In addition to the attempt to defund Planned Parenthood, there are other ways the bill will make it more difficult for women to access health care.

Effective January 2018, the bill would ban individuals and small employers from using their tax credits to buy health plans that cover abortion (except for when a pregnancy is the result of rape or incest, or an abortion necessary to save the life of the mother).

“If your plan covers abortion services today, it may not cover abortion services as of January 2018 if this bill were to pass,” health law expert Nicholas Bagley told Vox.

Before the ACA went into place, an anti-abortion faction of Congress wanted to make sure federal tax credits to help people buy private insurance on the Obamacare exchanges couldn’t be used to pay for plans that provided abortions.

The result was that under Obamacare, private health insurance plans on the exchanges could pay for elective abortions — but couldn’t use money from federal tax credits and subsidies to cover those costs. (Instead, insurers were required to have a separate premium for abortion coverage and pay for that coverage through a special fund.)

“With this change, all qualified health plans can’t include abortions,” said Laurie Sobel, associate director for women’s health policy at the Kaiser Family Foundation. It also means employers cannot get tax credits if their plans include abortion coverage. “The effect is that it’ll strongly discourage smaller employers from offering coverage that includes abortion,” Sobel added.

There’s a third way the Senate bill curtails coverage for abortion: It includes a provision banning insurance issuers from accessing funds in the State Stability and Innovation Program — a $115 billion pool of money states could use to keep insurance plans from leaving the market or to lower premiums, among other things — if they offer abortion coverage (again, outside cases of rape, incest, or when a pregnancy endangers a woman’s life).

“That means insurers can only pull funds from the program if they do not include abortion coverage beyond Hyde restrictions,” Sobel said, referring to the 1976 Hyde Amendment, which restricts federal money from being used to fund elective abortions.

All together, these changes will likely eliminate abortion coverage in the individual health insurance marketplace for individual health insurance nationwide, and have a chilling effect on employer sponsored coverage of abortion too, explained Adam Sonfield, senior policy manager at the Guttmacher Institute, a research and policy organization for sexual and reproductive health and rights.

So access to health care and abortion will be more limited through the defunding of Planned Parenthood (assuming health centers wind up closing), and coverage will be more limited through these restrictions on tax credits and access to funding. That’s going to make getting a safe abortion very difficult for a lot of people.

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