Add Washington to the list of states which would end up suing HHS if Alexander-Collins passed.

OK, this is kind of beating a dead horse since the Alexander-Collins bill is dead anyway, but just for completeness sake:

Last week I pointed out that aside from everything else that's problematic about the abortion restriction language included in the A-C bill, it would also have run into a big legal problem because three states (California, New York and Oregon) legally mandate that major medical healthcare policys cover abortion, in direct opposition to the A-C provision which would deny federal subsidies, CSR assistance or reinsurance funds to...any healthcare policy which covers abortion.

Well, today I can add a fourth state to this list:

OLYMPIA, Wash. (AP) — Gov. Jay Inslee has signed a measure that requires Washington insurers offering maternity care to also cover elective abortions and contraception.

In addition to linking abortion coverage with maternity care, the bill requires health plans issued or renewed after Jan. 1, 2019, to provide copayment- and deductible-free coverage for all contraceptive drugs and devices, as well as voluntary sterilization and any consultations or other necessary procedures.

The Office of the Insurance Commissioner says Health Alliance Northwest Health Plan is the only insurer in the state that has restrictions on coverage for pregnancy termination, covering the procedure only in cases where the life of the mother is in danger, the fetus cannot live outside of the uterus, or in the case of rape or incest.

Laura Mabry, a spokeswoman for Health Alliance, said Wednesday that the group intends to make the changes necessary to follow the law once it takes effect.

At first glance it sounds like this only applies to some policies...except that maternity care is one of the 10 Essential Health Benefits mandated by the Affordable Care Act.

In other words, the ACA requires all major medical policies to cover maternity care...and Washington State now requires all policies which cover maternity to also cover abortion...which means, by definition, all WA policies now have to cover abortion.

Which means that if A-C were to become law, no healthcare policies in Washington State would legally be allowed to participate in the ACA exchange, since that would open them up to having federally subsidized enrollees...when federal subsidies aren't allowed to be provided to those enrollees.

Currently, the ACA has a workaround for this problem when it comes to tax credits, via an absurdly complicated and stupid workaround involving separating out $1 per month from the enrollee's premium payments and putting into a separate bank account. Alexander-Collins would apply this same rule to CSR and reinsurance funds, which are handled an entirely different way and may not even be techincally practical to separate out anyway.

The Hyde Amendment is stupid and needs to be repealed.

UPDATEAs Kimberly Leonard in the Washington Examiner notes...

In October, the Trump administration scaled back rules on contraception, saying that employers could refuse to cover it if they had religious or moral objections. The Washington law eclipses that exemption.

...which presumably means more fun with lawsuits in the near future. Good times...