Special Rules – oh boy

Section 1303 starts out very tame. And by tame, I mean that it says that States can pass laws that prohibit abortion in their Exchange plans, if the States want to. Nothing controversial there, nope. It goes on for several paragraphs about this. If you do provide abortions in your Exchanges, you of course cannot use any of the money the Federal government gave you, unless they are for rape, incest, endangerment of the life of the mother (because of the Hyde Amendment).

It also explains how the coverage for abortions (which by the way, the plan refers to as coverage of services described in paragraph (1)(B)(i) – presumably because they didn’t want to keep drawing attention to the actual service in question) will be paid for, how the premiums will be collected, and then kept in segregated accounts, to be used for just those services described in paragraph (1)(B)(i). They minimum premium will be $1. So essentially, once this goes into place, if you ever want an abortion, or think that they should be paid for by your health insurance, you have pay $12 a year. It’s unclear from this writing how that would work, exactly. Would only women pay? If so, that would violate the previous sections on prevention of discrimination by sex. Would men pay if they supported insurance paid abortion? Would the insurance plan just charge everyone, and then you could opt out if you didn’t want to (the economically more efficient way to do it)?

Then there is a bunch of CYA stuff. This section doesn’t preempt state law, or federal law. You can’t discriminate against providers that don’t provide abortions, or institutions that don’t allow them. It doesn’t affect Civil Rights Laws. It doesn’t change current law about Emergency Services.

And, of course, it shouldn’t surprise you that this is the only Special Rule. Because our country is Special.

Section 1304 is definitions. Large Market. Small Market. Group Market. Individual Market. Large Employer. Secretary. No sense in repeating that here – just look them up if you want to know. Although, I will point out that one of the things they define is “Educated Health Care Consumers” which they define as an individual who is knowledgeable about the health care system, and has background or experience in making informed decisions regarding health, medical, and scientific matters, but could also be defined as “human unicorn”.


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