Starting next year, at least two universities in California will deny faculty, staff, and administrators seeking abortions coverage of the procedure, unless California state officials decide that the move violates state law.
An investigation by California Lawyer magazine found that the California Department of Managed Health Care (DMHC), which is tasked in part with reviewing employee health insurance policies, approved at least two insurance policies that did not provide coverage for certain abortions.
Loyola Marymount University and Santa Clara University, both Catholic-affiliated schools, have announced they will only offer those policies, one from Anthem Blue Cross and another from Kaiser Permanente, that include limited abortion coverage.
At issue is whether so-called elective abortion can be distinguished from “medically necessary” abortions, a term used to describe abortions performed in pregnancies that are the result of assault or incest, or in cases when the mother’s life is at risk.
Last October, Santa Clara University President Michael E. Engh sent a letter to faculty saying that the school’s “core commitment as a Catholic university are incompatible with the inclusion of elective abortion coverage in the University’s health plans,” and said the university plan would only cover “therapeutic abortions.”
Loyola has already instituted the changes to its plan, which were accepted by the trustees of the college last October. Santa Clara’s new policy won’t take effect until the start of 2015.
California has long had abortion protections on the books. In 1967, the state legislature enacted the Therapeutic Abortion Act, a law ensuring the rights of women to get an abortion within 20 weeks of the pregnancy when the health of the mother is at risk. Five years later, the California Supreme Court expanded the Therapeutic Abortion Act by removing the pieces of the law that restricted abortions to cases of maternal risk, leaving only the provision that an abortion be performed by a doctor in a hospital.
In 1975, California passed the Knox-Keene Health Care Service Plan Act, which required that health plans in the state cover all “medically necessary” procedures. Then, in the early ’80s the California Supreme Court struck down a law restricting the use of state funding for abortion services; now, Medi-Cal covers the cost of abortions. And finally, in the early 2000s, the state officially repealed the rest of the Therapeutic Abortion Act, and codified Roe v. Wade into state law.
Still, through open records requests the California Lawyer investigation found that the DMHC approved insurance plans from Anthem Blue Cross and Kaiser Permanente in 2008 and 2012, respectively, that limit coverage for abortion. The 2008 plan approved for Anthem did not include any coverage for abortion, and the Kaiser plan included coverage only in cases of medical necessity. Those approvals laid the groundwork for the Catholic universities’ plans.
However, state officials from the DMHC say they are in the process of reviewing their decision to approve the policies as well as California law related to abortion coverage.
Rodger Butler, an information office for the DMHC, told RH Reality Check via email that the department is “currently engaged in an in-depth analysis of the issues surrounding coverage for abortion services under California law. This analysis includes a review of all previously approved health plan documents and consultation with legal experts in areas of state, federal, and constitutional law. Once complete, the results of this analysis will inform the DMHC’s position moving forward.”
Butler did not confirm when the review process might end, but if a decision is made before the end of the year it could block Santa Clara’s policy change and reverse Loyola’s.