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Health Agencies Update
March 24/31, 2020

Government Cites California for Violating Federal Conscience Laws

JAMA. 2020;323(12):1123. doi:10.1001/jama.2020.3016

The US Department of Health and Human Services (HHS) recently issued a Notice of Violation of federal conscience laws to the state of California because it mandated that all health insurance plans provide coverage for abortions.

California began mandating that all plans provide coverage for abortion in 2014. Previously, about 28 000 Californians were covered by plans that did not provide coverage for abortion, according to the HHS.

The HHS Office for Civil Rights (OCR) investigated the state’s mandate after receiving 2 complaints alleging that the requirement represented unlawful discrimination. The complaints came from the Missionary Guadalupanas of the Holy Spirit, a Catholic order of religious sisters, and Skyline Wesleyan Church, a nonprofit Christian church. Each group’s religious beliefs preclude them from paying for insurance that covers elective abortions.

HHS issued a final conscience rule last May, after the launch of its Conscience and Religious Freedom Division in January 2018.

If California does not comply with federal conscience laws and continues to mandate abortion coverage, it could lose certain HHS funds, according to the agency.

In a letter to the OCR sent in response to the violation notice, California Attorney General Xavier Becerra and California Governor Gavin Newsom defended the California law and said that the OCR itself had previously determined that its law requiring health plans to provide abortion coverage did not violate federal conscience laws.