Press Release |

Rep. Williams and PRH: Insurers Must Consider Risks in New Landscape

Today, Representative Nikema Williams (D-GA), along with 17 Members of Congress, sent a letter to three major health insurance carriers expressing concern about various Provider/Quality Incentive Programs, which raise serious concerns about the potential for criminalization of both health care providers and patients seeking pregnancy-related care.  

Under these Provider/Quality Incentive Programs health care providers are asked to report pregnancy related health information in exchange for monetary compensation. While these programs and incentive forms may appear innocuous, they have the potential to put patients and providers at great risk, particularly in this current moment.  

The letter states:

“This is not a theoretical concern. For decades, pregnant people across the country have been arrested, subjected to prosecution, detained, sent to jail, separated from their children, and have had medical interventions forced upon them because of their pregnancy outcomes, including for self-managing their abortions or seeking care after experiencing a miscarriage. Our country has a long history of attempting to control the reproduction and building of families, especially in communities of color. The people most likely to be surveilled, targeted, and harmed by our nation’s carceral system are people with low incomes and Black, Indigenous, and other people of color. Many of the documented cases where pregnant people were subjected to unjust criminalization occurred even before the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, which stripped away the constitutional right to abortion. As we have watched an already devastating abortion access crisis become far worse, and the threats of criminalization for both providers and patients increase as states move to ban abortion, it is more important than ever to protect people who seek essential health care and the providers that care for them from the threat of criminalization.”  

In addition, Physicians for Reproductive Health coordinated a broad health care provider sign-on letter. Signed by over 175 providers, the letter echoes the concerns of Members of Congress stating: 

“Recent data from If/When/How revealed that 39% of people who were criminally investigated or prosecuted for suspicion of self-managing their abortion or experiencing pregnancy loss came to the attention of law enforcement after seeking care and being reported by health care providers. As providers, we are committed to our oath to “first do no harm” and, as such, refuse to participate in actions that may lead to the criminalization of our patients.” 

The letter continues:  

“We agree that there is a role for both providers and insurance providers in addressing our nation’s maternal mortality crisis. At the same time, we must understand that we are operating in a new legal landscape. In this moment, where providers and patients are facing threats of criminalization based on pregnancy outcomes, a deeper analysis of these programs raise serious concerns about data privacy and risks for criminalization.” 

A cohort of Florida state legislators sent a similar letter to Florida health insurance companies expressing their deep concern about the use of Provider Incentive Programs at Medicaid Managed Care Organizations.  

The letter states:

“As Medicaid Managed Care Organizations that insure 4.6 million Floridians, your company is positioned to share patient data with the state of Florida. Although HIPAA protects health information from being shared or used without a patient’s written permission, we know these protections are not strong enough to protect pregnant people when exceptions to HIPAA are overly broad. This raises concern given the intersection of the population enrolled in Medicaid and those most likely to be criminalized for pregnancy outcomes.”