Tag Archives: Healthcare

Trump eviscerates health insurance birth control mandate

Supporters of contraception rally before Zubik v. Burwell, an appeal brought by Christian groups demanding full exemption from the requirement to provide insurance covering contraception under the Affordable Care Act, is heard by the U.S. Supreme Court in Washington, U.S., March 23, 2016. REUTERS/Joshua Roberts/File Photo

By Sarah N. Lynch and Caroline Humer

WASHINGTON/NEW YORK (Reuters) – President Donald Trump’s administration on Friday eviscerated requirements under the Obamacare law that employers provide insurance to cover women’s birth control, keeping a campaign pledge that pleased his conservative Christian supporters.

Administration officials said two new federal rules will let any non-profit or for-profit entity make religious or moral objections to obtain an exemption from the law’s contraception mandate. The changes also let publicly traded companies obtain a religious exemption.

The move drew fire from reproductive rights advocates and praise from a conservative Christian activists. California’s Democratic attorney general pledged to fight to protect the mandate from circumvention. It remained unclear how many women would lose contraception coverage and which companies would use the exemptions.

“The Trump administration just took direct aim at birth control coverage for 62 million women,” Planned Parenthood Federation of America President Cecile Richards said in a statement.

“This is an unacceptable attack on basic healthcare that the vast majority of women rely on. With this rule in place, any employer could decide that their employees no longer have health insurance coverage for birth control,” Richards added.

Trump, who criticized the birth control mandate in last year’s election campaign, and won strong support from conservative Christian voters. The Republican president signed an executive order in May asking for rules that would allow religious groups to deny their employees insurance coverage for services they oppose on religious grounds.

The U.S. Department of Health and Human Services on Friday moved to broaden those narrow religious exemptions to include an exception “on the basis of moral conviction” for non-profit and for-profit companies.

The contraception mandate was one provision of the 2010 Affordable Care Act, Democratic former President Barack Obama’s signature legislative achievement, also called Obamacare.

The law required employers to provide health insurance that covers birth control, but religious houses of worship were exempted. Some private businesses sued regarding their rights to circumvent such coverage, and the Supreme Court ruled in 2014 that they could object on religious grounds.

“All Americans should have the freedom to peacefully live and work consistent with their faith without fear of government punishment,” the conservative Christian legal activist group Alliance Defending Freedom said in a statement praising the administration’s action.

“HHS has issued a balanced rule that respects all sides – it keeps the contraceptive mandate in place for most employers and now provides a religious exemption,” said Mark Rienzi, one of the lawyers for the Little Sisters of the Poor, an order of Roman Catholic nuns that runs care homes for the elderly and previously challenged the mandate in court.

“The Little Sisters still need to get final relief in court, which should be easy now that the government admits it broke the law,” Rienzi added.

The Little Sisters and other Christian nonprofit employers objected to a 2013 compromise offered by the Obama administration that allowed entities opposed to providing contraception insurance coverage to comply with the law without actually paying for the required coverage.

California Attorney General Xavier Becerra said he was “prepared to take whatever action it takes” to defend the mandate that health insurers provide birth control.

The administration’s new contraception exemptions “are another example of the Trump administration trampling on people’s rights, but in this case only women,” Becerra told Reuters.

The Justice Department on Friday released two memos that will serve as the government’s legal basis for justifying the rule and laying out a framework for how apply religious liberty issues in legal opinions, federal rules and grant making.

One memo instructs Justice Department employees to incorporate its legal arguments on religious freedom into litigation strategies and how they review rules. A second memo used a similar directive to government agencies to be used in the course of “employment, contracting and programing.”

