A5116

An Act concerning mandatory health insurance coverage of abortions and amending P.L.2021, c.375.

Be It Enacted by the Senate and General Assembly of the State of New Jersey:

1. Section 3 of P.L.2021, c.375 (C.26:2S-39) is amended to read as follows:

3. a. Upon concluding a study and issuing a report to the Governor and the Legislature demonstrating that such a regulation is necessary, the Department of Banking and Insurance may, through regulation adopted pursuant to the "Administrative Procedure Act", P.L.1968 c.410 (C.52:14B-1 et seq.), provide that health benefit plans delivered, issued, executed, or renewed in this State, provide coverage for abortion. If the department provides for coverage pursuant to this section, then the department shall also require carriers to grant, upon request of a religious employer, an exclusion under the contract for the coverage required if the required coverage conflicts with the religious employer's bona fide religious beliefs and practices. A religious employer that obtains such an exclusion shall provide written notice thereof to covered persons and prospective covered persons, and the carrier shall provide notice to the Commissioner of Banking and Insurance in such form and manner as may be determined by the commissioner. The provisions of this paragraph shall not be construed as authorizing a carrier to exclude coverage for care that is necessary to preserve the life or health of a subscriber. An exclusion from an insurance coverage mandate granted to a religious employer pursuant to this section shall not be considered a violation of section 2 of P.L.2021, c.375 (C.10:7-2).

b. If the department provides for coverage pursuant to this section, a carrier shall only provide coverage for abortion to any covered person who requests that abortion be covered as part of the covered person’s health benefits plan.

c. Any covered person, with a health benefits plan in effect prior to the enactment of P.L. , c. (C. ) (pending before the Legislature as this bill) that provides abortion coverage, shall be entitled to a reimbursement of the portion of premiums paid that is attributable to the previous plan year’s abortion coverage, if, when renewing the plan or agreeing to a new plan, the covered person does not request abortion coverage.

d. For the purposes of this section, "religious employer" means an organization that is organized and operates as a nonprofit entity and is referred to in section 6033(a)(3)(A)(i) or (iii) of the Internal Revenue Code of 1986 (26 U.S.C. s.6033), as amended.

(cf: P.L.2021, c.375, s.3)

2. Section 4 of P.L.2021, c.375 (C.52:14-17.29hh) is amended to read as follows:

4. A contract providing hospital or medical expense benefits purchased by the State Health Benefits Commission may shall provide coverage for abortion. A contract providing hospital or medical expense benefits purchased by the commission shall not exclude a provider from its network or otherwise restrict services from the provider solely on the basis that the provider is a religious employer, as defined in section 3 of P.L.2021, c.375 (C.26:2S-39), that refuses to provide abortion services. A contract providing coverage for abortion shall only provide coverage to a person covered thereunder who requests that abortion be covered as part of the contract. Any person covered thereunder, with a contract for hospital or medical expense benefits in effect prior to the enactment of P.L. , c. (C. ) (pending before the Legislature as this bill) that provides coverage for abortion, shall be entitled to a reimbursement of the portion of premiums paid that is attributable to the previous contract year’s abortion coverage, if, when renewing the contract or agreeing to a new contract, the covered person does not request abortion coverage.

(cf: P.L.2021, c.375, s.4)

3. Section 5 of P.L.2021, c.375 (C.52:14-17.46.6q) is amended to read as follows:

5. A contract providing hospital or medical expense benefits purchased by the School Employees' Health Benefits Commission may shall provide coverage for abortion. A contract providing hospital or medical expense benefits purchased by the commission shall not exclude a provider from its network or otherwise restrict services from the provider solely on the basis that the provider is a religious employer, as defined in section 3 of P.L.2021, c.375 (C.26:2S-39), that refuses to provide abortion services. A contract providing coverage for abortion shall only provide coverage to a person covered thereunder who requests that abortion be covered as part of the contract. Any person covered thereunder, with a contract for hospital or medical expense benefits in effect prior to the enactment of P.L. , c. (C. ) (pending before the Legislature as this bill) that provides coverage for abortion, shall be entitled to a reimbursement of the portion of premiums paid that is attributable to the previous contract year’s abortion coverage, if, when renewing the contract or agreeing to a new contract, the covered person does not request abortion coverage.

(cf: P.L.2021, c.375, s.5)

4. This act shall take effect on the first day of the twelfth month next following enactment and shall apply to health benefits plans that are delivered, issued, executed or renewed in this State, or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act.

STATEMENT

This bill requires health insurers (health, hospital and medical service corporations, commercial individual and group health insurers, health maintenance organizations, health benefits plans issued pursuant to the New Jersey Individual Health Coverage and Small Employer Health Benefits Programs, the State Health Benefits Program, and the School Employees’ Health Benefits Program) to provide coverage for abortion only if a person covered under the health benefits plan requests abortion coverage under the plan. The bill also provides that a covered person be reimbursed for the portion of premiums paid that are attributable to a plan’s abortion coverage, if the plan included abortion coverage before the enactment of this bill and, when renewing the plan or agreeing to a new plan, the covered person does not request abortion coverage.

It is the intent of the sponsor that the provisions of the bill provide an individual with the freedom to exercise the individual’s religious, moral, and ethical beliefs without interference from the State. It is also the intent of the sponsor to remedy any potential violations, under present law, of the First Amendment of the United States Constitution by providing an option within the bill for individuals to exempt themselves from a health benefit plan’s abortion coverage.