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Colorado’s effort to mandate abortion coverage by insurance companies advances

A Colorado bill that would require commercial insurance providers to cover abortions for patients without copays advanced through a House committee on Tuesday.

SB23-189 is one of a package of abortion bills that Colorado Democrats introduced this year to expand access and protections for abortion care.

In addition to covering abortions, the bill would require coverage and no-cost sharing for sexually transmitted infections treatment and vasectomies; remove prior authorization requirements for HIV medication; and create family-planning services coverage for people who are undocumented through the state’s reproductive health program. It also removes language from state law about who can refer minors to get contraception, including references to clergy, and it codifies federal requirements for preventative services coverage such as HIV prevention in case they are reversed at the federal level.

The bill does not change whether minors can access birth control on their own — they can already do so under current law — and it does not change the requirements for parental notification of abortions, said Jack Teter, policy director for Planned Parenthood of the Rocky Mountains.

Eight other states require private health insurance companies to cover abortions without copayments.

In 2020, Gov. Jared Polis said he wouldn’t sign off on bills with new health insurance mandates without specific cost analyses. An independent actuarial analysis released last month for SB 23-189 concluded that fewer unintended pregnancies would result in lower medical costs for pregnancy-related services, including for the insurance carriers, and that the bill would create more equity for low-income people of color.

The abortion coverage mandate would apply to all commercial plans regulated by the Colorado Division of Insurance — about 30% of Coloradans (“DOI” is noted on insurance cards for plans that this would apply to). It would not apply to federal or state-funded plans such as Medicaid because of the state constitution’s public funding ban for abortions passed in 1984. Employers would not have to provide such coverage if it conflicts with their “sincerely held religious beliefs.”

The cost of abortions varies, depending on medication or procedures, gestational age and pregnancy complications. For the vast majority of people, the cost without insurance coverage is $500-$800, Teter said.

Candace Woods, who is in the process of ordination with the United Church of Christ and has a seminary degree, testified in favor of the bill Tuesday because of its coverage of abortion care and vasectomies.

Woods had an abortion in 2018 in Colorado Springs. She was in graduate school and working full-time. Her insurance didn’t cover the cost of her medication abortion and clinic visit, but she said she knew she could not healthily parent a child with how her mental health was at the time. She ended up paying half the cost and her partner paid the other half, but she said there aren’t any good answers as to why it wasn’t covered.

“The birth control that failed was covered by my insurance. And if I had decided to stay pregnant and carry a pregnancy to term, all of that health care would have been covered, but my abortion was not,” she told The Denver Post.

Similarly, when Woods later had a bilateral salpingectomy — the removal of the fallopian tubes — that was covered by insurance. So it makes sense to her that vasectomies would be covered, too.

But anti-abortion opponents of the bill argued against the coverage Tuesday in the Health and Insurance Committee, citing personal responsibility, increased access for minors and coverage not being equitable for pregnancy and delivery.

Tom Perille of Democrats for Life of Colorado told committee members that “abortion is not health care” and asked why the state was prioritizing abortion rather than prenatal care and delivery.

The Colorado Catholic Conference also testified against the bill, with Executive Director Brittany Vessely saying the bishops’ group doesn’t believe it goes far enough with religious exemptions — employees could still sue under state civil rights employment laws for not providing coverage. Vessely also cited concerns that the bill would violate the state funding ban and reduce parental notification — both of which bill sponsors have disputed.

The bill passed along party lines and is headed to the House Appropriations Committee before being heard by the full House later this week.

Colorado newcomer and sociologist Ashley Blinkhorn told the members on Tuesday that she was delighted to be testifying in favor of a good bill, rather than one that harms people.

In 2016, she was living in Austin and spoke out against a then-proposed regulation by the Department of State Health Services to force women to bury or cremate aborted or miscarried fetal tissue — Blinkhorn had said she had two miscarriages by the time she was 25 and wouldn’t have been able to afford those costs, according to the Austin Chronicle.

“I can’t say enough good about it,” Blinkholn told Colorado lawmakers. “Making sure that people actually have access to things because this isn’t just an issue of life and preventing life. It’s an issue of preventing death.”

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