We hope you’re staying healthy and safe during our pandemic. Resources around us are limited, but we know sexual and reproductive health remains essential. Here is an ongoing list of resources compiled from our coalition members. We will continue to update this document as new resources become available.
To add to our list of resources, please send them to resources@reproductivefreedomca.org.
The Trump Administration is trying to bully California into decimating abortion access in the state. California has long required insurers to cover basic health care services, and in 2014 the state clarified that reproductive health care — including abortion care — is basic health care. With exceptions for some religiously-affiliated insurance companies, health plans in the state cannot treat abortion differently than other pregnancy-related care.
The Administration is now claiming that California’s policy violates the Weldon Amendment – a federal rule prohibiting local, state, and federal governments from requiring health care entities to cover, provide, or refer to abortion services. It doesn’t make sense. The Administration is singling out California – one of six states with this abortion coverage requirement. What’s more, this issue has already been decided! The Obama Administration rejected a similar challenge to California’s policy in 2016.
This is a pathetic attempt to punish the state of California for respecting the human right to health care. In the process, the Administration is threatening health care access for millions. Californians will not be bullied. We will not accept subpar plans denying people the full range of reproductive health care options. We will not accept insurance companies interfering in medical decision-making and reproductive freedom. Learn more from the resources below.
California Sets Example for Comprehensive Women’s Health Care Coverage
Notice of Violation from HHS and CA Response Letter (PDF)
Weldon Amendment, Consolidated Appropriations Act. HHS
HHS Issues Notice of Violation to California for its Abortion Coverage Mandate. HHS Press Release
Abortion is Basic Health Care. Phyllida Burlingame, ACLU NorCal
Trump’s Attack on Abortion Coverage in California Puts Politics Over Health. Dr. Jessica Beaman
Attorney General Becerra Issues Response to Trump Administration’s Baseless Allegations of Weldon Violation. Press Release.
From 2004: Attorney General Lockyer Readies Court Challenge to Fight Federal Attack on Women’s Right to Choose. Press Release. (with Pelosi and Boxer quotes)
Trump administration threatens to cut health funding for California over abortion insurance law
The battle over abortion rights: Here’s what’s at stake in 2020
Editorial: Trump seeks a new fight with California on abortion
Trump threatens to cut California funding over abortion coverage
The Trump Administration is trying to make it more complicated and burdensome for health plans to cover abortion care. The rule impacts qualified health plans – health plans that are on the Affordable Care Act (ACA) Marketplace and include ACA protections, such as the essential health benefits and potential subsidies.
Federal policies, such as the Hyde Amendment, prohibit federal funds from covering abortion except in the limited circumstances. States, however, can allow or require health plans to cover the abortion care that pregnant people need. When that happens, insurers have to collect at least $1 per month as a premium covering abortion services. They then keep that $1 separate from the rest of the premium to ensure no federal funds are used for abortion services.
This rule takes that separation requirement to the point of absurdity. It requires insurers to send enrollees two separate bills – one for the abortion part of the premium and another for the rest of the coverage. Apparently it’s not enough for the insurer to separate the funds, now the enrollee must send two checks.The rule is dangerous. It stigmatizes abortion care, making it seem separate from other basic health care services. It could lead to confusion and people losing health care coverage. Additionally, the administrative and reporting burden will likely raise costs, leading to higher premiums or encouraging health insurance plans to drop abortion coverage all together. The rule goes into effect June 27, 2020 unless it is stopped in the courts first.
The Trump administration is trying to chip away our access to basic health care — across the U.S. and in California specifically. Advocates and lawmakers in the state are not having it. Instead we have been working hard to enact progressive policies that advance reproductive freedom. One specific bill in the 2020 legislative session would eliminate insurance and deductibles for abortion services across the state. The bill would remove a significant barrier to care for people in California, ensuring that access to abortion services will not depend on how much money you have.
Stop Trump’s Gag Rule. Generation Progress and Center for American Progress. Target audience: Young People. Factsheets, social media tools, and a comment submission portal.
Specific articles and press releases that provide evidence of the impact of restricting Title X funding:
Anti-Choice Lawmakers Use Federal Budget Bills to Launch All-Out Assault on Reproductive Rights (Updated). Rewire.News.
What does the Affordable Care Act (ACA) say about abortion coverage in the marketplaces? (i.e. Covered California) The Affordable Care Act allows states to mandate or prohibit coverage in the marketplaces. The ACA also included other notable provisions that affect abortion coverage. Section 1303 of the ACA sets forth “special rules” regulating abortion coverage in the marketplaces (see below).
