The legal effort to ban mail-order abortion pills came along just as the fledgling telehealth industry became a more accepted and entrenched part of abortion care.
This week, Hey Jane, one of more than a dozen virtual abortion providers that have no physical locations, began contracting with the insurers Anthem Blue Cross Blue Shield of Connecticut, Empire Blue Cross Blue Shield of New York and Sana, which provides health plans for small businesses nationwide. Hey Jane also already accepted Aetna in eight of the nine states in which it operates.
It’s unusual for insurers to cover telehealth abortions, and most virtual clinics are cash only. The clinics are new, and insurance coverage for abortion varies widely. In the year before Roe v. Wade was overturned, just one-third of abortion patients used insurance. Some states require private insurers to cover abortions, while others bar it. Federal law prohibits the use of Medicaid for most abortions, although 16 states use state funds to cover them. But even plans that do cover abortion don’t generally include these new telehealth providers in their networks.
Health insurers tend to cover treatments that are widely accepted by clinicians and cost-effective, and Hey Jane’s insurance partnerships are the latest sign that virtual abortion clinics are seen by the health care industry as a safe, in-demand option. They also tend to be less expensive than in-clinic procedures for both patients and insurers.
“In abortion care, as in so many other areas of health care, we believe expanding telehealth’s role is a huge lever” for making care more accessible and affordable, said Will Young, chief executive of Sana.
Not all insurers are ready to cover this new way of providing abortions, said Gaby Santana, head of business at Hey Jane. For example, some require live visits, over video, while Hey Jane sees most of its patients through messaging. Other insurers told Hey Jane they only contracted with clinics with a physical location.
“Our goal is to make this as big and accessible as possible,” Santana said. “That’s why we want to bring on more states and more payers.”
New data shows telehealth accounts for a rapidly growing share of abortions, and Honeybee, the largest online pharmacy supplying mail-order abortion pills, said it was filling more than 10,000 prescriptions a month.
Yet these clinics could also be hobbled just as they are starting to grow. The 5th Circuit ruled last week that the Food and Drug Administration should ban telemedicine prescriptions and delivery by mail for mifepristone, the first of two drugs typically prescribed to induce abortions. It’s a temporary order while a Texas court considers whether to overturn the drug’s approval altogether. The Supreme Court ruled Friday that mifepristone would remain available until Wednesday at midnight while the court had time to review the case.
The FDA first allowed telemedicine abortion in 2020, an emergency decision made early in the pandemic and after extensive data demonstrated that it was a safe and effective way to offer abortion pills to patients. It made the policy permanent in 2021.
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