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HHS Issues Notice of Violation to California for its Abortion Coverage Mandate

This is HHS' announcement of a notice of violation to California for its abortion coverage mandate.

Final

Issued by: Office for Civil Rights (OCR)

Issue Date: January 24, 2020

HHS Issues Notice of Violation to California for its Abortion Coverage Mandate

Today, the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR), announced an action to protect human life and the conscience rights of all Americans.

OCR is issuing a Notice of Violation to the state of California, formally notifying California that it cannot impose universal abortion coverage mandates on health insurance plans and issuers in violation of federal conscience laws.  California has deprived over 28,000 people of plans that did not cover elective abortion, but now must cover abortion due to California’s mandate.  

OCR’s investigation arose from two complaints alleging that California engaged in unlawful discrimination when California’s Department of Managed Health Care (DMHC) ordered, in August 2014, that all health plan issuers under its jurisdiction must offer coverage for elective abortion in every plan they offer.  The two complainants are the Missionary Guadalupanas of the Holy Spirit, a Catholic order of religious sisters, and Skyline Wesleyan Church, a non-profit Christian church—organizations whose religious beliefs preclude them, in good conscience, from helping to pay for insurance coverage for elective abortions.

Pursuant to 45 CFR Part 88 (effective March 2011), OCR has completed the investigation of the complaints and determined that California violated the Weldon Amendment by mandating that California health care plan issuers cover elective abortion in each plan product, and continues to violate federal law by continuing to require objecting health care entities protected by the Weldon Amendment to cover elective abortion.  With this Notice, OCR requests that California inform OCR, within thirty days, whether California will continue to enforce its requirement that all health plans cover elective abortions, or whether it will agree to take corrective action and remedy the effect of its discriminatory conduct.

If, after 30 days, OCR does not receive sufficient assurance that California will come into compliance with federal law, OCR will forward the Notice of Violation and the evidence supporting OCR’s findings in this matter to the HHS funding components from which California receives funding for appropriate action under applicable grants and contracts regulations.  This action may ultimately result in limitations on continued receipt of certain HHS funds.

This is not the first time OCR has found California to be in violation of federal conscience statutes.  In January 2019, OCR found that California violated the Weldon and Coats-Snowe Amendments when it subjected pregnancy resource centers in the state to potential fines and discrimination for refusing to post notices referring for free or low-cost abortions.

“Once again, President Trump’s administration is delivering on his promise to protect human life and all Americans’ freedom of conscience,” said HHS Secretary Alex Azar. “Under President Trump, HHS has been vigorously enforcing the statutes Congress passed to protect Americans’ consciences and institutionalizing these protections within the department’s civil rights work.”

“No one in America should be forced to pay for or cover other people’s abortions,” said Roger Severino, Director of OCR. “We are putting California on notice that it must stop forcing people of good will to subsidize the taking of human life, not only because it’s the moral thing to do, but because it’s the law,” Severino concluded. 

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A copy of the California Notice of Violation may be viewed here - PDF*.

See more about HHS’s pro-life and pro-conscience accomplishments here:

*People using assistive technology may not be able to fully access information in this file. For assistance, please contact digital@hhs.gov

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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.