California goes all in for reproductive rights: "Abortion is a basic health care service"

California issued a letter requiring insurers to cover abortion, no exceptions. Will others take notice?

Published August 25, 2014 8:41PM (EDT)

                                     (ProgressOhio via Flickr Creative Commons)
(ProgressOhio via Flickr Creative Commons)

In the wake of the Supreme Court's Hobby Lobby decision, the Wheaton College injunction and a stream of recent political blows to access to reproductive healthcare, California is breaking with the national trend and defending reproductive rights in unprecedented ways. Last week, officials from the state's Department of Managed Health Care sent a letter to seven insurance companies informing them that they must cover abortion in all plans, calling the procedure "a basic health care service."

The letter was a reversal on a previous decision allowing Anthem Blue Cross and Kaiser Permanente to limit abortion coverage in plans offered to two Catholic universities. According to the Associated Press, the letter said that “the California Constitution prohibits health plans from discriminating against women who choose to terminate a pregnancy. Thus, all health plans must treat maternity services and legal abortion neutrally.”

One of the great successes of the anti-choice movement has been to isolate abortion -- both in terms of where the procedure is performed and how we talk about it -- from other healthcare. Facing tremendous political pressure, many hospitals do not perform abortions, leaving providers working out of free-standing clinics that are easily targeted by state legislatures hostile to abortion rights. The physical separation of abortion from other medical care is mirrored in how we talk about the procedure. Rather than being discussed as essential healthcare, we are told (even by pro-choice lawmakers) that it should be "safe, legal and rare."

California, however, is reclaiming the terms of the debate, and rejecting the idea that abortion can be singled out for punitive restrictions that do not apply to other medical services. In her letter to the insurance companies, DMHC director Michelle Roullaird said her department was wrong to approve of health insurance policies excluding abortion coverage, and asked each insurer to review their plans to make sure they provide the full range of coverage required under the law.

Anti-choice groups have threatened to sue, according to the Associated Press:

Two groups that oppose abortion, the Life Legal Defense Foundation and Alliance Defending Freedom, sent a letter to Rouillard on Friday saying that under federal law California cannot force employers to cover elective abortions. The groups said they would file a civil rights complaint with the federal government unless the state's previous determination was reinstated.

"Pro-life employers have the freedom to choose health insurance plans that do not conflict with their beliefs on the dignity of human life," Life Legal Defense Foundation Legal Director Catherine Short said. "California cannot be allowed to discriminate against health plans that don't cover elective abortions and force people to purchase coverage that conflicts with their convictions."

But it appears that California is ready for the fight.

h/t RH Reality Check

By Katie McDonough

Katie McDonough is Salon's politics writer, focusing on gender, sexuality and reproductive justice. Follow her on Twitter @kmcdonovgh or email her at

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Abortion Abortion Rights Aca Affordable Care Act California Insurance