Feds hit state on abortion coverage
Threat to withhold funds over insurance mandate
WASHINGTON — The Trump administration said Friday it will withhold potentially billions of dollars in federal funding for California if the state refuses to repeal a requirement that health insurers provide coverage for abortions.
Roger Severino, director of the Office for Civil Rights at the Department of Health and Human Services, said a 2014 California regulation mandating that employers and private insurance plans offer abortions violates a federal law prohibiting discrimination against providers that don’t cover the procedure.
If the state doesn’t change its approach within 30 days, the administration will move to cut off federal money for unspecified health and human services programs, Severino said.
“This is an important day for people who respect the inherent dignity of every human being, regardless of their stage of development,” Severino said. “The president is a fierce defender of life. He is fearless in his support of human dignity.”
The announcement came hours before President Trump became the first president to attend the March for Life, the annual antiabortion rally in Washington, D.C. He told attendees that “unborn children have never had a stronger defender in the White House.”
His warning to California, which has some of the most expansive abortion coverage requirements in the country, represents an overture to evangelicals and other conservative Christians whom Trump has aggressively courted in his reelection campaign.
Gov. Gavin Newsom, a supporter of abortion rights, called it an attempt to “score cheap political points,” noting that the Obama administration previously found that California’s rule does not violate federal law.
He blasted the president on Twitter for “threatening to take away” tens of billions of dollars in funding, which he said would put 10 million people at risk of losing their access to health care. “You sicken me,” Newsom wrote.
The Trump administration did not specify what funding might be targeted. California received $77 billion in health and human services funding from the federal government in the most recent fiscal year, according to the state Department of Finance.
H.D. Palmer, a spokesman for the Finance Department, wrote in an email that billions more for labor, education and other programs could also be affected. “Clearly, it’s potentially huge,” he said.
Political leaders and abortion rights advocates in California said the state would not change its policies in response to the federal warning. The state Senate leader did so in a bluntly personal dig at Trump.
“If Donald Trump is dissatisfied with the abortion services California provides, we will happily reimburse him for any and all abortions he has paid for in California, immediately upon receipt of legal documents freeing the potential women involved from any nondisclosure agreements they may have been compelled to enter into,” Senate President Pro Tem Toni Atkins, DSan Diego, said in a statement.
Attorney General Xavier Becerra, who is suing the Trump administration for imposing new restrictions on federal funding for organizations that perform abortions, said in a statement that California “will continue to protect our families’ access to health care, including women’s constitutional right to abortion. Nothing changes.”
California has been at the forefront of recent efforts to expand abortion access nationally. A 2015 law would have required antiabortion clinics to notify their patients that the state provides reproductive services including abortion at little or no cost, but it was ultimately overturned in court. Dozens of legislators gathered at the Capitol this week to introduce a bill that would eliminate insurance copayments and deductibles for abortion services.
The Trump administration’s action came two months after
“The president ... is fearless in his support of human dignity.”
Roger Severino of the U.S. Department of Health and Human Services
the California Supreme Court rejected a challenge by a Catholic missionary organization to a state ruling that voluntary abortions are “medically necessary” procedures that health plans must cover.
The administration cited that challenge, by the Missionary Guadalupanas of the Holy Spirit, and a similar complaint by Skyline Wesleyan Church in La Mesa (San Diego County) in issuing its funding cutoff threat Friday. Both organizations said their religious beliefs precluded them from offering abortion coverage in health insurance.
Regulations requiring the coverage, adopted by the California Department of Managed Health Care in 2014, were upheld in August by a state appeals court in Sacramento.
The court said the choice a pregnant woman makes — to give birth or have an abortion — must be considered “medically necessary.”
Severino said the Department of Health and Human Services will give California 30 days to come into compliance with the federal law after receiving notice from the Trump administration. If the state refuses, he said, the federal government could revoke “streams of federal funding.”
He said California is a large recipient of various types of health and human services funding that could be withheld under a law known as the Weldon Amendment. It has been included in appropriations bills for more than a decade to block funding for any state or local government that “subjects any institutional or individual health care entity to discrimination on the basis that the health care entity does not provide, pay for, provide coverage of, or refer for abortions.”
“We have given California the opportunity to come into compliance, and they still have that opportunity,” Severino said.
California’s insurance rule forced more than 28,000 people off plans that had previously chosen not to cover abortions, according to the federal government’s notice of violation.
A previous complaint by antiabortion groups was dismissed by the Civil Rights Office of the Department of Health and Human Services in 2016, when Barack Obama was president. The office concluded then that the “right of conscience” protecting individual health care workers and hospitals from performing abortions did not extend to health insurance companies because they were acting at customers’ request.