For Consumers

Kreidler: Trump rule on abortion payment needlessly harms consumers, risks their coverage

Commissioner instructs health plans to continue to follow state law

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January 30, 2020

OLYMPIA, Wash. – Washington state Insurance Commissioner Mike Kreidler has instructed health insurers to continue following state law by sending consumers a single bill for their monthly premium. They also should continue segregating the portion of the premium they collect to pay for abortion services excluded by federal law, as required by the Affordable Care Act. 

Kreidler’s instructions are in response to questions insurers have raised about a new federal rule that would require health insurers selling plans in exchanges to send consumers two bills each month – one for $1 to cover certain abortion services and one for the rest of their coverage. The rule is scheduled to take effect in June. 

“There’s no logic in requiring two bills,” Kreidler said. “It’s unnecessary. I understand they want people to know that part of their premium pays for abortion services. But consumers may not understand why they’re getting two bills each month. If they’re confused by multiple bills, or miss the second bill, and fail to pay their premium, they risk losing coverage. I believe our approach fully complies with state law and the requirements of the Affordable Care Act, and avoids putting consumers at risk of losing coverage.

“I strongly encourage Washington Attorney General Bob Ferguson to challenge the federal rule. I would fully support him in this effort.” 

The Affordable Care Act prohibits any federal funds – including premium subsidies and cost-sharing subsidies – from being used to pay for abortion, except in the case of incest or rape. 

To make sure insurers comply with the Affordable Care Act, Kreidler adopted a rule in 2013 instructing health insurers how to comply with the requirements to segregate funds without creating unnecessary confusion for consumers. That approach was adopted into state law in 2019. 

Current Washington state law requires all insurers selling in the exchange to:

  • Bill enrollees with one invoice for all services.
  • File accounting plans with the insurance commissioner on how premium will be segregated to meet federal law. 
  • Hold the portion of premium for abortion services in a separate account. 
  • Certify each year that its accounting practices meet the requirements of the Affordable Care Act and state law.