Insurance coverage limits for abortions advanced

Senators advanced a bill March 2 that would limit health insurance coverage for abortions in Nebraska.

The federal Patient Protection and Affordable Care Act allows each state to opt out of offering abortion coverage through qualified health plans offered in the act under a health insurance exchange.

LB22, introduced by Omaha Sen. Beau McCoy, would opt out of allowing health insurance plans operating under an exchange to cover abortions unless necessary to prevent the death of a woman or to treat medical complications arising from an abortion.

Additionally, the bill would prohibit private health insurance policies in the state from providing coverage for an abortion, except through an optional rider paid for solely by the insured. A health insurance plan issuer would be prohibited from providing any incentive or discount to an individual who chooses abortion coverage via a rider.

McCoy said Nebraskans who object to abortion on moral grounds should not have to contribute to an insurance premium pool that covers the procedure.

“Nebraska has a long history of not allowing taxpayer dollars to be used for abortions and we’re extending that to private insurance,” he said. “Our premium dollars go into a pool and that is why private insurance is included in this [bill].”

McCoy offered an amendment, adopted 36-2, which removed some intent language from the bill.

Omaha Sen. Jeremy Nordquist supported LB22, saying it reflects the state’s values.
“I think it’s a policy that the majority of Nebraskans support,” he said.

Omaha Sen. Brenda Council spoke in opposition to the bill. She said allowing an individual to purchase a rider to cover a potential future abortion would create different levels of insurance coverage and inconsistent public policy.

“I think that flies squarely in the face of the professed desire of this [Legislature] to reduce or prevent abortions,” Council said.

Lincoln Sen. Danielle Conrad also opposed the bill, in part, because it provides no exception for cases of rape or incest. Medicaid coverage provides exceptions in those two cases, she said, but LB22 is more prohibitive.

“I think [the bill] sets up an inequity and disparity based on socioeconomic status,” Conrad said. “It may provoke some equal protection challenges.”

Malcolm Sen. Ken Haar offered an amendment that would have allowed abortion coverage in cases of rape or incest. Calling failure to provide an exception “enormously callous,” Haar said the bill as written would compound the traumatic impact on a woman who became pregnant as a result of either crime.

“This seems so obvious to me,” he said.

Lexington Sen. John Wightman supported the Haar amendment, saying a law without such an exception lacks empathy.

“I think it’s a reasonable exception,” he said.

The Haar amendment failed on a 12-28 vote.

Conrad offered, and later withdrew, an amendment that would have required qualified health insurance plans to cover preventative reproductive health services, including contraception.

“The one area where we should have common ground is prevention and education,” Conrad said. “If we’re serious about reducing abortion in Nebraska then we must focus on some of those common sense policies.”

Omaha Sen. Brenda Council offered an amendment that would have replaced the provisions of LB22.

The amendment instead would have isolated health insurance premium funds designated for abortion coverage in a separate allocation account.

She said the amendment would preserve the original intent of preventing state funded abortions, but also would avoid unintended consequences by providing the option to purchase a rider for abortion coverage.

The amendment failed on a 10-32 vote.

Omaha Sen. Gwen Howard offered an amendment that would have required insurance companies to cover children who have pre-existing conditions.

Because LB22 would deny abortion coverage to women, she said, there should be an obligation to provide health coverage to their children.

“Life doesn’t end at birth,” she said. “That is when all of our responsibilities to that child begin.”

McCoy challenged the germaneness, or relevance, of the amendment, saying it did not pertain to the subject matter of LB22.

The chair ruled the amendment not germane to LB22 and Howard challenged the ruling.

“I feel this amendment is germane,” Howard said. “It is regarding children.”

“Children can be born into our society and left to a system that may or may not care for them,” she said. “If we are going to say a child should be born then we need to say that we are going to give that infant the care they deserve.”

Sen. Fulton agreed the amendment was germane.

“If an expectant mother knew there was insurance waiting for her, it might make it more likely that she would chose the life of the child,” Fulton said.

Senators voted 24-16 to sustain the ruling of the chair, and Howard’s amendment was not considered further.

Haar offered another amendment that would have required any health insurance plan offered in the state to provide an optional rider for elective abortions, saying that “it levels the playingfield.”

Under LB22, insurance companies that offer abortion riders could be stigmatized, Haar said, forcing them to stop offering abortion riders.

The amendment was defeated 35-4 and the bill advanced from general file on a 36-9 vote.