(Reporting by Sarah N. Lynch in Washington and Caroline Humer in New York; writing by Will Dunham; Editing by David Gregorio)

House Republicans seek $1 billion in Medicaid funds for Puerto Rico

A local resident sits on the roof of his home that was damaged by Hurricane Maria in Guaynabo, Puerto Rico, October 2, 2017. REUTERS/Alvin Baez

WASHINGTON (Reuters) – Puerto Rico, struggling to recover from hurricane damage, could receive $1 billion in additional funding for the Medicaid health insurance program for the poor under a proposal from a U.S. House of Representatives panel, a congressional aide said on Tuesday.

Republicans who lead the House Energy and Commerce Committee included the request for more Medicaid funding for Puerto Rico as part of a separate bill to reauthorize the Children’s Health Insurance Program. It is scheduled to be considered and voted on in committee on Wednesday.

The U.S. territorial island, hard-hit by Hurricane Maria, already had faced a drop-off of Medicaid funding at the end of the year, according to the Washington Post, which first reported Republicans’ plan.

Now Puerto Rico also faces massive damage from Maria that wiped out much of its infrastructure, left hospitals struggling and residents without clean water, electricity and cellphone service.

Committee spokeswoman Jennifer Sherman said the panel would take up the bill on Wednesday as part of its effort to renew funding for the larger U.S. children’s insurance program, which saw its funding expire during the weekend.

Under the proposal, Puerto Rico would receive $880 million through 2019. It also would get another $120 million if its financial oversight board certified that the joint federal-state program there had taken steps to prevent fraud and abuse and improve efficiency, among other oversight steps.

Lawmakers sought to pay for the additional Medicaid funding by charging higher premiums on wealthier people in the Medicare health insurance program for seniors, and redirecting some prevention health funding from community-based health centers, among other changes, according to a copy of the plan.

Republican U.S. President Donald Trump visits the island on Tuesday amid criticism over his administration’s response to the storm. [nL2N1ME09T]

About 3.4 million people live in Puerto Rico, which in recent years had faced recession and, in May, bankruptcy.

(Reporting by Susan Cornwell; Writing Susan Heavey; Editing by Bill Trott)

Senators close to bipartisan deal on health exchanges: Schumer

FILE PHOTO - Senate Minority Leader Chuck Schumer speaks with reporters following the party luncheons on Capitol Hill in Washington, U.S., September 26, 2017. REUTERS/Aaron P. Bernstein

WASHINGTON (Reuters) – Two U.S. senators from both parties are close to finalizing a bipartisan deal to shore up the health insurance exchanges created under Obamacare, the chamber’s top Democrat said on Thursday.

The move, which Senate Democratic Leader Chuck Schumer said was “on the verge” of completion, would stabilize the market for individuals who buy their own insurance plans on the federal or state-based exchanges.

The potential agreement comes after Republicans have repeatedly failed to carry out their years-long pledge to repeal and replace the 2010 Affordable Act, former Democratic President Barack Obama’s signature healthcare overhaul.

Schumer said Senate Health, Education, Labor and Pension Committee Chairman Lamar Alexander, a Republican, and ranking Democrat Patty Murray had resurrected a bipartisan approach, which had been cast aside amid the latest near-vote on a repeal bill.

Alexander and Murray had been working to protect the government payments made to insurers to help reduce medical expenses for low-income Americans enrolled in Obamacare. Alexander also wanted states to have more flexibility to design insurance plans under the program.

“They both inform me that they’re on the verge of an agreement, a bipartisan healthcare agreement to stabilize markets and lower premiums,” Schumer said on the Senate floor on Thursday.

The pact could buoy health insurance companies, which came out forcefully against the Republican repeal effort and have faced uncertainty since the November election of Republican President Donald Trump, who vowed to sink the law.

While the majority of insured Americans receive coverage through their employers or government programs such as Medicare and Medicaid, more than 10 million people have individual plans through the online exchanges, and about 11 million are expected to sign up next year.

Most of these consumers receive income-based tax credits and subsidies to reduce costs. Insurers have filed their premium rates for 2018, many of which are expected to rise at least 20 percent because of uncertainty that the government will continue paying some of those subsidies.

