California reverses position on health insurance abortion coverage

Spurred by faculty and staff outrage over the refusal by two Catholic universities to pay for elective abortions, Gov. Jerry Brown’s administration on Friday announced that health insurance companies in the state can no longer deny coverage for these procedures.

California’s Department of Managed Health Care, which oversees HMOs, issued letters to seven insurance companies saying refusing to pay for any abortion, whether medically necessary or not, violates the state constitution and a 1975 state law.

“All health plans must treat maternity services and legal abortion neutrally,” department director Michelle Rouillard wrote in the two-page letter that also noted the decision becomes effective immediately.

The department’s reversal from an earlier decision that allowed insurance companies to eliminate that coverage drew swift reaction from both sides.

“We welcome the department’s action in really enforcing what current California law is,” said Dipti Singh, staff attorney with the National Health Law Program. Over the last year, the non profit has worked with groups including Planned Parenthood and the ACLU to bring the discrepancy to the department’s attention.

“The faculty (at Catholic universities) has done a great job advocating for themselves and ensuring that their health insurance is comprehensive,” Singh said.

But the letter was immediately denounced by The Catholic League for Religious and Civil Rights, the country’s largest Catholic civil rights group, whose leaders issued a statement Friday saying that Catholic universities “have a right and a duty to uphold the tenets of their faith in everything they do.

“Paying for abortions is in direct conflict with the teachings of the Catholic Church,” president Bill Donohue said in the statement.

The decision is the latest in a string of high-profile, health care political firestorms that have pitted women’s rights again religious freedom in the wake of the Affordable Care Act, also known as Obamacare.

The federal health care law requires employers to provide health insurance to its workers, but it does not mandate insurance coverage for abortion. However, California guarantees that right under state law and the California Reproductive Privacy Act.

In her letter, Rouillard said that her department had “erroneously approved or did not object” to discriminatory language that limited or excluded abortion coverage in some health insurance policies that cover “a very small fraction” of health plan enrollees dating back to 2008. The controversy surfaced last year after administrators at Santa Clara University and Loyola Marymount University in Los Angeles, both founded by the Jesuit order, decided to drop health insurance coverage of elective abortions.

The decision led to uproar among staff and faculty at each institution, prompting some members to reach out to non-profits like Planned Parenthood for assistance. Those abortion rights advocates in turn contacted the Legislature’s Women’s Caucus, which sent a letter to Gov. Brown this month asking him to direct the department to change its position about what constitutes a covered abortion.

Since Jan. 1, a restrictive health insurance policy has been in place at LMU, which allows employees to pay extra for abortion coverage through a third party.

A similar policy was scheduled to take effect at Santa Clara University on Jan. 1, 2015.

On Friday, several Santa Clara University faculty members who have vehemently objected to university president Michael Engh’s handling of the issue expressed relief over the state’s decision to reverse.

“I’m very grateful to the Department of Managed Health Care for reaffirming a women’s right to choose,” said Nancy Unger, a professor of American History, who has consistently protested Engh’s decision.

“This is not just confirming and clarifying that this is a right we have, but by having comprehensive health insurance, it includes a woman’s right to have an abortion without any qualifiers,” said Unger, who is Catholic and whose health care insurance covers her 21-year-old daughter.

Stephen Diamond, an associate professor of law who last year resigned from the school’s ethics center in protest over Engh’s decision, agreed with Unger.

“It’s an important reaffirmation of a woman’s right to choose, and of the importance of the values of shared governance on a campus like ours,” he said.

Spokespeople for both universities on Friday said they are conferring with their insurers, Anthem Blue Cross of California, and Kaiser Permanente, about the decision in order to ensure that the plans at the schools are fully compliant with state and federal law.

Both health insurers said they intend to comply with the law.

Contact Tracy Seipel at 408-920-5343. Follow her at Twitter.com/taseipel.

 

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