Michigan will join more conservative states in requiring residents who want health insurance coverage for abortions to buy an extra policy, after Republican legislators passed the law on Dec. 11 over the objections of Democrats who pleaded for them to take the issue to voters instead.
The citizens' initiative approved 62-47 by the House and 27-11 in the Senate - almost entirely along party lines - will become law in March without the signature of Republican Gov. Rick Snyder, who vetoed similar legislation a year ago. The anti-abortion group Right to Life collected more than 300,000 signatures to put the legislation before lawmakers, who also had the option of letting it go to a statewide vote next November.
The law prohibits insurance companies from offering abortion coverage as part of both public and private health plans, except when a woman's life is at risk. Employers and individuals who want abortion coverage must buy supplemental policies, known as riders.
Michigan is the ninth state to restrict private plans from covering the procedure. Seven of the states - Idaho, Kansas, Kentucky, Missouri, Nebraska, North Dakota and Oklahoma - allow patients to purchase riders, just as Michigan will. Utah doesn't allow even supplemental coverage of elective abortions but lets general plans cover the procedure when the woman's life in endangered, her health is severely compromised or in cases of rape, incest or fetal impairment.
Several states, including Wisconsin, have approved broad abortion limits in recent months, but Michigan is a swing state that has generally stayed away from the tougher restrictions.
Michigan's law won approval after emotional debate on the chamber floors, which included Democratic female legislators telling personal stories in opposition to what they called "rape insurance" legislation that is among the most misogynistic they have seen.
Trying to hold back tears, Democratic Senate Minority Leader Gretchen Whitmer of East Lansing disclosed that she was raped more than 20 years ago.
"Thank God it didn't result in a pregnancy because I can't imagine going through what I went through and then having to consider what to do about an unwanted pregnancy from an attacker," she said. "If this were law then and I had become pregnant, I would not be able to have coverage because of this. How extreme, how extreme does this measure need to be?"
Opponents said 4 percent of Michigan's population shouldn't be able to dictate health care for women, a reference to the number of people who signed the petition to bring the issue to lawmakers. But Right to Life said abortion isn't health care and applauded legislators for standing firm.
Republican Rep. Margaret O'Brien of Portage said in an interview after session that she rejects the "notion that women only have one way of thinking" about abortion. She noted that federal law says abortion riders sold through the new government health insurance exchange can't cost less than $1 a month, so comprehensive abortion coverage should be available.
"I respect the seriousness of the emotions. I went through an unplanned pregnancy. I've counseled people who've been raped that has resulted in pregnancies. ... But I've also seen women who've embraced those babies through rape and seen that that child shouldn't be punished for the horrendous act that happened to them."
Of the roughly 23,000 reported abortions in Michigan last year - the second-fewest in 30 years - health insurance covered 739, or 3.3 percent, according to state statistics.
Low-income women on Medicaid already must pay out of pocket for abortions except when their life is at risk or in cases of rape or incest. Other women may not have insurance that covers abortions or they don't want their employer or family to find out they're having the procedure.
A thrust behind the law is keeping taxpayer-subsidized plans on Michigan's insurance marketplace from covering abortions, an option for states under the federal health care law. With Michigan's move, 24 states now restrict abortion coverage in plans offered through their insurance exchanges. But the state says none of the 73 plans being offered to individuals covers what the industry calls elective abortions. Three of the 68 small employer plans do.
The initiative's biggest practical effect will be on plans sold outside the exchange, and the governor cited concerns about government overreach and no exceptions for rape, incest or the woman's health as reasons for his earlier veto.
All 26 Republicans and one Democrat in the Senate voted for the initiative Wednesday, with 11 Democrats opposed. In the House, all 59 Republicans, two Democrats and one independent supported it, and 47 Democrats voted against it.