HHS Finds California in Violation of Federal Law by Requiring All Health Insurance Plans to Cover Abortion

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WASHINGTON — The Department of Health and Human Services (HHS) has issued a notice of violation to the State of California, advising that it is breaking federal law by requiring all insurance plans to provide coverage for abortion — a mandate that had resulted in churches and other religious organizations lodging a complaint with HHS.

“[The Office of Civil Rights] OCR is issuing a Notice of Violation to the state of California, formally notifying California that it cannot impose universal abortion coverage mandates on health insurance plans and issuers in violation of federal conscience laws,” HHS said in a press release on Friday.

“California has deprived over 28,000 people of plans that did not cover elective abortion, but now must cover abortion due to California’s mandate.”

As previously reported, the California Department of Managed Health Care (DMHC) issued a letter in August 2014 requiring all insurance companies in the state to cover abortions, seemingly leaving no way for religious organizations — including churches — to opt out or choose an alternative plan.

“Abortion is a basic health care service,” Director Michelle Rouillard wrote to the seven insurance companies that refused to offer coverage. “All health plans must treat maternity services and legal abortion neutrally.”

She asserted that abortion must be covered because the “California Constitution prohibits health plans from discriminating against women who choose to terminate a pregnancy,” and also cited a 1975 law surrounding “medically necessary” health care.

The directive is believed to be a result of a decision made in 2014 by two Roman Catholic/Jesuit universities in the state — Santa Clara University and Loyola Marymount University — to no longer pay for abortions, but that employees could buy coverage through a third party. Some faculty members objected to the announcement and called upon Gov. Jerry Brown to intervene.

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The Life Legal Defense Foundation (LLDF) and Alliance Defending Freedom (ADF) soon filed a complaint with the U.S. Department of Health and Human Services after the DMHC refused to change its decision following written correspondence between the groups.

They then filed a second complaint with the federal government on behalf of seven churches, one of which operates a Christian school, to again assert that the mandate violates the rights of faith-based employers. It cited the federal Weldon Amendment, which mandates that a state be forfeited of certain government funds if it “subjects any … health care entity to discrimination” because the entity “does not provide, pay for, provide coverage of, or refer for abortions.”

Skyline Church in La Mesa, Foothill Church and Foothill Christian School in Glendora, Alpine Christian Fellowship in El Cajon, The Shepherd of the Hills Church in Porter Ranch, City View Church in San Diego, Faith Baptist Church in Santa Barbara, and Calvary Chapel Chino Hills in Chino were all represented in the complaint.

On Friday, HHS outlined that its Office of Civil Rights conducted an investigation in light of the Skyline complaint, as well as one filed by the Roman Catholic charity Missionary Guadalupanas of the Holy Spirit.

Agreeing with the complainants, it “determined that California violated the Weldon Amendment by mandating that California health care plan issuers cover elective abortion in each plan product, and continues to violate federal law by continuing to require objecting health care entities protected by the Weldon Amendment to cover elective abortion.”

California has 30 days to advise whether or not it will correct its actions or continue to enforce the coverage requirement. If the State refuses to comply, it could lose federal funding, or as HHS put it, the matter “may ultimately result in limitations on continued receipt of certain HHS funds.”

“No one in America should be forced to pay for or cover other people’s abortions,” Roger Severino, director of OCR, said in a statement. “We are putting California on notice that it must stop forcing people of good will to subsidize the taking of human life, not only because it’s the moral thing to do, but because it’s the law.”

ADF applauded the move on Friday, similarly remarking, “No one should force a church or any other employer to participate in funding abortion. For years, California’s Department of Managed Health Care has demonstrated hostility to churches by forcing them to pay for elective abortions. The agency has unconstitutionally targeted religious organizations, repeatedly collaborated with pro-abortion advocates, and failed to follow the appropriate administrative procedures to institute its unprecedented mandate.”

Read the Notice of Violation in full here.

As previously reported, the State of California was the center of a 2018 Supreme Court case after it required pro-life pregnancy resource centers to post information about how residents can take part in government programs that would allow them to obtain an abortion at little or no cost.

The court ruled 5-4 in favor of the pregnancy centers, finding the requirement to be unconstitutional forced speech.

“It does appear that viewpoint discrimination is inherent in the design and structure of this Act. This law is a paradigmatic example of the serious threat presented when government seeks to impose its own message in the place of individual speech, thought, and expression,” wrote Justice Anthony Kennedy.

“For here the State requires primarily pro-life pregnancy centers to promote the State’s own preferred message advertising abortions. This compels individuals to contradict their most deeply held beliefs, beliefs grounded in basic philosophical, ethical, or religious precepts, or all of these. … Governments must not be allowed to force persons to express a message contrary to their deepest convictions. Freedom of speech secures freedom of thought and belief. This law imperils those liberties.”


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