Insurance mandate for abortion care starts for some N.J. health benefits plans

Some health insurers in New Jersey will be required by state law to fully pay for abortion care this year, with coverage already kicking in Jan. 1 for people covered by individual, small-employer, and state health benefits plans.

Coverage for people insured by larger employers — those with more than 50 workers — will start sometime later this year after a state-mandated rules-making process is completed.

The changes come after Gov. Phil Murphy signed a law last January intended to make abortion more accessible and affordable in New Jersey. Abortion care can cost hundreds to thousands of dollars in out-of-pocket expenses, depending on stage of pregnancy, type of termination, and associated costs like transportation, according to the health care site GoodRX.

Under the new law, Murphy directed the state Department of Banking and Insurance to study the necessity and impact of mandating insurance coverage for abortions and, if the department deemed a mandate worthy, to set up regulations.

The department released that study last month, finding that mandated coverage would reduce confusion among consumers about what their plan covers, align with medical experts’ opinion that abortion is essential to reproductive health, and remove the cost barrier for residents who can’t afford abortions.

Providers estimated that covering abortion care would cost .1% or less of insurance premiums, so the mandate isn’t expected to significantly impact rates, according to the department.

The mandate doesn’t affect all health insurance plans. It applies only to those regulated by the state, which include state Medicaid and individual, small-employer, and large-employer markets. Less than 20% of residents are covered under such state-regulated commercial health plans, according to the New Jersey Association of Health Plans.

New Jersey is the eighth state nationally to require abortion coverage in private health insurance plans.