Good News, Everyone: You don't have to start paying Trump's Abortion bills for awhile longer!

In U.S. politics, the Hyde Amendment is a legislative provision barring the use of federal funds to pay for abortion except to save the life of the woman, or if the pregnancy arises from incest or rape. Legislation, including the Hyde Amendment, generally restricts the use of funds allocated for the Department of Health and Human Services and consequently has significant effects involving Medicaid recipients. Medicaid currently serves approximately 6.5 million women in the United States, including 1 in 5 women of reproductive age (women aged 15–44).

Federal dollars can't be used to pay for abortion outside of the above restrictions, but Medicaid is funded via hybrid federal/state funding, so there are 15 states where Medicaid does pay for abortion using the state's portion of the funding.

The Hyde Amendment has popped up as an issue many times, and I've written about it more than a few times even in cases where I didn't mention it directly, such as this post regarding Planned Parenthood funding, but I've obviously mainly focused on writing about Hyde as it relates to the Affordable Care Act.

This is an incredibly long, dumb story; for the full version, read the details here.

The short version is that for reasons which get too stupid to delve into today, a year and a half ago the Trump Administration came up with an insane new regulatory rule for Americans enrolled in ACA-compliant individual market policies:

Trump administration proposes new rule requiring separate premium bills for abortion coverage

The Trump administration wants insurers that offer plans through Access Health CT, Connecticut’s Affordable Care Act exchange, and other exchanges nationwide, to send people separate monthly bills for the cost of their abortion coverage — in addition to the bill they get for their regular premium costs.

This means people would receive two separate bills in the mail or electronically — one to cover the premium costs for services such as primary care, mental health, maternity, etc. — and another one solely for the cost of their abortion coverage premium.

People on the exchange would also have to make two separate payments for these bills, according to a proposed rule recently released by the Centers for Medicare and Medicaid Services (CMS).

Yes, that's right: The Trump Administration is now insisting that insurance carriers send out separate bills for $1.00 per month per enrollee, specifically for "Abortion Services" or whatever the euphemistic language they decide to go with is. Between printing, postage, processing and so forth, there's a good chance it will cost the carriers more than $1.00 per enrollee anyway, which will lead some of them to drop abortion coverage from their policies altogether, which is of course the entire point.

In addition, this will humiliate and embarrass many women enrolled in the policies as they're further degraded by having an extremely personal and sensitive medical issue specifically called out. And of course I guarantee that thousands of people will end up receiving late payment notices (potentially even losing their coverage eventually) even when they pay their premiums regularly because they didn't notice the second invoice for a mere $1.00 that shows up each and every month.

It's actually even worse than that, because...

...Insurers would be required to bill all consumers at least $1 per enrollee per month (even if a consumer’s premium is less than $1 per month because of APTCs). In addition, insurers must actually transmit the bills separately—they must be sent to enrollees in separate envelopes with separate postage or in separate emails—from communications about the plan’s overall premium. HHS, somewhat bewilderingly, suggests that this would “help reduce consumer confusion about receiving two separate bills in a single envelope.” Insurers must also develop separate invoices or bills for non-Hyde abortion services.

As you might expect, this absurd new rule (which was supposed to go into effect this summer) led to lawsuits:

California Attorney General Xavier Becerra and New York Attorney General Letitia James, leading a coalition of eight attorneys general, filed a motion for summary judgment in their case against the U.S. Department of Health and Human Services (HHS) for its unlawful reinterpretation of Section 1303 of the Affordable Care Act (ACA), which limits healthcare coverage including reproductive care. On December 27, 2019, HHS issued a final rule requiring qualified health plans participating in the state exchanges like Covered California to send and collect separate bills—one for a health insurance premium and one of at least one dollar for abortion coverage. If a consumer misses the one dollar payment, they could lose all coverage on the exchange. This onerous and confusing requirement threatens women’s access to abortion and puts millions at risk of accidentally losing their health insurance coverage. Today’s motion argues that the new rule violates federal law and is inconsistent with the ACA and therefore should be vacated. 

It's important to note that this gets even more complicated, because while some states legally bar abortion from being covered by ACA policies at all, there are other states where they're legally required to cover abortion...

77% of those impacted by this live in one of the following states: California, Colorado, Connecticut, DC*, Idaho, Maryland, Massachusetts, Minnesota, New York, Rhode Island, Vermont or Washington. What do 11 of these 12 have in common? That's right: They're all blue states, and in fact [three] of them (CA and NY, along with Oregon) legally require carriers to include abortion coverage.

I'm sure that's just a coincidence, though.

Anyway, that brings me to today's update:

BREAKING: Federal district judge in Maryland just enjoined the Trump admin's rule requiring insurance companies to bill separately for abortion coverage. @ACLU and @PPFA sued earlier this year. Judge says it's "arbitrary and capricious" & violates the ACA.

— Alice Miranda Ollstein (@AliceOllstein) July 10, 2020

Ollstein doesn't provide any additional details as of yet, so I don't know how long the policy has been delayed for, but at least for the moment, millions of people won't have to put two separate invoices in the mail every month...