Although the federal Affordable Care Act does not compel employers to provide workers with health insurance that includes abortion coverage, the director of California's Department of Managed Health Care said in a letter to seven insurance companies on Friday that the state Constitution and a 1975 state law prohibits them from selling group plans that exclude the procedure. The law in question requires such plans to encompass all "medically necessary" care.
August 26, 2014
"Health insurance companies in California may not refuse to cover the cost of abortions..."
"... state insurance officials have ruled in a reversal of policy stemming from the decision by two Catholic universities to drop elective abortions from their employee health plans."
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45 comments:
Abortion is sad.
Interesting.
So, the state law is clearly constitutional -- RFRA was ruled not to apply to states. (City of Boerne v. Flores) And the law doesn't require companies to cover abortion, it just bans the sale of insurance policies that don't cover abortion.
But now California state law + Obamacare are together illegal Federal law (violating the RFRA). (under Hobby Lobby)
So what's the remedy? Do California companies with a religious objection suddenly find themselves completely exempt from Obamacare requirements? Will we not know until/unless the Supreme Court hears yet another RFRA/ACA case?
What usually happens when Federal law mandates what State law forbids? Are there past examples of a valid state law rendering a federal law invalid? (The RFRA can't be the only example of a federal law expressing a specific exemption to other federal laws...)
Interesting.
clint said...
Interesting.
So, the state law is clearly constitutional -- RFRA was ruled not to apply to states. (City of Boerne v. Flores) And the law doesn't require companies to cover abortion, it just bans the sale of insurance policies that don't cover abortion
Clint, I think you are reading far to much into this. The article seems to make it clear that the State law doesn't mention abortion. What it does is state that:
The law in question requires such plans to encompass all "medically necessary" care.
So a state employee (not the legislature) has now determined by fiat that "elective abortions" are "medically necessary".
That would seem to require that every possible procedure and cost would be covered if a doctor determined that it was "medically necessary".
Expect your rates to rise in CA.
I guess we need to look to the definition of "medically necessary." This being California, i could see it including "politically necessary" operations.
Medical necessity just got much, much bigger. California had a big reform of workers comp law a few years ago. "Out of body experience " used to be medically necessary for carpal tunnel syndrome. I guess the quacks will be streaming into California again.
So a state employee (not the legislature) has now determined by fiat that "elective abortions" are "medically necessary".
That would seem to require that every possible procedure and cost would be covered if a doctor determined that it was "medically necessary".
I agree that the interpretation of what is "medically necessary" could define just about any procedure that exists.
I thought "elective abortion" was pretty clear as a procedure. However, since economic factors are now permissible evidence it's impossible to ever fence in "elective". This is abortion on demand. We have this in just about every state.
I believe the CA code in question is 1348.6.
http://wpso.dmhc.ca.gov/regulations/docs/13kkap.pdf
(a) No contract between a health care service plan and a physician, physician group, or other licensed health care
practitioner shall contain any incentive plan that includes specific payment made directly, in any type or form, to a
physician, physician group, or other licensed health care practitioner as an inducement to deny, reduce, limit, or
delay specific, medically necessary, and appropriate services provided with respect to a specific enrollee or groups of
enrollees with similar medical conditions.
Brennan said...
"I believe the CA code in question is 1348.6.
http://wpso.dmhc.ca.gov/regulations/docs/13kkap.pdf
(a) No contract between a health care service plan and a physician, physician group, or other licensed health care
practitioner shall contain any incentive plan that includes specific payment made directly, in any type or form, to a
physician, physician group, or other licensed health care practitioner as an inducement to deny, reduce, limit, or
delay specific, medically necessary, and appropriate services provided with respect to a specific enrollee or groups of
enrollees with similar medical conditions."
That's not it. This is regarding contracts between providers and payers not health insurance, which is betwween payers and policyholders.
Abortion is almost never medically necessary.
I'd think it would be impressive if the places that have actual concerns just uprooted entirely to a state more tolerant of their beliefs.
I'd hate that a lot of innocent Californians would get caught as collateral damage, but until states start seeing consequences to rule by fiat, you'll keep getting laws that aren't flexible and tolerant enough to encompass the full universe of beliefs and world experiences.
The law in question requires such plans to encompass all "medically necessary" care.
Hell..this means that within five years, insurance will be covering medical marijuana here in California.
The sad thing is that the two colleges in question apparently covered abortion without giving it too much thought for many years. I suspect they will have a much more difficult time making their case than if they'd refused to cover abortion in the first place.
But, yes, if an abortion "because I don't want to have a child at this time" is medically necessary, then why isn't liposuction "because the size of my body causes me emotional distress", or maybe a tummy tuck "because my abdominal muscles were disfigured during pregnancy" (that's true for me)?
Isn't there some legal principle that a term such as that in legislation has to actually mean something?
I thought the Left thought passing laws in opposition to SCOTUS precedent was bad.
You know, IT'S THE LAW and all.
I'd think it would be impressive if the places that have actual concerns just uprooted entirely to a state more tolerant of their beliefs.
