State Backs Off Abortion Exclusion for Catholic Schools

[UPDATED] The California department that regulates insurance plans has reversed an earlier decision that allowed two Catholic universities to purchase health plans that excluded staff coverage for most abortions.

The Department of Managed Health Care in 2008 approved an insurance plan requested by Anthem-Blue Cross for unnamed clients “affiliated with the Roman Catholic Church” to sell a health plan that excluded “elective” abortions but allowed those to save the life or health of the woman. (My initial report in California Lawyer Magazine here.)    Kaiser received its approval in 2012.

[Update:  Access to DMHC letter to Anthem-Blue Cross here.]

Loyola Marymount University in Los Angeles and Santa Clara University bought the plans in 2013.   DMHC’s behind-the-scenes approval in 2008 allowed sale of the plans despite a 1975 state law that “medically necessary” care must be covered without discriminating on the basis of whether a woman chooses maternity care or to terminate a pregnancy.

DMHC disclosed it would send letters Friday to the insurers at Kaiser and Anthem-Blue Cross rescinding its earlier decision.

Department Director Michelle Rouillard said in the letter provided to the Chronicle that “abortion is a basic health care service” and that the California Constitution prohibits health plans from discriminating against women who choose to end a pregnancy.

Loyola began implementing its limited coverage earlier this year and Santa Clara said it would wait until January.

When the schools announced the exclusion of abortion coverage to staff in letters late last year it prompted protests by faculty and students in both schools.

The  DMHC gets its authority to regulate 68 HMOs and 52 specialty plans covering 20 million Californians under the state’s Knox-Keene Health Care Service Plan Act of 1975.  The law spells out the basic health services insurers must provide to meet medical standards of care.  Knox-Keene does not include a religious exception that would allow for elimination of abortion coverage.

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