California, others sue over abortion billing
The Trump administration’s new rule requiring insurers under the federal health law to send separate bills for abortion and nonabortion coverage was challenged in court Thursday by California and other states, which said the requirement was an illegal assault on reproductive care and could deprive millions of families of health coverage.
The rule, scheduled to take full effect June 27, is “an onerous and unnecessary regulation designed to restrict women’s constitutionally protected reproductive rights,” the states said in a lawsuit filed in San Francisco federal court.
Under the Affordable Care Act, the 2012 law sponsored by President Barack Obama, people with belowaverage incomes can receive government subsidies to reduce their health costs. They are billed for the remaining costs by insurers that have enrolled in the state’s regulated marketplace, where 1.5 million Californians are signed up in the Covered California program.
Under the Trump administration’s rule, those individuals will receive two bills per month, one for the small amount of their premium that pays for abortion, the other for nonabortion care. Those who don’t pay both bills, because of confusion, personal views or any other reason, could lose their entire health insurance coverage until the next period of open enrollment in the fall. Cancellation would apparently be left up to individual insurers.
“The separate billing requirement fulfills Congress’ intent and reflects President Trump’s strong commitment to preventing taxpayer funding of abortion coverage,” Health and Human Services Secretary Alex Azar said in announcing the rule. He was referring to the Hyde Amendment, which since 1976 has prohibited most federal funding of abortions for poor women.
But the states noted in their lawsuit that insurers have complied with the Hyde Amendment by creating separate accounts that can be used only for abortion care in states that allow it — including California, one of six states that require all health insurers to cover abortion. The Trump administration threatened last week to cut off federal health care funding to California because of that requirement, although the Obama administration had concluded in 2016 that the state was acting legally.
The new billing rule “penalizes (insurers) for doing business in the states” that require or allow abortion coverage, and will discourage them from covering abortions, the suit said. It said the doublebilling requirement would also “increase consumer confusion,” drive up insurers’ costs and raise premiums.
The 2012 health care law prohibits any government regulation that “creates unreasonable barriers to the ability of individuals to obtain appropriate medical care,” and the billing rule establishes such a barrier, the states contended.
“The new rule is just another Trump administration attack on women and reproductive rights,” California Attorney General Xavier Becerra said in a statement. Other plaintiffs are New York, Maine, Maryland, Oregon, Vermont and the District of Columbia.