Health insurers required to cover abortion services in the state, court rules

The California Department of Managed Healthcare acted properly when it sent a letter to health insurers telling them they must cover abortion services, the 3rd District Court of Appeal ruled on Wednesday.

The case was filed by a Catholic group that claimed the agency violated the state's Administrative Procedures Act. The group claimed abortions did not qualify as "medically necessary" under state regulations of health insurers. Missionary Guadalupanas of the Holy Spirit v. Rouillard, 2019 DJDAR 7400 (Cal. App. 3rd, filed Oct. 19, 2016).

"By setting up a false choice between 'voluntary' abortions and 'medically necessary' abortions, the petitioner attempts to limit coverage of most abortions by health care service plans in California," Justice Cole Blease wrote for the unanimous three-member majority.

Blease ruled the state Legislature was within its rights to delegate the authority to the department to determine "the scope of basic healthcare services." Efforts by the plaintiffs to identify "ambiguity" around the meaning of the term "necessary" were not supported by state law, he added.

"Even though the term 'medically necessary' might be ambiguous in some applications, it is not ambiguous under the circumstances presented in this case ... nothing in the statute or the regulation limits medically necessary services to those required to save the patient's life, nor can we imagine that is what the Legislature intended," he wrote.

-- Malcolm Maclachlan