House Bill 2148 passed on a 54-44 mostly party-line vote and now heads to the Senate, where it's expected to have trouble gaining traction.
Rep. Eileen Cody, a Democrat from Seattle who sponsored the measure, said that while abortions are already covered by most plans, this measure ensures that women's abortion access isn't limited if insurance plans choose to not cover the procedures.
"Choice belongs to an individual, it should not be made by your employer or a health insurance company," she said.
Opponents argued that business owners and others will be required to pay for policies that are out of line with their personal beliefs.
Republican Rep. Liz Pike of Camas called herself a "conscientious objector" of the measure.
"I'm offended that I'm going to be forced to buy a policy that's going to do something that's against my own moral code," she said.
Two Democrats, Reps. Chris Hurst of Enumclaw and Roger Freeman of Federal Way, crossed party lines and voted against the measure. One Republican, Rep. Chad Magendanz of Issaquah, voted for it.
The same measure also passed the Democratic-controlled House last year, but stalled in the Senate, which is controlled by the Majority Coalition Caucus, a group of 24 Republicans and two Democrats.
Advocates of the measure have pointed to confusion from new rules under the federal health care law that they say create more administrative burdens for insurers when they cover abortions.
A longstanding federal provision known as the Hyde amendment prohibits the use of federal funds to pay for abortion except in cases of rape, incest or to save the life of the mother, and insurers on the exchange have to create separate accounts that segregate premium payments for abortion services from premiums for everything else. Some states have banned abortion coverage for plans being sold on the exchanges, which are a centerpiece of the federal Affordable Care Act. Washington's law, if passed, would be the first in the nation to require abortion coverage.
Stephanie Marquis, a spokeswoman with the Washington state Office of the Insurance Commissioner, said that the federal accounting requirement has created some complications for insurers, but that currently, all plans but those offered by two companies offer full coverage for abortion services under the new health exchange. Group Health isn't covering abortion through its plans being offered on the marketplace, but women will still be able to access the service at Group Health facilities. Kaiser Foundation Health Plan of The Northwest will cover elective surgical abortion, but Marquis said its current plans don't cover prescriptions for drug-induced abortions. A spokesman for Kaiser has said, however, that it will still provide access to abortion-inducing drugs.
Under federal requirements, eight Blue Cross multistate plans offered by Premera in Washington state don't offer abortion coverage, and if the House measure is passed, it wouldn't require abortion coverage on those multistate plans, Marquis said.
Sen. Linda Evans Parlette, the Senate Republican caucus chairwoman, called the measure a "political issue rather than a policy issue."
"It is not necessary," she said. "We are sent here to do the business of the people on policy issues."
Parlette said she doubts the measure will receive a hearing this year in the Senate