The Trump administration announced plans to cut at least $200 million in health care funding to California — after President Trump leaves office — in protest over a 2014 state regulation requiring insurers to cover abortions.
Health and Human Services Secretary Alex Azar, who has proclaimed his agency is the "Department of Life," announced the move against California during a White House event on Wednesday celebrating the administration's "work to fight abortion."
"Unless California amends its policies we will seek to withhold an additional $200 million every quarter until it complies," he threatened.
Roger Severino, the anti-abortion activist who heads the Office for Civil Rights at the Department of Health and Human Services, declared ahead of January's anti-abortion March for Life that the state regulation requiring employers and private insurance companies to cover abortion costs violates the Weldon Amendment, which protects medical providers from being forced to cover the procedure — even though the Obama administration already determined that California's rule does not violate federal law.
On Wednesday, Severino explained that HHS will respond by withholding $200 million in federal funding for California's Medicaid program as the state becomes the epicenter of the latest coronavirus outbreak. The funding will begin to be withheld in the first quarter of 2021 — after Trump leaves office.
"Entities that receive HHS funds should think twice before flouting federal law and refusing to come into compliance," Severino said in a statement. "Whatever one thinks of the legality of abortion, no one should be punished for declining to pay for or assist in the taking of human life."
HHS said it would withhold an additional $200 million for each quarter that the state does not drop its requirement even though President-elect Joe Biden, who takes office in five weeks, can reverse the decision. Severino told reporters on Wednesday that "conscience rights aren't up for partisan debate," according to CNN. "It should not matter who is president. It should not matter who's the director of the office for civil rights, whether it's me or somebody else — the laws that Congress has passed on a bipartisan basis deserve to be enforced," he said.
The Trump administration's move comes after Biden announced that he will nominate California Attorney General Xavier Becerra, a strong supporter of reproductive rights, to head HHS. As California's top prosecutor, Becerra sued the Trump administration over its abortion funding restrictions last year and vowed to "protect our families' access to health care, including women's constitutional right to abortion" after the January threat.
"California is already in compliance with the Weldon Amendment," Becerra wrote in a letter to Severino earlier this year, citing the Obama administration's investigation.
Becerra said Severino's threat "contradicts" the agency's previous findings, "ignores the legal limits of the Weldon Amendment [and] exacerbates the Trump Administration's prior defiance of those same limits." Cutting off funds "is not in accordance with the law, and raises new constitutional concerns, including impeding California's sovereignty," Becerra argued.
Gov. Gavin Newsom, a Democrat, has called the administration's demand a ploy to "score cheap political points" with evangelicals and said the health care cuts would put millions of people at risk.
Newsom's office said on Wednesday that it "will continue to stand up for reproductive health and push back against this extreme presidential overreach."
Sara Rosenbaum, a former health care adviser to Bill Clinton and professor of health law at Georgia Washington University, told CNN that "politically, practically, it's an empty threat, but legally it's a real threat."
"When you're starting up a whole brand new agency, standing up whole divisions, they're walking into a deluge of issues," she explained. "It may be justifiable to seek (court) protection so that nothing can happen. Because turning the wheels and turning off the wheels and reversing course inside an agency is a complicated thing procedurally and legally to do."
Trump has called for banning all abortions with few exceptions and his administration has backed multiple efforts seeking to restrict abortion rights. He has appointed dozens of anti-abortion judges, including to the Supreme Court, and filled his administration with longtime abortion opponents. His administration banned taxpayer-funded clinics from making abortion referrals and banned global health funds from going to foreign groups that provide or discuss abortion.
Jodi Hicks, the CEO and President of Planned Parenthood's California affiliates, vowed to fight the Trump administration's "tyrannical withholding of critical funds" after Wednesday's announcement.
"The Trump Administration's latest political stunt to punish California for ensuring coverage for abortion services, in the middle of a global health crisis, is nothing short of cruel and oppressive," Hicks said.
The American Civil Liberties Union of Northern California argued that the Trump administration's policy was the one that violated the Constitution.
"To refuse to provide insurance coverage for people who choose to end their pregnancies while providing coverage for those who choose to give birth would be discriminatory and a violation of fundamental constitutional rights," the group argued. "It is outrageous that in the height of the pandemic, [HHS]-- an agency that is supposed to protect patients' rights—would withhold needed health care funds, jeopardizing the health and safety of millions of Californians, based solely on the political agenda of abortion opponents."
Rep. Barbara Lee, D-Calif., slammed the administration for trying to "undermine reproductive freedoms" on "their way out the door."
"This is shameful at any time," she added, "but especially cruel during a pandemic."