As would I...but that'd be a one way street.
clint: What usually happens when Federal law mandates what State law forbids?
The Hobby Lobby ruling does not say that federal law mandates health insurance policies that don't cover abortion, it just allows them.
State law can make things illegal which federal law does not (which is effectively what's happening here), but California might need to pass a new law doing so explicitly.
"Abortion is almost never medically necessary."
Mental health, as always, is the camel's nose. One need only find a pro-abortion psychiatrist to declare medical necessity.
Medically necessary I would assume meant those abortions that were required because the mothers health was in jeopardy. Not an abortion that was chosen for convenience.
I suggest retroactive and post-partum abortions for the authors of that action.
"ELECTIVE abortions" "Medically NECESSARY" Clearly two modifiers that mean the same thing. Either this is a case of poor reporting, or words have no meaning.
What ever happened to the freedom of two people to enter into a contract with one another? Did someone spill coffee on that part of the Constitution?
Once the second tech bubble bursts--or the Bay Area companies relocate to cheaper ground--that state is going to be hurting, with nothing but their smug good intentions to keep their people afloat.
It was the abortionists' strategy to get abortion declared a medical procedure so that all laws and regulations with respect to medicine in general would then automatically apply to the abortion procedure.
But notice how outraged the abortion crew become if any laws or regulations that apply in general to medicine are actually applied to abortionists or the places they run except for the laws and regs that say "allow this procedure"
For instance, look at how outraged they become when doctors who perform hundreds or medical procedures a year are required to have hospital admitting privileges. It's outrageous, says the abortion lobby, to ask for that because many abortionists can't get those privileges. But they never say why these doctors operating on hundreds or thousands of women a year aren't highly regarded specialists easily able to obtain hospital admitting privileges.
And look at how outraged the abortion apologists become when these places operating on thousands of women are required to be able to treat emergencies caused by accidental slips of the knife - a situation which is inevitable when that many operations are performed.
Why is competence impossible and readiness a burdensome requirement for abortionists and the places they run?
These men do thousands of procedures and make hundreds of thousands a year. They interrupt a natural process in a women's body, they end another human life, they do it fast, they proceed whether the women has a sexually transmitted disease on the site or not, they push STD germs into the womb, their knives slip, they cover all errors by sending the women home with instructions to take problems to a hospital ER, the women do so because they never want to see the butcher again, the hospitals treat the women and do not code the problem as a consequence of abortion but do refuse the butcher admitting privileges. And this happens thousands of times a year. Abortion statistics for the US government are collected by the Guttmacher Institute, an arm of Planned Parenthood. The government therefore has a cut-out and can and does continue to claim ignorance. Planned Parenthood allows this disgrace to continue because the worst practitioners are mostly treating African-American women and the worst consequences are scarred wombs and sterility and a falling African-American birthrate.
And, of course, a "sadness too sad to be true" among a lot of women of all races - but what do women matter? Why find out what they really feel? Or what really happens to them during and after this "medical procedure"?
Here's to women, whose majority vote to let men off the hook for their responsibilities time and time again.
As a man, I couldn't have designed any better a system than the current for letting men treat women like disposable dolls.
Abortion isn't necessary. How does the State handle teenagers whose parents have insurance? Let OPM handle it, the clinic, hospital or PP can handle it, or the doctors who believe in it can walk their talk.
It's amusing that the story is illustrated with a photo of a demonstrator holding a "Pro-Choice" sign. They aren't really in favor of choice, are they?
"Everything which is not forbidden is compulsory." T.H. White.
I thought that WildSwan's point was interesting, given the recent lawsuits against laws requiring abortionists to have admitting privileges at some hospital that they could send their patients, should anything go wrong. I agree that the pro-abortio/anti-life faction should have to take one side of this or the other - either it is a medical procedure, and should be treated like similar medical treatments in terms of health regulations, or t isn't, and therefore shouldn't be covered by insurance as a medical expense.
SeanF said...
"State law can make things illegal which federal law does not (which is effectively what's happening here), but California might need to pass a new law doing so explicitly."
Yes. California has the authority to do this. The issue appears to me to be that when California does this, it brings the federal laws (the ACA and RFRA) into conflict with each other -- almost exactly the conflict faced in Hobby Lobby.
I can see the signs now:
Pro-choice: abortion for money, sex, ego, and convenience.
A human life evolves from conception to a natural or artificial death. The standard in a civilized society is that termination of a human life is only justified as an act of self-defense. That excludes committing murder for reasons of money, sex, ego, and convenience.
As for other "medically necessary" rationalizations, including mental health, the risks associated with pregnancy are known and well documented. When women and men choose to have sex, they should be prepared to accept responsibility for the life and welfare of a human life they conceive.
Since abortion is murder, that is it artificially terminates a human life, and since the human life is wholly innocent, elective abortion can be only be justified under self-defense statutes. Hopefully, that will be sufficient to end the vast majority of trivially justified procedures. The goal is, or should be, to preserve the value and dignity of human life and unalienable rights, not degrade them for trivial causes.
