Abortion Coverage By State: In 31 States, Obamacare Plans Offer Limited Or No Such Options For Women

For a woman with Obamacare insurance seeking an abortion, the odds are slim her health insurance plan will cover the procedure, unless — depending on the state — her life is endangered or she has been a victim of rape or incest. That's because 25 states either ban abortion coverage in plans sold on Affordable Care Act exchanges or limit it to those specific instances, and six states simply do not have Obamacare plans offering abortion coverage at all, an analysis by the nonprofit Kaiser Family Foundation found.

The findings come amid a rising spate of limitations that further restrict access to abortions for women in the United States, including requirements on who can perform abortions, when they can be performed, how they can be funded, how long a woman must wait before getting one and other factors, according to the Washington-based Guttmacher Institute, which does research and policy analysis on reproductive health.

Under the Affordable Care Act, every plan sold on exchanges created by the law must cover 10 essential health benefits. Abortion is not one of them. Federal law does not require any plan to offer abortion coverage; rather, every single marketplace is required by 2017 to have at least one plan that excludes abortion coverage.

Of the 25 states that currently ban abortion coverage, 11 allowed exceptions for rape, incest or threat to the mother's life, 12 had exceptions that were narrower than that, and two states, Louisiana and Tennessee, had no exceptions whatsoever, Kaiser's analysis found. Six other states — Delaware, Iowa, Minnesota, Nevada, West Virginia and Wyoming — simply lacked abortion coverage altogether in their plans. And even in states that did not ban abortion coverage, actual access to and availability of those plans varied by county.

The only way women can receive subsidies to help offset the cost of health insurance is by purchasing their health insurance through Obamacare exchanges.

Since 1977, under the rule known as the Hyde Amendment, federal funds cannot be used for abortion unless the mother's life is threatened or she's been a victim of rape or incest. Kaiser's findings underscored not an issue of funding but the question of women's ability to access and purchase private health insurance plans that would cover abortion.

Some 10 million women of reproductive age (ages 15-49) live in the United States and lacked insurance in 2014. An estimated 2.3 million of those women qualified for federal subsidies to offset the cost of health insurance, provided they bought plans through Obamacare exchanges. And of those women, 62 percent would not have access to a health insurance plan that covers abortion beyond some of the exceptions noted because of the state in which they lived, Kaiser found.

Every year, more than 1 million women in the U.S. have abortions. The cost of an abortion varies but can range from a few hundred dollars to more than $1,650.