GAO reports 26% of exchange plans cover non-excepted abortions in 2026
Qualified health plans on federal and state exchanges must estimate coverage costs at $1 per enrollee per month, affecting 1,719 plans nationwide.
The Government Accountability Office reports that, for 2026, 26 percent of qualified health plans (QHPs) offered through health insurance exchanges covered non-excepted abortion services. The coverage applies to 1,719 of 6,655 plans in the 50 states and the District of Columbia and obligates issuers to estimate the cost of that coverage at no less than $1 per enrollee per month.
State law determines whether QHPs may provide such coverage. Fourteen states prohibit coverage, accounting for 0 of 2,109 plans; eleven states permit coverage only in limited circumstances, also accounting for 0 of 2,235 plans; thirteen states generally require coverage, representing 1,609 of 1,620 plans; and thirteen states have no law on the issue, covering 110 of 691 plans.
Federal law also requires issuers to set a premium of at least $1 per enrollee per month for the abortion coverage component. All 15 issuers selected from ten states reported an average estimated cost below $1 per enrollee per month and set the premium to $1 to meet the requirement. Eleven of those issuers disclose on enrollee bills or plan materials that part of the premium funds non-excepted abortion services, and all fifteen make the coverage information publicly available.
The Centers for Medicare & Medicaid Services (CMS) supplies general guidance, templates for benefits documentation, and oversight that varies by exchange type. For state-based exchanges, CMS notes that states retain primary regulatory authority and play a prominent role in QHP certification.
GAO identified instances where issuer practices may diverge from federal requirements. CMS officials indicated in August 2026 that they would decide on appropriate actions after reviewing the specific facts of each case.
Further reading