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Coverage for Abortion Services and the ACA

Impact of the Affordable Care Act on Health Coverage for Women

Signed into law on March 23, 2010, the ACA is a federal law that aims to ensure that U.S. citizens and legal residents have health insurance by requiring most individuals to obtain a minimum level of insurance coverage. This is to be achieved through a combination of public and private insurance expansions. The ACA was designed to expand health care coverage to the poorest uninsured by extending Medicaid eligibility to all qualifying individuals with incomes up to 138% of the federal poverty level (FPL).1 The 2012 Supreme Court ruling, however, had the effect of giving states the option to expand their Medicaid programs rather than requiring this expansion, as was the design of the ACA. As of January 2014, 25 states and the District of Columbia have expanded Medicaid eligibility, but 25 states have not, leaving millions of poor individuals without a pathway to affordable coverage.2

The ACA also includes reforms that aim to make insurance more affordable and accessible. Individuals with incomes above the federal poverty level will be able to obtain insurance through healthcare Marketplaces, also known as exchanges, which will offer a variety of plans from which they can purchase insurance. To help those with low and moderate incomes with the costs of insurance, the federal government will provide subsidies (in the form of premium tax credits) to eligible individuals and families with incomes between 100% and 400% FPL.3 All of the plans offered on the Marketplace must provide coverage for 10 Essential Health Benefits (EHB). Abortion services, however, are explicitly excluded from the list of EHBs that all plans are required to offer.

Introduction Federal and State Laws Regarding Coverage of Abortion Services