Religious Groups Battle with California over Abortion Coverage
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A position taken by the California Department of Managed Healthcare (DMHC) has religious groups and the state of California battling over whether state law requires health insurance plans to include coverage for abortions. The DMHC is the state agency that regulates healthcare service plans, which include managed care plans such as health maintenance organizations (HMOs) and preferred provider organizations (PPOs).
The DMHC sent letters to California’s major health insurers in August 2014 regarding health insurance coverage for abortions. According to the DMHC’s letters, all healthcare service plans must treat maternity services and legal abortion neutrally, and they must provide coverage for legal abortions. In response, a number of religious groups filed formal complaints with the U.S. Department of Health and Human Services (HHS) challenging the legality of the DMHC’s abortion mandate.
California law doesn’t include an accommodation for employers that have religious objections to providing coverage for abortions. However, the DMHC has recognized that no individual healthcare provider, religiously sponsored health carrier or healthcare facility may be required by law or contract in any circumstances to participate in the provision of or payment for a specific service if they object to doing so for reasons of conscience or religion. Also, no person may be discriminated against in employment or professional privileges because of these objections.
HHS’ investigation into the legality of the DMHC’s directive is ongoing. At this time, it is unclear whether the DMHC’s directive will be overturned or what action, if any, HHS will take. In the meantime, California employers may receive notices from their insurers that their health insurance plans regulated by the DMHC must include abortion coverage.
Some insurance industry observers have pointed out that employers looking to get around California’s rules could become self-insured for health coverage. Taking this action would bring their health benefits under the jurisdiction of ERISA, which doesn’t impose an abortion mandate. However, a move to self-funded plans could be more expensive for some not for profits, as they would shoulder more of the risk of their employees’ healthcare.
If you have specific questions about the coverage you offer employees, contact an ‘A’ Team member today and get educated!
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