One Question

At Gov. Jay Inslee's first press conference last week, a reporter asked the new governor why he wanted to pass the Reproductive Parity Act. (Inslee gave the pro-choice legislation a shoutout in his inaugural address; it was the only specific piece of legislation he called for in his whole speech. The legislation, co-sponsored by Sen. Steve Hobbs, D-44, and Sen. Steve Litzow, R-41, would require every insurance policy that covers maternity care to also cover abortion.) 

“Insurance plans in the state, from my understanding, already cover abortion, as most maternity care, so what's the need for this?” the Seattle Times asked Inslee.

“The need is to make a very clear guarantee to women that that is the case,” Gov. Inslee replied, “When we adopt statutes it’s an assurance, it’s a confidence level, and frankly it’s a statement for future decades… We should have a decision to extend liberty and privacy to all Washington women.”

Nice political speech. But despite Inslee's passionate pro-choice answer, he left the actual technical question unanswered: Is signing the Reproductive Parity Act necessary or is it largely symbolic? (Inslee's inaugural speech shoutout pissed off the Republicans.)

PubliCola's One Question goes to Planned Parenthood. Is the RPA really necessary?

Trying to guarantee insurance coverage in state statute

Jennifer Allen, Director of Public Policy at Planned Parenthood Votes Northwest, says the Reproductive Parity Act is absolutely necessary. “There seems to be an interesting idea going around that we have a law on the books that requires insurance funding for abortion. Not true,” she says.

There is no existing state statute that requires insurance carriers to cover abortion. She's correct. We checked with legislative staff at the state. There is no existing state statute that requires insurance carriers to cover abortion, though most here do anyway. Nor does the Affordable Care Act, which complicates the issue, require insurance companies to cover abortions.  (State law, passed by voters in 1991, does mandate that women have access to abortion—and because insurers in Washington currently provide it—abortion services are granfathered into our local ACA guidelines through 2015.)

What Obamacare does do is allow insurance companies that cover abortions to participate in federally funded exchanges, assuming state law doesn't prohibit it. If they choose to do so, though, they must set up a dual-payment system in which women receiving subsidies will have to pay a separate premium for abortion coverage—creating a financial burden for women and an administrative hassle for insurance companies. 

“The reason why it’s really critical that we pass the Reproductive Parity Act is that [insurance coverage for abortion] is almost certainly going to go away following implementation of the Affordable Care Act," Allen says. 

“Insurance companies are businesses, and they like to homogenize their product. If you have to manage another product [i.e. abortion coverage], it gets harder and you’re less likely to do it. ... They'll have to operate a whole parallel insurance plan to their existing insurance plan, collect money from buyers of that plan, put the funds in a separate account, and pay with those separate funds.”

And by making more women eligible for Medicaid, the ACA also subjects more women to the Hyde Amendment, which says no federal funds may be used to pay for abortions. 

“Here’s what I can tell you. If we don’t do something to protect [abortion coverage], it will go away.”

ACA provisions are decided on a state-by-state basis, just as Washington state is currently defining how our own exchage will work. Since the passage of the ACA, 17 states have passed legislation that restricts insurance coverage for abortion in their insurance exchanges.

Washington state, of course, has a long pro-choice history—we were the first to legalize abortion by popular vote, in 1972—and a pro-choice governor. But that's no guarantee that the state will always favor abortion rights.

Last year, the RPA died during a late-session dispute over the senate budget.

Sen. Litzow, a pro-choice Republican, but a fiscal conservative, who helped kill the RPA in the budget vote, along with Democrat Hobbs, reintroduced the pro-choice legislation in January. Hobbs, a fiscal conservative himself, but a liberal on social issues, sponsored the bill last year.