The U.S. leads the pack in the percentage of older adults who have trouble paying their medical bills.
By Julian Walker
Even as health benefit exchanges bring the promise of more medical coverage for Virginians, access to abortion could become further restricted.
Abortion services could be more limited under an amendment being developed by Gov. Bob McDonnell's staff to graft onto legislation aligning Virginia health insurance statutes with the federal health care law. It is likely to mirror one the governor put on a 2011 health benefits exchange bill; with few exceptions, it prohibited abortion coverage on insurance offered through an exchange.
Now, it's being considered as an add-on for two bills - SB921 and HB1900 - submitted to prepare Virginia for changes coming under the health care act in 2014.
It's permissible under the Affordable Care Act, which stipulates abortion coverage can't be mandated as part of a compromise negotiated when the bill was in Congress.
An aide to McDonnell characterized the amendment in the works as "a necessary, technical modification to existing state policy."
"Two years ago, the General Assembly passed legislation, allowed under the Affordable Care Act, to exclude abortion coverage from state exchanges," said Tucker Martin, a spokesman for the governor.
"Now that the Commonwealth will be participating in the federal plan, rather than a state-based exchange, the language simply has to be updated to reflect that change," added Martin, calling it "a continuation of existing state policy."
Family Foundation president Victoria Cobb said an amendment would "ensure that Virginians are not forced to underwrite abortion" and is consistent with state policy.
Not everyone sees it that way. Sen. John Watkins, R-Powhatan County, said he has asked McDonnell not to amend his SB921 and worries how far a potential amendment could go.
Watkins said his bill "deals with plans inside and outside of an exchange," noting that an amendment drawn too broadly could restrict abortions in private insurance plans, something that would go "way too far" in his view.
McDonnell's 2011 amendment prohibited abortion coverage in any "qualified health insurance plan that is sold or offered for sale through an exchange established or operating in the Commonwealth." It made exceptions for abortions when the life of a mother is endangered by a pregnancy, or pregnancy resulting from rape or incest.
Del. Terry Kilgore carried that legislation two years ago. This year, he has one of the bills to permit state agencies to perform plan management functions for health benefit plans to participate in a federal exchange, so he's mindful of how a McDonnell amendment could unsettle things.
"It could be a problem," said Kilgore, R-Scott County, noting Democrats who helped pass health insurance conformity bills might oppose an abortion amendment.
Del. Tom Rust remains skeptical such an amendment will be offered, noting that if one were presented, he'd consider it unfriendly.
"No one has officially talked to me about it," said Rust, R- Fairfax County. "I've just heard some rumors about it."
Democrats asked about the possible amendment Monday weren't pleased to hear it's on the table.
Del. Patrick Hope of Arlington County called the idea "outrageous." And Sen. Donald McEachin of Henrico County said restricting marketplace options run contrary to Republican free market economic principles in order to continue a "war on women in Virginia."
Health benefits exchanges are online marketplaces through which moderate-income individuals and small businesses can purchase health insurance, some with government subsidies.
Figures from the Urban Institute suggest that in Virginia about 283,000 individuals and 232,000 small-business employees could participate in the exchanges in 2014.
States are required to have exchanges as condition of the health care act - McDonnell has said Virginia will have a federal model. Friday is the deadline for the state to let the federal government know whether it plans for a partnership exchange.
Pilot writer Amy Jeter contributed to this report.
Julian Walker, 804-697-1564, firstname.lastname@example.org
An amendment is being considered as an add-on for two bills - SB921 and HB1900 - submitted to prepare Virginia for changes coming under the health care act in 2014. The Affordable Care Act stipulates that abortion coverage can't be mandated.