, now heads to Gov. Ralph Northam’s desk.

“Abortion was the only legal and safe medical procedure that was explicitly prohibited for coverage on our state exchange,” Hudson said in an interview last month. 

Under current law, health exchange plans are barred from covering abortion services in all but narrow circumstances. Those included life-endangering pregnancies and conception resulting from rape or incest. Otherwise, any Virginian who purchased health care coverage through the state marketplace would be required to pay out-of-pocket for abortion services. 

Lawmakers passed the ban in 2011, soon after the passage of the Affordable Care Act. The federal law included its own caveats on coverage. Under the ACA, insurers cannot be required to cover abortion. And then-President Barack Obama also signed an executive order — still in effect today — that prohibited federal subsidies from being used to cover abortion except in the same limited cases of rape, incest, or life-endangering pregnancies. 

Hudson emphasized Tuesday that the state law does nothing to change the federal restrictions already in place.

“The bill will not require any health insurer to offer plans that cover abortion, nor will it require any patient to purchase a plan that covers abortion care,” she said.

Republicans had previously raised concerns that the measure would allow federal funds to go toward abortion services.

“I think that’s why you have a number of people that are concerned about the intent of the Hyde amendment,” Sen. Steve Newman, R-Bedford, said in January on the Senate floor, where the bill passed on a 20-18 vote. “Which is basically, there are some of us who believe that on this very controversial item, no tax money should be used in this way.”

Abortion is covered by many employer-provided plans, which aren’t regulated under the Virginia marketplace. But both McClellan and Hudson had concerns that the prohibition disproportionately impacted low-income residents who purchased benefits through the state exchange. Hudson said it was especially important amid the ongoing COVID-19 pandemic, as many Virginians have lost their jobs and employer-provided benefits.

Out-of-pocket abortion services can be significant. According to Planned Parenthood, prices often start at $460 for the procedure alone. That doesn’t include affiliated expenses, including sedation or the transportation and lost wage costs that many often shoulder.

The bill passed the House of Delegates on a 54-45 party-line vote on Tuesday. It narrowly cleared the Senate last month on 20-18 vote, with Republicans in the chamber also unanimously opposing the measure.

The vote is the latest step Democrats in Virginia have taken to roll back abortion restrictions enacted by the GOP since winning control of the General Assembly in 2019. Last year, lawmakers voted to repeal a state law that mandated an ultrasound and 24-hour waiting period before undergoing the procedure.