Despite those worries, insurers on Wednesday signed contracts with the government that will result in every U.S. county having at least one company selling Obamacare plans.

Trump has signaled that his administration would take other action to unwind the law, and on Wednesday said he would sign an order next week allowing people to buy insurance coverage across U.S. state lines.

Republican Senator Rand Paul, who has been pushing for the move, says Trump can do this by legalizing nationwide health associations that individuals could then join.

(Reporting by Susan Heavey; Editing by Lisa Von Ahn)

Obamacare repeal in U.S. Senate collapses as Republicans falter

Protesters, mostly handicapped, line the hallway outside the Senate Finance Committee hearing room hours ahead a hearing on the latest Republican effort to repeal Obamacare on Capitol Hill in Washington, U.S., September 25, 2017. REUTERS/Kevin Lamarque

By Susan Cornwell

WASHINGTON (Reuters) – Another Republican attempt to dismantle Obamacare collapsed in the U.S. Congress on Tuesday as the party was unable to win enough support from its own senators for a bill to repeal the healthcare reform law.

Several Republican senators said there will be no vote in the Senate after some lawmakers withheld support for the measure.

“We basically ran out of time,” said Senator Ron Johnson.

Senator Pat Roberts, another Republican, told reporters the party would target healthcare “in some form” later in the current legislative session.

Failing to carry through on a 7-year-old effort to roll back the 2010 healthcare law would be an embarrassing setback for Republicans and a heavy blow for President Donald Trump, who vowed during the 2016 election campaign to scrap Obamacare.

After losing a Senate vote on repealing Obamacare in July,

Republicans tried again this month with a bill that would take

federal money and give it to the states in block grants to regulate their own healthcare systems.

But several Republican senators refused to back the latest bill, including Senator Susan Collins, who on Monday complained that it undermined the Medicaid program for the poor and disabled and weakened protections for people with pre-existing conditions, such as asthma, cancer and diabetes.

Trump said on Tuesday his administration was disappointed in “certain so-called Republicans” who did not support the bill.

Republicans hold a slim 52-48 majority in the Senate and

at least two other Republican senators, John McCain and Rand Paul, had earlier rejected the bill.

Republicans have tried for years to get rid of the Affordable Care Act, or Obamacare, but they were up against a Sept. 30 deadline to pass a bill with a simple majority, or face a much tougher path toward dismantling it.

(Reporting by Susan Cornwell and Richard Cowan; Additional reporting by Susan Heavey; Writing by Alistair Bell; Editing by Kevin Drawbaugh and Bill Trott)

Obamacare repeal on the ropes as pivotal Republican rebuffs Trump

U.S. Senator John McCain (R-AZ) (C) departs after the weekly Republican caucus policy luncheon at the U.S. Capitol in Washington, U.S. September 19, 2017. REUTERS/Jonathan Ernst

By Susan Cornwell and Yasmeen Abutaleb

WASHINGTON (Reuters) – U.S. Senator Susan Collins rebuffed intense lobbying from fellow Republicans and the promise of money for her state in deciding on Monday to oppose – and likely doom – her party’s last-ditch effort to repeal Obamacare.

The most moderate of Republican senators joined John McCain and Rand Paul in rejecting the bill to end Obamacare. It was a major blow for President Donald Trump who has made undoing Democratic former President Barack Obama’s signature healthcare law a top priority since the 2016 campaign and who pressured Collins in a call on Monday.

The bill’s sweeping cut in funding to Medicaid, a program for low income citizens and disabled children, was her top reason for opposing the bill, said Collins, from the state of Maine where 20 percent of the population depend on the program.

“To take a program that has been law for more than 50 years, and make those kinds of fundamental structural changes … and to do so without having in depth hearings to evaluate the impact on our most vulnerable citizens was unacceptable,” Collins said outside the Senate chambers.

She also opposed the bill for weakening protections for people with pre-existing conditions, such as asthma, cancer and diabetes.

