Louisiana sets the stage for a free market experiment: Would prohibiting insurers from paying for abortions drive down the price of abortions?
On April 22, 2010 Louisiana's House of Representatives passed a bill
that would prevent insurers from covering abortion in any insurance plan offered through Louisiana's health exchange.House Bill 1247
would stop insurers from covering any elective abortion - defined under the statute as "an abortion for any reason other than to preserve the life of the mother when her life is endangered by a physical disorder, physical illness, or physical injury, including a life-endangering physical condition caused by or arising from the pregnancy itself."
An open question in the health care marketplace is whether a procedure being covered by insurance drives up the cost of this procedure. For some sense of how long the question has been open, and how hard it's been to fashion an experiment to test the question, read about Rand's Health Insurance Experiment
, a study that started in 1971 to find out how much medical care people would use if medical care were free, and the effect this would have on their health; also check out this
1995 article in the New England Journal of Medicine that largely takes off from the Rand HIE (if you're not a subscriber to the NEJM - and, really, shouldn't you be? - you can access a PDF of the article here
But now we may have ourselves a petri dish in which to find out what will happen to a procedure's price when that procedure ceases to be covered by insurance. Will consumers of elective abortions become more price conscious and
demand that the price of abortions in Louisiana come down?
We need baseline numbers, of course, including the number of abortions in Louisiana now being covered by insurance, and how much they cost:
A call to one Louisiana clinic
for numbers led to a confused sounding staffer asking me to call back tomorrow to speak with the clinic's medical director regarding the question of how many abortions are covered by insurance. The price we got, however: a first trimester abortion is $425, and by the second trimester the price goes up every week - at 14 weeks an abortion costs $575, at 16 weeks it costs $625, etc. Side note: I had no idea that abortions were priced according to the week of the pregnancy!
If this bill were to become law, let's check in again in 2015, a year after the state health insurance exchanges go into effect.