How would regulating abortion under self-defense statutes affect the abortion industry? I would think that at minimum both the mother and contractor (e.g. abortionists) would be subject to greater scrutiny. That alone may cause people to consider a second review of their conscience before potentially committing a capital offense.
By the same logic then, are the previously elective procedures of breast enhancement, tummy tuck and butt lift now medically necessary?
If so, expect the price to skyrocket.
clint: Yes. California has the authority to do this. The issue appears to me to be that when California does this, it brings the federal laws (the ACA and RFRA) into conflict with each other -- almost exactly the conflict faced in Hobby Lobby.
Now, wait. California currently has a law which says that if an employer provides insurance that insurance must include abortion. There is currently a federal law that requires employers to provide insurance, but does not require that insurance to include abortion.
If California were to pass their own law explicitly requiring employers to provide insurance, there'd be no problem. Businesses in California would have to provide insurance and it would have to include abortion. California could do that, and it would not violate the Hobby Lobby ruling.
But can they do it indirectly? The basic question is, if you have a state law that says, "You don't have to do x, but if you choose to, you must also do y," and a federal law that says "You must do x, but you don't have to do y if you don't want to," are you then required by law to do both x and y?
The details, beyond that, don't really matter much.
If airlines have to allow emotional support anmials on since they're medically necessary, I don't see what all the fuss is about here. Healthcare is a human right/get your prejudices off women's bodies/think of the children, ok?
"elective abortions" are, by definition, not "medically necessary".
Time for a lawsuit.
"elective abortions" are, by definition, not "medically necessary".
The equivalent of liposuction. Removal of unwanted tissue for appearance and lifestyle reasons.
In reference to surgery, "elective" refers to timing, and is in contrast to "emergency surgery" such as a gunshot wound or a c-section. 95% of surgeries are "elective" but medically necessary.
No more abortuaries. If it's medically necessary perform the procedure in a hospital.
Maybe we can require stewardesses to give blow jobs, you know, to ease the medically unsafe tension. After all, I might cut my dick on my zipper!
Why do I have to pay so much for LASIK surgery? Shouldn't it be covered! It's medically necessary. It braces. If you have crooked teeth that's a medical emergency.
Although the federal Affordable Care Act does not compel employers to provide workers with health insurance that includes abortion coverage, the director of California's Department of Managed Health Care said in a letter to seven insurance companies on Friday that the state Constitution and a 1975 state law prohibits them from selling group plans that exclude the procedure. The law in question requires such plans to encompass all "medically necessary" care."
If the Republicans ever get control of Congress again this would be an excellent reason to end he ban on interstate health insurance. California can insist what ever it wants but it can't compel insurance purchasers to purchase California compliant policies if interstate policies were again legal. Still California is not above the US Constitution so it's insistence that medical insurance policies must provide for abortion coverage may in of itself violate the US Constitution, no doubt this will ultimately heard by the federal courts and in light of Hobby Lobby probably be ruled invalid along similar lines.
TomHynes@2:49,
I think no! 95%! What are you trying to say. Seriously! A bowel obstruction? Elective? A heart surgery? Elective? 95%!
So even if you're right, tell me, what percentage of abortions are necessary? Terminating a pregnancy is necessary how often?
Come on, tell us! I' m tired of trolls like you playing games.
TomHynes@2:49 elective doesn't mean unnecessary, it simply means not acute.
Immigration - legal and illegal - turned California deep, deep, blue.
This is one result.
BTW, I know tons of immigrants - both Asian and Hispanic. They believe in family, hard work, and resent paying taxes.
They are also Pro-choice and social liberals.
Loren:
No, those are cosmetic procedures. The libertine philosophy describes abortion as a medical procedure to remove a "burden". Similar to cancer or another unwanted growth. Hence the description of a human life before birth, and some time thereafter, as a "clump of cells". The relevant religious (i.e. moral) doctrine is derived from a faith in spontaneous conception (they want to believe), which was concocted to relieve the cognitive dissonance suffered by women and men with a conscience.
Anyway, it's a choice. To corrupt natural standards. To normalize ambiguous (i.e. selective) morality. To classify human life as a commodity. That is the choice in "pro-choice". Many people will tolerate, if not actually normalize, this dysfunctional behavior because they adhere to a "go along to get along" doctrine. Sounds familiar? Yeah, history repeats itself.
A state of 34 million people only has seven health insurance companies. There's about that many in Switzerland, a country about 1/5th the size. That's also sad.
"elective" ain't "medically necessary"...
state sponsored killing.
they had a name for it in the '40s
cubanbob: Still California is not above the US Constitution so it's insistence that medical insurance policies must provide for abortion coverage may in of itself violate the US Constitution, no doubt this will ultimately heard by the federal courts and in light of Hobby Lobby probably be ruled invalid along similar lines.
Doubtful. Hobby Lobby won because requiring them to cover abortion violated federal law (specifically, the RFRA), not because it violated the Constitution.
Under existing Supreme Court precedent, requiring employers to cover abortion would likely be upheld as not violating the First Amendment.
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