Collins’ decision came even after the sponsors of the bill, Senators Lindsey Graham and Bill Cassidy, offered a boost in federal health care funds of 43 percent for Maine and benefits for states with other undecided senators.

Republicans have vowed to get rid of the Affordable Care Act, or Obamacare, since it was passed in 2010. While it extended health insurance to some 20 million Americans, they believe it is an unwarranted and costly government intrusion into healthcare, while also opposing taxes it imposed on the wealthy.

Republicans hold a slim 52-48 majority in the Senate and are up against a tight September 30 deadline to pass a bill with a simple majority, instead of the 60-vote threshold needed for most measures. Senate Majority Leader Mitch McConnell wanted to hold a vote this week, but it is not clear he will do so now that three senators have said they will cast “no” votes.

Graham dismissed notions that the bill was the last chance for Republicans to get rid of Obamacare and pledged to keep working on the legislation.

$1 TRILLION CUT TO MEDICAID

Democrats kept up their pressure for killing the bill. In an evening speech on the Senate floor, Senate Democratic leader Chuck Schumer said, “The Trumpcare bill would gut Medicaid, would cause millions to lose coverage, cause chaos in the marketplace.”

Schumer said once repeal of Obamacare is off the table, Democrats want to work with Republicans “to find a compromise that stabilizes markets, that lowers premiums.”

Collins and McCain, who voted against the last major repeal effort in July, have both advocated for a bipartisan solution to fixing the parts of Obamacare that do not function well.

U.S. hospital stocks were down across the board as the bill struggled. Shares of HCA Healthcare Inc and Tenet Healthcare Corp were hit particularly hard, falling 2.5 percent and 5.7 percent, respectively, on Monday.

“The Graham-Cassidy bill is looking to reduce funding for Medicaid in the longer term,” said Jefferies analyst Brian Tanquilut. “That is a benefit that we have seen improve the earnings outlooks for these hospitals.”

Collins announced her opposition shortly after the non-partisan Congressional Budget Office said that the number of people with health insurance covering high-cost medical events would be slashed by millions if it were to become law.

CBO also found that federal spending on Medicaid would be cut by about $1 trillion from 2017 to 2026 under the Graham-Cassidy proposal, and that millions of people would lose their coverage in the program, mainly from a repeal of federal funding for Obamacare’s Medicaid expansion.

The Trump administration, including Health Secretary Tom Price had lobbied her hard in recent days, Collins said.

“The president called me today, the vice president called me in Maine over the weekend, Secretary Price has called me, it would probably be a shorter list of who hasn’t called me about this bill,” she said.

Trump had not called Collins before the vote in July.

PROTESTERS IN WHEELCHAIRS

The Senate held its first hearing all year on the proposed Obamacare repeal on Monday, but it was immediately disrupted by protesters who forced Senate Finance Committee Chairman Orrin Hatch to postpone its start by about 15 minutes.

Police arrested 181 demonstrators, including 15 in the hearing room. The protesters, mainly from a disability rights group and many of whom were in wheelchairs, were forcibly removed one-by-one from the hearing room as they yelled, “No cuts to Medicaid, save our liberty.” The hearing eventually proceeded for about five hours, but protests could be heard outside for more than an hour.

Television talk show host Jimmy Kimmel, who had become part of the debate on U.S. healthcare legislation in May after discussing his newborn son’s heart surgery, had taken aim at the bill in recent days. On Monday he tweeted: “Thank you @SenatorCollins for putting people ahead of party. We are all in your debt.”

A new CBS poll released on Monday said that a majority of Americans, or 52 percent, disapprove of the Graham-Cassidy bill, while 20 percent approve. The poll was taken between Sept. 21 and 24.

