non-excepted abortion

Click to Enlarge the Full Invoice

My health insurance bill this week included $1 for “Non-excepted Abortion Services” which confused me. Firstly, I’m a guy. Secondly, despite this, I’d not actually had an abortion recently.

All of my friends I shared this with laughed (including many women) and a public health nurse who texted back, “WTF?” Another commented on my wisdom to purchase “Total Current Period Coverage” as well which she said would soon be more useful again. All of us began to wonder if the cost of abortions for men had now dropped to only $1 in Washington State — Justice Scalia would be rolling in his grave! (On second thought, he likely thought it’s just fine for men to have abortions.)

I was also perplexed because I’ve actually been trying to cancel my insurance with LifeWise since December having switched over to their sister company, Premera, which did not bill me for an abortion this month. I began to wonder if Lifewise meant that my request to abort their coverage was non-accepted and they would charge me a $1 for every time I kept asking them to cancel. This was the fourth invoice of the year they’d sent after I’d emailed reminding them of the switch.

None of the people I showed this to, including several professional women in the health care industry, had any idea what this might be for. All of us laughed. One friend sent me the congratulatory e-card above.

It turns out, the rest isn’t really funny. Google set me straight. According to the GAO Report on Non-excepted Abortion Services:

The Affordable Care Act “prohibits the use of federal funds made available to offset the cost of QHP [Qualified Health Plans] coverage—that is, income-based tax credits and subsidies—to pay for ‘non-excepted abortion services,’ which…are abortion services performed except where the pregnancy is the result of an act of rape or incest, or the life of the pregnant woman would be endangered unless an abortion is performed.

While QHPs may cover non-excepted abortion services, [the ACA] places requirements on the provision of such coverage. These include the requirement to estimate the cost of coverage of such services, at an amount of no less than $1 per enrollee, per month, and to collect from each enrollee an amount equal to the actuarial value of the coverage—segregated from any other premium amounts collected by the QHP—to be used to pay for the costs associated with providing non-excepted abortion services.

In other words, abortion isn’t treated like other health conditions like elective knee surgery or the craniotomy which at least partially aborted my brain tumor last year. Abortions are itemized separately from the premium that covers everything else to keep women’s health care unfairly politicized. The actual implementation may vary by plans in different states based on local variations in the law. And, it’s done so in such a way that little of the public knows what’s going on — it appears like some bizarre invoicing error.

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Posted by Jeff Reifman

Jeff is a technology consultant based in the Pacific Northwest.


  1. Thanks for posting this, Jeff. I was equally perplexed to see the $1 charge on my current Premera bill. Turns out I hadn’t noticed it in previous months. What a needlessly complicated provision. I appreciate your commentary on the topic.


    1. Thanks Erin. Weird for me that Premera isn’t charging me but Lifewise is – and they are the same company, different plans. Weird altogether.


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