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E&C Democrats Alarmed by New Report Identifying Serious Medicaid Abortion Coverage Violations in 15 States

Feb 8, 2019
Press Release
“The failure of states to cover these medically necessary health services imperils women’s health and well-being.”

Energy and Commerce Chairman Frank Pallone, Jr. (D-NJ), Health Subcommittee Chairwoman Anna Eshoo (D-CA) and Oversight and Investigations Subcommittee Chair Diana DeGette (D-CO) sent a letter to Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma today raising a series of questions following an alarming new report from the Government Accountability Office (GAO) identifying serious Medicaid abortion coverage violations in 15 states.

The recent report from GAO found that 14 states are in violation of CMS requirements to cover mifepristone, a prescription drug used in combination with misoprostol for medical abortions. GAO also found that South Dakota does not cover abortion services in the case of rape or incest, which is required by CMS to be covered as medically necessary care. Even more alarming is the fact that CMS has been aware of the state’s failure to comply with the law for 25 years without acting to compel compliance.

“It is deeply troubling that in the aforementioned report, GAO identified significant compliance violations with federal requirements for Medicaid abortion coverage,” the Democrats wrote to Administrator Verma. “For two and a half decades, CMS has allowed the state to deny medically necessary care to women who have been subjected to the horrible trauma inflicted as a result of rape. This is unacceptable.” 

The Democrats continued, “The failure of states to cover these medically necessary health services imperils women’s health and well-being.  Furthermore, the agency’s response to bring these states into compliance has been woefully inadequate and blatantly disregards the health and wellbeing of some of our nation’s most vulnerable.” 

As part of their inquiry, the Committee leaders are requesting documents and answers to a series of questions, including:

  • A copy of the letter CMS sent South Dakota in 1994 regarding the state’s failure to cover abortion in the cases of rape or incest and any correspondence from South Dakota to CMS on this issue.
  • When CMS becomes aware that a state is out of compliance with federal law, what steps does it take to bring the state into compliance?
  • What steps will CMS take to ensure that South Dakota covers abortions in the case of rape and incest?
  • What steps will CMS take to ensure that the 14 states identified by GAO come into compliance with their obligation to cover mifepristone?

The Democrats’ letter is available HERE.