(Reporting by Susan Cornwell and Richard Cowan; Additional reporting by Timothy Gardner, Philip Stewart, Makini Brice, Amanda Becker and Alistair Bell in Washington and Caroline Humer in New York; writing by Timothy Gardner; Editing by Bill Trott and Mary Milliken)

Anthem cuts back Obamacare coverage in Missouri to 68 counties

FILE PHOTO: The office building of health insurer Anthem in seen in Los Angeles, California February 5, 2015. REUTERS/Gus Ruelas

NEW YORK (Reuters) – U.S. health insurer Anthem Inc said on Friday that it will no longer offer Obamacare plans in 17 counties in Missouri but will remain in the bulk of the state, covering 68 counties that would not otherwise have Obamacare coverage for their residents.

Health insurers are facing an upheaval in their businesses amid growing uncertainty about healthcare legislation under President Donald Trump, who seeks to follow through on his promise to dismantle former President Barack Obama’s signature healthcare law, formally known as the Affordable Care Act.

Insurers such as UnitedHealth Group Inc, Aetna Inc and Humana Inc have exited most of the states where they sold Obamacare plans, leaving hundreds of U.S. counties at risk of losing access to private health coverage in 2018.

But other insurers, including Centene Corp, have filled those gaps, expanding into counties that had lost their coverage options.

Every U.S. county is currently projected to have at least one insurer offering Obamacare individual coverage next year. Still, 1,476 counties could have only one insurer in 2018.

(Reporting by Michael Erman; Editing by Steve Orlofsky)

Mylan, U.S. finalize $465 million EpiPen settlement

EpiPen auto-injection epinephrine pens manufactured by Mylan NV pharmaceutical company for use by severe allergy sufferers are seen in Washington, U.S. August 24, 2016. REUTERS/Jim Bourg/File Photo

By Nate Raymond

BOSTON (Reuters) – Mylan NV <MYL.O> has finalized a $465 million settlement resolving U.S. Justice Department claims it overcharged the government for its EpiPen emergency allergy treatment, which became the center of a firestorm over price increases.

The U.S. Attorney’s Office in Massachusetts on Thursday announced the accord, which was soon after criticized by some congressional members as being too easy on the drugmaker. It came 10 months after Mylan said it had reached a deal.

The settlement resolved claims that Mylan avoided higher rebates to state Medicaid programs by misclassifying EpiPen as a generic product, even though it was marketed and priced as a brand-name product.

“Taxpayers rightly expect companies like Mylan that receive payments from taxpayer-funded programs to scrupulously follow the rules,” Acting U.S. Attorney William Weinreb said in a statement.

Under the deal, Mylan did not admit wrongdoing. It will reclassify EpiPen and pay the rebate applicable to its new classification as of April 1, 2017.

“Bringing closure to this matter is the right course of action for Mylan and our stakeholders to allow us to move forward,” Mylan Chief Executive Heather Bresch said in a statement.

The deal followed a False Claims Act whistleblower lawsuit filed by French rival Sanofi SA <SASY.PA> in 2016, two years after it first raised the matter with authorities, Weinreb’s office said.

Sanofi, which formerly marketed a rival product called Auvi-Q, will receive nearly $38.8 million as a reward from the government.

Sanofi in a statement called pursuing the matter “the right thing to do.” It has a separate antitrust lawsuit pending alleging Mylan engaged in illegal conduct to squelch competition to EpiPen.

Mylan shares rose 2.10 percent to $31.11 on the Nasdaq.

The EpiPen, which Mylan acquired in 2007, is a handheld device that treats life-threatening allergic reactions by automatically injecting a dose of epinephrine.

Mylan came under fire last year after raising the price of a pair of EpiPens to $600, from $100 in 2008, enraging consumers and putting it in the center of the ongoing U.S. debate over the high cost of prescription medicines.

Mylan has since offered its own generic version for about $300. The company announced it had reached a Justice Department settlement in October.

Some congressional members previously criticized the $465-million settlement as too small. U.S. Senator Richard Blumenthal, a Democrat from Connecticut, renewed that position on Thursday, calling it “completely insufficient.”

