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Do 13 states require fully-insured health insurance plans to cover abortion, as Sen. Lankford claimed?


by Matthew Yim, Oklahoma Watch
February 13, 2026

Yes.

Abortion coverage is required for Medicaid, private, and Affordable Care Act Marketplace enrollees in 13 states. Some plans, such as those that are self-insured or self-funded, do not share this requirement.

However, Lankford’s further claim that the ACA excludes Hyde Amendment limits is patently false; the ACA explicitly restricts the use of federal funds and tax credits for abortions to instances that endanger the life of the woman or that are a result of rape or incest.

Non-Hyde abortions are required to be paid using segregated funds that come from charging each enrollee $1 per month. Issuers estimate the actuarial value of abortion coverage to be even less than that.

The ACA also allows states to ban marketplace plans from covering abortion, which half of the states have done, while the remaining 12 and DC have no restriction or coverage requirements. 13 states, including Oklahoma, have banned abortion altogether.

Oklahoma Watch partners with Gigafact to produce fact briefs — bite-sized fact checks of trending claims.

Sources

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