Trump Administration To Make ACA Enrollees Pay $1 Billion In Order To Bill Abortion Separately
Starting in June, thanks to a new and incredibly stupid rule from the Trump administration, those who get their health care plans through the ACA will be getting two bills each month. One bill for their regular insurance, and another, separate bill just for "abortion coverage." This "abortion coverage" bill will amount to no less than $1 per enrollee and is mostly symbolic as insurance companies do not set aside a specific amount of money to be used on certain procedures.
Here is the rule itself, explained in an inordinately confusing way, from the Health and Human Services website:
CMS is finalizing that, beginning with an issuer's first billing cycle that starts on or after the date that is 6 months after publication of the final rule, QHP [Qualified Health Plan] issuers be required to: (1) send an entirely separate monthly bill to the policy holder for only the portion of premium attributable to coverage of certain abortion services, and (2) instruct the policy holder to pay the portion of their premium attributable to coverage of certain abortion services in a separate transaction from any payment the policy holder makes for the portion of their premium not attributable to such abortion coverage. QHP issuers sending paper bills will be permitted to send the separate paper bill in the same mailing as the separate bill for the rest of the enrollee's premium. QHP issuers sending bills electronically will be required to send the separate bill in a separate email or electronic communication. We are also finalizing that QHP issuers must instruct the policy holder to pay the separate bill in a separate transaction. However, if the policy holder fails to pay the separate bill in a separate transaction as instructed by the issuer, the issuer may not terminate the policy holder's coverage on this basis, provided the amount due is otherwise paid.
This whole thing -- they claim -- is meant to make the ACA compliant with the Hyde Amendment, a garbage law preventing federal funds from going towards abortion. Since some people get subsidies, no one can truly know whether the money covering their abortions comes from the money that they have personally paid towards their coverage or from the subsidies. This way, people who don't understand how insurance works can pretend that all of the money covering abortion comes directly from that $1 bill policy holders will get to pay -- separately -- every month.
In reality, it is meant to piss people off that they're having to pay for abortions if they don't need or believe in them -- and they have to do so inconveniently.
Naturally, this has made some forced birth enthusiasts very happy.
Via Washington Post:
"Consumers have a right to know if they are paying for elective abortion," said Archbishop Joseph F. Naumann of Kansas City, Kan., a USCCB official. "While the Affordable Care Act still allows government-subsidized plans to cover abortion, at least with this rule, Americans can now see and try to avoid complicity by choosing plans consistent with their consciences."
They could also do that before.
They could have, like anyone else, looked at what their plan covers and decided to choose a plan that did not cover abortion. In half of the states, this isn't even an issue because it is either illegal for insurance plans sold on the Marketplace to cover abortion, or for private insurance plans to cover abortion, period.
What this also means is that it will now cost insurance companies more to offer insurance that covers abortions than it would otherwise, because billing costs money. It does not happen by magic! That is extra work for someone, for which they must be paid. And the fact is, since insurance companies exist to make money (not to be glorious and benevolent dispensaries of "choice" or whatever line it is they're trying to sell these days), many of them will almost definitely choose not to cover abortion at all. Those that do will pass that cost on to you, the consumer. Health and Human Services states that this cost will come to over a billion dollars.
The insurance industry has said the changes would create huge burdens for them, including changing their billing software, managing double the payments and dealing with confusion from customers. HHS wrote that the total cost to insurers, exchanges and enrollees would reach $546.1 million in 2020 and then stabilize at $232.1 million in 2021, $230.7 million in 2022 and $229.3 million in 2023 and subsequent years.
That is over $1 billion in four years. Simply for some symbolic billing.
They will not, to be clear, simply pass that cost onto those who check some "Sure, I might have an abortion someday" box on their ACA application. They will be passing it on to everybody. Including the very people who are so very horrified by the very idea of "their money" going to fund abortion.
In fact, because it costs more than just not billing these things separately, more of those people's money will be going to fund abortion. Through their insurance payments.
I guess the hope here is that these insurance companies will give up and just not cover abortion at all and spark a whole new Victorian-style orphanage industry. Or, you know, those who don't want to be forced to give birth will just throw themselves down the stairs, stick a hanger up their hoo-ha, or drink some pennyroyal tea.
But whether abortion is billed with regular insurance or in a separate bill, whether it is legal or illegal, it will still happen and will, oftentimes, be paid for with money that has passed through the hands of someone who opposes abortion at one point or another, because that's how money works.
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Robyn Pennacchia is a brilliant, fabulously talented and visually stunning angel of a human being, who shrugged off what she is pretty sure would have been a Tony Award-winning career in musical theater in order to write about stuff on the internet. Follow her on Twitter at @RobynElyse