The final legislation requires insurers that sell plans in new government-run exchanges to segregate payments for abortion coverage from other premiums to ensure government subsidies won’t go toward the procedure.
Still, many abortion opponents say that didn’t go far enough.
So lawmakers are turning to another provision in the legislation that says states can choose to prevent plans offered through their exchanges from covering abortion altogether. That would likely affect most individual and small-group plans in a state, starting when the exchanges launch in 2014.
The new state-level proposals are likely to rekindle abortion as a political issue in November elections. Many state candidates, particularly those running for governor and state legislature, may be forced to take a position on abortion coverage, said John C. Green, director of the Ray C. Bliss Institute of Applied Politics at the University of Akron. “Once an issue like this starts being debated in a state, everyone could become involved,” said Mr. Green, who studies how religion affects elections.
The debate could spill over to congressional races as well. But these are expected to largely turn on bigger-picture issues like the economy and the role of government, said Charlie Cook, who edits the Cook Political Report.
Since the beginning of this year, lawmakers in five states including Tennessee and Oklahoma have introduced bills that would generally block abortion coverage in exchange plans, according to the Guttmacher Institute, a research group that supports abortion rights.
In Mississippi, state Sen. Alan Nunnelee, who is a Republican candidate for Congress, plans to introduce a similar bill this month. The federal language in the health bill, Mr. Nunnelee said, is “absolutely not” enough to ensure that government funds don’t support abortion. Mr. Nunnelee is in a competitive congressional race this fall, according to the Cook Political Report.