Does California cover abortions in the marketplaces? Yes. Most health plans in California* – whether they are private, public, or marketplace plans – are required to cover abortions. California is one of the four states in the US that mandate abortion coverage. (*Self-funded plans and a narrow group of religiously affiliated self plans are not governed by state benefit requirements.)
What are the “special rules” that plans that cover abortions must follow? The Affordable Care Act requires insurance plans to collect a separate premium amount (at least $1 per month) for each enrollee to cover non-Hyde abortion services, and hold it in a segregated account. The ACA prohibits insurers from using exchange subsidies to pay for non-Hyde abortions; therefore all services for non-Hyde abortions (beyond rape, incest, and life endangerment) must be funded from the separate account. The separate payments must be collected on behalf of everyone enrolled in the plan without regard to the enrollee’s age, sex, or family status.
What do the proposed rules change? The proposed rule would require issuers to send—and consumers to pay—two entirely separate bills for the amount of the premium attributable to certain abortion services and the amount of the premium for all other services. In essence, qualified health plan issuers must send an entirely separate monthly bill for only the portion of the premium related to the non-Hyde abortion; this means separate billing, a separate mailing, and separate postage. If bills are sent electronically, plans must send two separate electronic bills and possibly provide separate payment links for the portion of the premium related to the non-Hyde abortion services in the electronic bills. In turn, enrollees must pay this premium using a separate check, a separate envelope, and use separate postage.
What will happen to enrollees if they do not follow these requirements? Will they lose coverage? The proposed rules are unclear about this. The proposed rules maintain that enrollees should not be dropped off coverage if the enrollee sends one combined payment. However, the proposed rules do not indicate what the consequences will be if the enrollee fails to send the second payment for the non-Hyde abortion coverage. It is likely that consumers may get confused or simply refuse to make the second payment. At that point, there is nothing explicit in the rule that prohibits plans from dropping enrollees from coverage. The impact of this rule will fall harshest on low-income individuals, particularly women of color, immigrant populations, and other individuals who struggle to navigate the health care system.
All Above All Webinar and Toolkit “Fight Back Against Trump’s ACA Abortion Coverage Rule”
Description: Many of you may have heard that the Trump administration recently released a rule on abortion coverage in the state exchanges. The intent of the rule is to force insurers to drop abortion coverage from their policies by making it very difficult, if not impossible to comply. The state exchanges have been an important tool in narrowing racial disparities in health insurance enrollment – this also means that communities of color will be disproportionately impacted by roll backs in abortion coverage in the exchanges. On this webinar, Kelsey Ryland from All*, Kelli Garcia from National Women’s Law Center, and Fabiola Carrion from the National Health Law Program discussed the changes, what it means for states (including California), what tools are available, and how organizations can activate their constituencies.
Slidedeck from CCRF Member, Fabiola Carrion (National Health Law Program)
National Asian Pacific American Women’s Forum (NAPAWF), National Latina Institute for Reproductive Health (NLIRH), In Our Own Voice: National Black Women’s Reproductive Agenda and National Women Law Center (NWLC)
It has been brought to our attention that any cited research should now be attached to your comments. In addition to the inserting links, you should have as an appendix digital copies of the actual reserach papers, reports, etc. (Yes, that means that your comments can be dozens of pages long).
Dignity Health and Catholic Healthcare Initiatives are creating a mega Catholic health entity that would forbid all reproductive health services, including all birth control methods, sterilization, miscarriage management, abortion, the least invasive treatments for ectopic pregnancies, and some infertility treatments.
No exceptions for risks to a patient’s health or even life. LGBTQ patients would face discrimination and be denied health services at some of these hospitals, too. (The NYT just did a story on these issues, which you can read here.) We have concerns that Dignity will try to reduce its commitment to emergency services, charity care, and other services that are of particular importance to low-income and uninsured or underinsured communities.NHeLP, the ACLU, and other advocates across the state have been working together for years to push back against health care restrictions at these and other hospitals.
The ACLU has sued Dignity Health in particular twice in California over denial of reproductive health services and health care for transgender patients. This proposed merger, affecting Dignity Health hospitals across California, could further restrict access to essential health care.
There will be over a dozen more meetings across the state, throughout September and possibly into October, at the fourteen other counties that contain a Dignity hospital (possibly: Calaveras, Kern, Santa Cruz, and Tehama).
Email Karen Camacho at kcamacho@aclunc.org with your name, organizational affiliation if any, email address and/or phone number, and the public meeting(s) that you are interested in attending. We will circle back with you when we have more information about your county.
Some Things to think about
