STEVE INSKEEP, host:
It's MORNING EDITION from NPR News. Good morning. I'm Steve Inskeep. Since the health care overhaul became law, we've been taking a closer look at some of its provisions. Today we exam two points, beginning with the bill's language on abortion.
Abortion opponents describe the new law as a major expansion of abortion rights, but that is not at all how abortion rights advocates view things. They see this as a potential rollback of insurance coverage for abortion that many women have now. And as NPR's Julie Rovner reports, several states are already moving to make that rollback a reality.
JULIE ROVNER: As the new health law was being written, the uneasy truths between abortion rights supporters and opponents was this: the law should neither expand nor contract existing abortion policy. Federal abortion funding is currently allowed in cases of rape, incest or when the life of the woman would be in danger by carrying the pregnancy to term.
But where that got complicated was in the new health insurance marketplaces the law calls for. They're called exchanges. That's where the federal government would subsidize many people's private policies. One option in the law would let states ban all abortion coverage in the exchanges.
Charmaine Yoest, president and CEO of the anti-abortion group Americans United for Life, said her group wasted no time drawing up a model state law to that effect. They sent it out the day after Congress approved the health bill.
Ms. CHARMAINE YOEST (President, Americans United for Life): It was a part of the legislation, and so we had a heads-up and we moved right in to make sure that we could equip states with the tools that they need to have the most effective opt-out possible.
ROVNER: So far at least three states - Missouri, Tennessee and Louisiana - are already moving to ban abortion coverage in the exchanges. And that's even though the exchanges themselves don't have to be up and running until the year 2014.
But even without new state laws, abortion rights advocates say the new federal health law is likely to make abortion less available for many women.
Ms. JUDY LICHTMAN (National Partnership for Women and Families): In general it has been the norm that private health plans provide abortion coverage.
Judy Lichtman is with the National Partnership for Women and Families, which supports abortion rights. She says the law in theory allows health insurance plans in the exchanges to offer abortion coverage.
Ms. LICHTMAN: However, it does so in a way that creates really serious disincentives to providing the coverage and very serious disincentives from people buying it.
ROVNER: Here's how it works. Under the law, insurance plans can offer coverage for abortion only if they offer it as a separate policy. Individuals or their employers will have to write two separate checks each month - one for the abortion coverage and one for all other coverage. And those premiums will have to be kept in separate accounts.
Timothy Jost, a law professor at Washington and Lee University, says he thinks that will all but eliminate health coverage for abortion in the new exchanges.
Professor TIMOTHY JOST (Washington and Lee University): This segregation of funds and strict auditing of the funds is going to be a real hassle for insurers, it's going to be a hassle for consumers. And you know, markets are going to lead people to the low cost, low hassle solution, which is plans that do not cover abortion.
ROVNER: And many women don't realize their plans don't cover abortion until it's too late. For example, in 2008, D.J. Feldman, a federal lawyer, had a fetus diagnosed with anencephaly. It's a birth defect where the brain, skull and spinal column fail to connect. Her doctor said an abortion was medically necessary. But her insurance claim was denied.
That's because federal health plans have long been barred from offering most abortion coverage. Feldman read from her denial letter at a news conference last year.
Ms. D.J. FELDMAN: Our medical experts determined that you could have carried to term because your life was not in danger. And by the way, you owe $9,000.
ROVNER: Stories like that could become a lot more common for women buying insurance in the new marketplaces.
Julie Rovner, NPR News, Washington.
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