As we transition from the Trump Administration to the Biden Administration, we hear policy goals and ideals that could not further contrast from one another. This includes the two administrations’ views and policy intentions regarding abortion across the nation.

 

One place we will almost certainly see change regarding abortion following this month’s inauguration of President Joe Biden is California’s Abortion Coverage Mandate,[1] which has been a back-and-forth battle under the last two presidential administrations. To understand the upcoming changes, we need to look back at the abortion mandate battle over the past two presidential administrations.

 

In 2014, California ordered a statewide mandate through the state Department of Managed Health Care[2] that instructed all insurance providers to remove so-called “discriminatory” coverage rules, specifically those limiting coverage on abortion procedures. The Department referenced both the California Constitution[3] and the federal Weldon Amendment[4] as legal documents that prohibit state actions and health plans that do not cover abortions and "discriminate" against women who seek to terminate their pregnancies.

 

The enactment of this mandate revoked the health plans of numerous institutions and organizations, including various Catholic universities --- Santa Clara University and Loyola Marymount University[5]-- and other religious organizations that had health care plans that exclude coverage of abortions.

 

The Obama Administration upheld the state mandate even after complaints from religious organizations who argued that the state could not force them to provide healthcare coverage of abortions in various letters challenging the mandate[6]. As an unfortunate result, this mandate forced more than 28,000 individuals[7] out of their healthcare plans due to the suspension of seven health insurance issuers within the state.

 

Again in 2017, the mandate was challenged by the Trump Administration who stated that California was in complete violation of federal law,[8] and after an extensive investigation, the Department of Health and Human Services finally followed suit and reversed its opinion issuing a notice in January 2020 that California’s rule violated federal law.[9]

 

The state of California continued to put up a fight to defend the mandate and refused to comply with the HHS decision. Californian Attorney General Xavier Becerra[10] maintained the argument that the state was adhering to the Weldon Amendment and that HHS’s new position was a direct contradiction to its previous statement in 2016 with no new information.[11]

 

In response to the state’s refusal to comply, in December of 2020, HHS announced the decision to withhold $200 million in Medicaid funds from California in the next quarter and an additional withholding of $200 million per quarter, totaling $800 million annually.[12]

 

This is incredibly important now as the battle of California’s Abortion Mandate continues into 2021, especially as President Biden announced Xavier Becerra-- the man leading the fight to uphold California’s mandate-- to lead the HHS.[13]

 

What we will see following the Biden inauguration is the California mandate to be implemented again, and even more fully, as the administration will not put up a fight against it. We will see tens of thousands of Americans losing their healthcare coverage in the state of California, especially among those who work within religious institutions that refuse to provide coverage of abortions.

 

This mandate is just the first of many pro-abortion policies to be implemented statewide in California. We will see these policies bleed into other states and likely reach federal levels as well.

​

________________________

[1] https://www.dmhc.ca.gov/Portals/0/082214letters/abc082214.pdf

[2] https://www.dmhc.ca.gov/

[3] http://www.leginfo.ca.gov/const-toc.html

[4] https://www.hhs.gov/sites/default/files/ocr/civilrights/understanding/ConscienceProtect/publaw111_117_123_stat_3034.pdf

[5] http://go.nationalpartnership.org/site/News2?abbr=daily2_&page=NewsArticle&id=45431

[6] https://perma.cc/G4WP-V69V

[7] https://www.hhs.gov/about/news/2020/12/16/hhs-disallow-200m-california-medicaid-funds-due-unlawful-abortion-insurance-mandate.html

[8] https://www.hhs.gov/about/news/2020/01/24/hhs-issues-notice-of-violation-to-california-for-its-abortion-coverage-mandate.html

[9] https://www.hhs.gov/sites/default/files/ca-notice-of-violation-abortion-insurance-cases-01-24-2020.pdf

[10] https://oag.ca.gov/about

[11] https://oag.ca.gov/system/files/attachments/press-docs/Letter%20to%20Director%20Severino.pdf#page=2

[12] https://www.hhs.gov/about/news/2020/12/16/hhs-disallow-200m-california-medicaid-funds-due-unlawful-abortion-insurance-mandate.html

[13] https://cheac.org/2020/12/12/president-elect-biden-rolls-out-health-team-becerra-nominated-hhs-secretary/