A U.S. Department of Health and Human Services’ Office of Inspector General analysis released in May found the U.S. government may have overpaid for EpiPens by up to $1.27 billion between 2006 and 2016.

“Absolving Mylan from a finding of wrongdoing has cleared the way for the company to pocket the money it embezzled from an American public in desperate need of lifesaving and affordable medications,” Blumenthal said in a statement.

Republican Senator Chuck Grassley of Iowa in a statement called the accord a “disappointment,” saying it “looks like the settlement amount short-changes the taxpayers.”

Mylan shares were up 0.1 at $30.50 in late trading.

 

(Reporting by Nate Raymond in Boston; Editing by Nick Zieminski)

 

End of U.S. payments to health insurers would cause premiums to rise: CBO

FILE PHOTO: A patients room is pictured at a medical center hospital in San Diego, California, U.S., April 17, 2017. REUTERS/Mike Blake

By Yasmeen Abutaleb

WASHINGTON (Reuters) – Health insurance premiums for many customers on the Obamacare individual insurance markets would be 20 percent higher in 2018 if U.S. President Donald Trump follows through on a threat to stop billions of dollars of payments to health insurers, a nonpartisan congressional office said on Tuesday.

The Congressional Budget Office also found that terminating the payments would mean that 5 percent of Americans would live in areas that do not have an insurer in the individual market in 2018. However, the agency estimated that more insurers would participate by 2020 because they will have observed how the markets work without the payments and most people would be able to purchase insurance.

The CBO’s assessment echoes concerns raised by insurers over the past several months, who have said that terminating the payments would cause premiums to rise.

Trump has repeatedly threatened to withhold the payments, called cost-sharing reductions, which amount to about $7 billion in 2017 and help cover out-of-pocket medical expenses for low-income Americans. Trump has derided the payments as a “bailout” for insurance companies.

The CBO found that the number of uninsured would be slightly higher in 2018 but slightly lower in 2020 as more insurers joined the market. It also found that premiums would be 25 percent higher by 2020, which would increase the amount of government-provided tax credits to help shield low-income people from premium increases.

Several insurers have cited the uncertainty over the payments in raising insurance premiums by double digits for 2018 or in exiting some individual insurance markets.

Anthem Inc, one of the largest remaining Obamacare insurers, earlier this month scaled back its offerings in Nevada and Georgia and blamed the moves in part on uncertainty over the payments. Blue Cross and Blue Shield of North Carolina earlier this year raised premiums by more than 20 percent, but said it would have only raised premiums by about 9 percent if Trump agreed to fund the payments.

The payments are the subject of a lawsuit brought by House Republicans against the Obama administration that alleged they were unlawful because they needed to be appropriated by Congress. A judge for the federal district court for the District of Columbia ruled in favor of the Republicans, and the Obama administration appealed the ruling.

The Trump administration took over the lawsuit and has so far delayed deciding whether to continue the Obama administration’s appeal or terminate the subsidies. That case became more complicated earlier this month when a U.S. appeals court allowed Democratic state attorneys general to defend the payments and have a say in the legal fight.

The administration has decided month-to-month whether to continue the payments. Its next installment is due Aug. 21.

Trump has grown increasingly frustrated as Republicans, who control the White House, Senate and House, have been unable to pass a repeal or replacement of the Affordable Care Act, former Democratic President Barack Obama’s signature domestic policy achievement. After the Senate effort failed in July, Trump tweeted days later threatening to stop the payments.

The CBO estimated the federal deficit would increase by $194 billion from 2017 through 2026 if the payments are terminated.

(Reporting by Yasmeen Abutaleb; Editing by Michele Gershberg and Chris Reese)

Anthem to exit Obamacare market in Virginia next year

FILE PHOTO: The office building of health insurer Anthem is seen in Los Angeles, California February 5, 2015. REUTERS/Gus Ruelas/File Photo

(Reuters) – U.S. health insurer Anthem Inc <ANTM.N> said on Friday it will exit Obamacare markets in Virginia and reduce its plan offerings in Washington and Scott counties and the city of Bristol next year.

