RU-486: Most Insurers Will Cover, But Obstacles Remain
Antiabortion groups at the state level have moved to restrict the use of mifepristone through new state laws, the Washington Post reports. Officials from nearly two dozen antiabortion groups also said that they planned to ensure that mifepristone fell under the jurisdiction of existing state laws -- such as requiring parental consent and waiting periods for abortions and prohibiting public funding of the procedure and abortion counseling by state employees. According to some abortion foes, states with laws requiring doctors to examine fetal tissue could "force women to collect the products of their drug-induced miscarriages and take them to their doctor's office" to deter use of mifepristone. Other abortion-rights opponents, such as Indiana Right to Life Executive Director Michael Fichter, favor extending "conscience based exemption" laws, which permit health care workers to refuse participation in abortions, to hospital pharmacists "on the front line" of distributing mifepristone to physicians. In Michigan, Michigan Right to Life Legislative Director Ed Rivet said his group will attempt to include mifepristone in a bill banning state-funded coverage for surgical abortions. Other groups plan to lobby states to pass "safety" restrictions, "informed consent legislation" and other bills to help curb abortion after legislatures return to session. "I think states will first be looking to tweak existing abortion laws to specifically include (RU-486) and all non-surgical abortions, and then they'll go from there," Laura Tobler, senior policy specialist for the National Conference of State Legislatures in Denver, said. According to NARAL, state lawmakers, especially in the Midwest, introduced 439 bills to restrict abortions last year, and Betsy Cavendish, NARAL's legislative director, expects "them to continue their onslaught and open up a new front on mifepristone." Center for Reproductive Law and Policy President Janet Benshoof warned, "It's not a magic pill that will make the burdensome restrictions on abortion in each state vanish. ... [A]ntiabortion state legislatures have already erected a labyrinth of law restricting all abortions" (Claiborne, Washington Post, 10/5).
Insurers Contemplate Coverage
Although several insurers have said they will cover mifepristone, medical abortions are "potentially laden with prohibitions" and access difficulties, the Wall Street Journal Europe reports. Cigna, United HealthCare, and Aetna will cover the pill as a standard benefit, although the latter will allow employers to exclude it from coverage if they wish. Kaiser Permanente and Empire Blue Cross and Blue Shield of New York have said they will treat mifepristone as any other FDA approved medicine. Danco Laboratories, the producer of mifepristone, has not asked the American Medical Association for a "so-called insurance code" for the medical abortion procedure, which is necessary for providers to charge insurance companies or Medicaid. Even so, mifepristone will not alter the fact that 29 states' Medicaid programs do not pay for abortions because of a federal statute prohibiting the use of federal funds for the procedure except in cases of rape or incest. Other factors may determine the availability of mifepristone, such as the more "cumbersome" aspects of medical abortion, including multiple visits to physicians. Richard Hausknect, medical director of Danco, said, "For those of us who were trained to be surgeons, this will require some rethinking." The National Abortion Federation has already trained more than 1,800 physicians to provide and counsel women on the drug, but Gloria Feldt, president of Planned Parenthood, said that "training is the most pressing obstacle on the medical front at this point" (Zimmerman, Wall Street Journal, 10/3).