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California Dreaming Up Abortion Coverage Double Standard
By Peter Jesserer Smith
California state officials lately have been dreaming up new standards for unlimited abortion coverage, telling health insurers that it doesn’t matter who their clients are, or what they believe about human life: the message is every abortion must be a covered abortion.
Except if you’re one of 1.3 million state employees and their families — California’s only paying for “medically necessary” abortion in those health plans.
The Cardinal Newman Society deserves kudos for uncovering this apparent double-standard in Gov. Jerry Brown's administration. CNS has just published an article that explores the irony of how California government officials’ ideological commitment to abortion rights has quashed two Catholic universities’ attempts to get insurance policies more in line with their Catholic beliefs even though the state health plans administered by the California Public Employees’ Retirement System (CalPERS) have the same abortion coverage limitations.
Which raises an important question from CNS president Patrick Reilly: “Why can’t Catholics who are morally opposed to abortion have the same options as California state employees?”
My Register story goes into detail about the California state health plan regulator’s decision to re-interpret the law to force the insurers for Santa Clara University and Loyola Marymount University to cancel plans that limited abortion coverage only to abortions deemed “medically necessary.” But here’s the short version: the Department of Managed Health Care gave seven major health insurers that they have 90 days from Aug. 22 to eliminate any restrictions or limitations on “coverage for termination of pregnancies.” LMU and SCU are figuring out how to respond.
CNS’s research points out a couple things: One, the CalPERS health plans place serious doubt on the DMHC’s claim that they had “erroneously” applied state law and the state constitution to allow health plans that would not pay for abortions not considered “medically necessary.”
CalPERS doesn’t fall under the jurisdiction of the DMHC, and has to abide by federal regulations, but they are both state agencies under Gov. Brown.
Two: Customer service reps contacted by CNS told them that practically speaking just getting a doctor’s referral for abortion is enough to get it covered under the state plan. Of course, CalPERS official plan summaries indicate that a medical provider’s saying so isn’t good enough, and the theory is that the plan will review those services to determine whether they were "medically necessary" — the insurance game of second-guessing the doctor.
But if what the CalPERS reps say about abortion coverage is the effectively the case, then whether your plan covers “elective abortion” or “medically necessary abortion” really doesn’t matter. All that matters is having a doctor who will sign off that your health requires it, and the state not contesting the point.
Which starts to make this whole fiasco seem really ideological: if there truly is no effective obstacle to a person getting insurance to cover abortion -- because a doctor will sign off on its "medical necessity" -- then why are SCU and LMU's insurers being told that they have to drop any language that says they'll only pay for what a doctor deems necessary for the patient's well-being, and not the abortion that the patient "elects" to have. It leaves the sense that the message is that if you’re a Catholic employer in California, such as a high profile Jesuit university, then you absolutely have to violate your religion and conscience by subsidizing an employee’s decision to pay a doctor to kill her unborn child that is in no way a danger to her life or health. And that message is a far cry from the safe, legal, and rare mantra that was once in vogue, but seems to have fallen out of the recent vocabulary of the thought leaders in the abortion rights movement.
If you’re the state of California — well there are two possible conclusions for not demanding the same abortion rights rigor in your plans: a) you're not going to pay for what you don’t have to; b) "Elective" and "medically necessary" really makes no difference when it comes to covering abortion, and there's nothing to be gained symbolically by forcing the change. California’s status is well-known as the number one state for abortion in the U.S.
The CNS article is worth reading in full.
Exit question #1: CNS’s attorneys at the Alliance Defending Freedom and Life Legal Defense Foundation have warned California that they’re in violation of the Weldon amendment and could lose nearly 90 billion in federal funding as a consequence. As of Aug. 27, DMHC told the Register that they have not received an official Weldon complaint. So when will ADF and LLDF pull the trigger and file a complaint?
Exit question #2: The last time California challenged the Weldon amendment in federal court was 2005 — during Gov. Arnold Schwarzenegger's administration. It was dismissed as untimely since the federal government hadn’t revoked any funds citing the Weldon amendment. Given the current political landscape, is it really outside the realm of imagination to say that a Weldon complaint would not be an unwelcome development for Gov. Jerry Brown? If California thought it had a good chance to beat the Weldon amendment back in 2005, I’m sure Gov. Brown’s willing to gamble that his chances of winning have only increased, not diminished, over the years.
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