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Church Group Sues State Agency Over Abortion Coverage Requirement

A San Diego-area church has sued the California Department of Managed Health Care, arguing that the state agency overstepped its authority in requiring the church to cover abortion services in its health insurance for employees.

The suit alleges that the ruling by the department, which regulates managed care insurers, “violates the church’s rights and freedoms under the state’s Administrative Procedures Act and both the federal and state constitutions,” according to a plaintiff’s press release.

The lawsuit was filed earlier this month in San Diego County Superior Court on behalf of Skyline Wesleyan Church in La Mesa, whose pastor, Jim Garlow, is known for rallying conservative support for Proposition 8 — California’s same-sex marriage ban, which passed in 2008 and was later overturned in federal court.

Two legal groups, Alliance Defending Freedom and Freedom of Conscience Defense Fund, are representing the church.

A Department of Managed Health Care spokesman declined comment.

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Alliance Defending Freedom has filed a similar lawsuit in federal court. Both suits add to a contentious legal landscape of court cases challenging — on religious freedom grounds — the government’s right to require abortion and contraception coverage in employer-based insurance.

In the closely-watched Hobby Lobby case, the U.S. Supreme Court ruled in 2014 that some privately held companies and some religious employers do not have to provide contraception coverage under the Affordable Care Act. The ACA excludes abortion from the list of ten essential health benefits that private insurance plans are required to cover.

States, however, vary widely in their policies on whether abortion coverage must be included in private and public insurance, and under what circumstances, such as rape, incest, or the health of the mother.

California is the only state that requires all insurance plans, individual and employer-based, to treat abortion coverage and maternity coverage neutrally. Since health plans in California are required to offer maternity coverage under the Affordable Care Act, they must also cover abortions.

When two Catholic universities in California tried to strip “voluntary or elective” abortion coverage from employee health insurance in 2013, the managed care department sent a strongly-word letter to the state’s insurers that the elimination violated state laws and California’s constitution. The universities reinstated the coverage.

Skyline Wesleyan Church had also excluded abortion coverage from its employee insurance, but the department’s letter prompted the church’s insurer to restore that coverage, according to the lawsuit. The church’s attorneys characterized the letter as a “mandate” that violated the church’s religious freedom.

“California forced abortion coverage into churches’ health insurance plans without their knowledge or approval,” Alliance Defending Freedom attorney Jeremiah Galus said in a written statement. “Because Obamacare requires employers to provide health insurance coverage, the California mandate has left churches with no way to opt out of paying for abortions.”

Tracy Skaddan, general counsel for San Diego-based Planned Parenthood of the Pacific Southwest, said the DMHC letter was not a mandate, but a reminder of existing law.

“This is not a new mandate,” Skaddan said. “The DMHC is merely enforcing what has been in effect since 1975.

Skaddan added that Planned Parenthood is not involved in the lawsuit, “but we fully support DMHC’s actions and work that they’ve done to ensure that insurance providers offer coverage for full range of reproductive services including abortion, which is a legal right for women to have.”

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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