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Bill Would Exclude Elective Abortions in State Health Care Plans

The House Insurance Committee heard debate Tuesday on a bill that would prohibit the coverage of elective abortions in minimum state health plans, and would require women to opt into and pay more for abortion coverage.

State Rep. John Smithee (l), R-Amarillo, with a reporter off the House floor in 2011.

State Rep. John Smithee, R-Amarillo, told a committee of his colleagues on Tuesday that Texans should not be forced to pay for abortion coverage they don't want and won't use, and he urged the House Insurance Committee to approve House Bill 997.

“If we’re opposed to abortion for whatever reason, or we say we’re not going to have an abortion, we can’t be forced to buy coverage for a procedure, an elective abortion, that we would not use,” Smithee, who leads the committee, said. “If you don’t feel that way, you are able to purchase extra coverage.”

Anti-abortion and pro-choice advocates lined up to debate Smithee's bill, which the committee left pending. The measure would prohibit the coverage of elective abortions in minimum state health insurance plans, including the health care exchange program — a set of government-regulated plans that are eligible for federal subsidies — unless the mother’s life is at risk. The bill would allow women to opt into abortion coverage, but they would pay extra to do so.  

Since the passage of the Affordable Care Act in March 2010, at least 17 states have chosen not to include abortion coverage in minimum health care plans, according to the National Conference of State Legislatures

Opponents of HB 997 said that the bill would unfairly exclude low-income women who might seek abortions. And they argued that the measure does not clearly define when a woman’s life is “at risk.” The bill would also not require coverage of elective abortions in cases of pregnancy resulting from rape or incest.

Blake Rocap, legislative director for Pro-Choice Texas, gave a hypothetical example of a pregnant woman diagnosed with cancer for whom doctors recommend pregnancy termination. Since her life would not necessarily be in immediate danger, her insurance would not have to cover the abortion. 

“This committee will never know every woman’s circumstance,” Rocap said. “She and her family will always be in a better position to make that decision.”

The Texas Hospital Association also urged lawmakers to consider requiring coverage in cases where the fetus has severe abnormalities.

Supporters of the bill say it would require health care providers to be more transparent with their costs. 

“Right now, Texans are paying for abortion coverage that they don’t know is in their plans and that they’ll never use,” said John Seago, legislative director for Texas Right to Life. “This is a customer transparency issue.” 

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Health care State government Abortion Texas Legislature