The move comes nearly two weeks after President Donald Trump took aim at insurers by threatening to cut the healthcare subsidy payments that make Obamacare plans affordable, after repeatedly failing in his efforts to dismantle former President Barack Obama’s healthcare law.

Insurers are facing an upheaval in their health insurance businesses due to uncertainty over the healthcare legislation as Republican lawmakers seek to follow through on their promise to repeal and replace the Affordable Care Act.

Health insurers, such as UnitedHealth Group Inc <UNH.N>, Aetna Inc <AET.N> and Humana Inc <HUM.N>, have also exited most of the states where they used to sell plans.

The insurers have asked the government to commit to making the $8 billion in subsidy payments for 2018, saying they may raise rates or leave the individual insurance marketplace if there is too much uncertainty.

On Monday, Anthem said it would no longer offer Obamacare plans in Nevada’s state exchange and half of Georgia’s counties in 2018.

The company said on Friday it will only offer off-exchange plans in Washington and Scott counties and the city of Bristol.

Hundreds of U.S. counties are at risk of losing access to private health coverage in 2018 as health insurers consider pulling out of those markets in the coming months.

Last week, Molina Healthcare Inc <MOH.N> said it would stop selling Obamacare plans in Utah and Wisconsin.

(Reporting by Divya Grover in Bengaluru; Editing by Shounak Dasgupta)

Texas bill restricting insurance coverage for abortions nears approval

Texas bill restricting insurance coverage for abortions nears approval

By Jon Herskovitz

AUSTIN, Texas (Reuters) – A Texas bill that would restrict insurance coverage for abortions was approved by the state’s Republican-controlled House of Representatives on Wednesday, a move critics called cruel and damaging to women’s health.

The House measure would ban insurance coverage for abortions and require women who wanted coverage to purchase a supplemental plan for an abortion, the latest effort by the most-populous Republican-controlled state to place restrictions on the procedure.

If enacted, the bill would take effect on Dec. 1 and make Texas the 11th state to restrict abortion coverage in private insurance plans written in the state.

The Republican-dominated Senate has passed a similar bill, and Republican Governor Greg Abbott has shown support for the measures.

The bill’s backers say it would protect abortion opponents from subsidizing the procedure. A Democratic critic decried it as forcing people to buy “rape insurance.”

“It’s a question of economic freedom and freedom in general,” Republican Representative John Smithee, the bill’s sponsor, said in House debate on Tuesday ahead of the bill receiving preliminary approval.

The Republican sponsor of the Senate bill, Brandon Creighton, has told local media supplemental coverage would cost $12 to $80 a year

House Bill 214, which passed mostly on a party-line vote, does not offer exceptions for cases of rape or incest. Abortion rights groups are likely fight the measure in court if enacted.

“Women and parents will be faced with the horrific decision of having to purchase ‘rape insurance’ to cover them if they are victimized,” Democratic Representative Chris Turner said in a statement. “This is not only ridiculous, but it is cruel.”

Idaho, Kansas and Oklahoma are among the 10 other states that make abortion coverage a supplement on private plans. There are 25 states with restrictions on abortion coverage in plans set up by state exchanges as part of the Affordable Care Act under former Democratic President Barack Obama, according to the Guttmacher Institute, which tracks such legislation.

“It is surprising that Texas has not done this before,” said Elizabeth Nash, senior state issues manager for Guttmacher.

The insurance measure is one of several bills concerning abortion before Texas lawmakers in a special session that runs through next week.

The Senate has already approved bills that include requiring physicians to improve notification of complications that occur during abortions and another that prohibits local governments from having contracts with abortion providers and their affiliates.

(Reporting by Jon Herskovitz; Editing by Colleen Jenkins and Lisa Shumaker)