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2024 Annual Public Policy Forum, December 4, 2024 REGISTER

Requirements for comprehensive abortion coverage by insurers in the individual and small employer markets in New Jersey went into effect Jan. 1, for the 2023 plan year.

The state Department of Banking & Insurance conducted a study last fall that found a need for regulatory action to require coverage for abortion services under state-regulated health benefits plans. The study was mandated by the Freedom of Choice Act signed into law by Gov. Phil Murphy earlier in 2022.

The Individual Health Coverage Program and the Small Employer Health Benefits Program boards began the process last month to implement coverage changes and the boards voted unanimously on Dec. 29 to formally accept the changes.

“Adoption of these changes will reduce barriers and expand access to comprehensive reproductive health care in the new year,” said DOBI Commissioner Marlene Caride.

DOBI regulates the individual market, which includes plans offered through Get Covered New Jersey, the state’s official Health Insurance Marketplace, and off the marketplace, the small employer market, and the large employer market.

The changes approved by the two boards affect the individual and small employer markets. The requirement would take effect in the large employer market after the rules process under the Administrative Procedure Act is completed in 2023.

As part of its study, the department requested specific information from carriers and conducted an analysis of available data on the cost and possible impacts to insurance coverage if coverage for abortion was required in the regulated markets.

Carriers in the individual and small employer markets in New Jersey were asked to provide the impact of covering abortion without exception as part of their 2023 rate filings. DOBI said that health insurance carriers estimated a range of zero impact to 0.1% of premium.