Is California forcing churches to pay for abortions?

California on a globe.

(RNS) Religious groups are battling the state of California over whether employee health insurance plans require them to pay for abortions and some forms of contraception that some find immoral.

So is the state forcing churches to pay for abortions? It depends on who you ask.

The issue gained traction after Michelle Rouillard, director of the California Department of Managed Health Care, sent a letter to Anthem Blue Cross and several other insurance firms in August warning providers that state law requires insurers to not deny woman abortions. “Thus, all health plans must treat maternity services and legal abortion neutrally,” she wrote.

Rouillard wrote that state law provides an exemption for religious institutions.

“Although health plans are required to cover legal abortions, no individual health care provider, religiously sponsored health carrier, or health care facility may be required by law or contract in any circumstance to participate in the provision of or payment for a specific service if they object to doing so for reason of conscience or religion,” she wrote.

“No person may be discriminated against in employment or professional privileges because of such objection.”

However, two legal groups have filed complaints with the U.S. Department of Health and Human Services, alleging the California rule puts faith-based organizations in a position to violate their conscience.

Loyola Marymount Sunken Gardens Sacred Heart Chapel.

Photo courtesy of Mishigaki via Wikimedia Commons

Loyola Marymount University’s Sunken Garden and Sacred Heart Chapel.

The August letter followed protests by mostly non-Catholic faculty at two Jesuit schools, Loyola Marymount University and Santa Clara University, over the schools’ plans to drop abortion coverage from their employee insurance plans.

Earlier this month, California’s Catholic bishops filed a federal civil rights complaint over the state requirement, claiming that the DMHC discriminated against those morally opposed to abortion, and requested an investigation.

“It is a flagrant violation of their civil rights and deepest moral convictions, and is government coercion of the worst kind,” said a statement from Bishop Robert McElroy, auxiliary bishop of the Archdiocese of San Francisco and chairman of the Institutional Concerns Committee of the California Catholic Conference.

Seven churches in California received notifications from their insurers that elective surgical abortion coverage would be required as part of their employee health plans, according to Casey Mattox, an attorney with the Arizona-based Alliance Defending Freedom.

On Oct. 9, ADF and the Life Legal Defense Foundation filed a complaint with HHS saying the California abortion-coverage mandate violated the 2004 Weldon Amendment, a measure passed every year, which prohibits funding from the HHS, Labor and Education departments going to states that don’t allow conscience exemptions to abortion coverage requirements.

In a statement, the California agency says it only regulates “health plans,” not the “purchasers” of health coverage.

The churches’ complaint suggests the state receives an estimated $40 billion from Labor Department funding each year. “California accepted those funds with full knowledge of the requirements of the Weldon Amendment, but it has chosen to ignore this law,” they wrote in their complaint.

Nonetheless, the insurance plans have the burden to cover abortion, said Maggie Crosby, senior staff attorney of the American Civil Liberties Union of Northern California.

“California has not required churches — or any other employers — to cover abortion,” Crosby said in a statement. “It has clarified long standing law which regulates commercial insurance plans.”

That requirement has been in place since 2002, built on a state law passed in 1975, according to the August letter.

Demonstrators rallied at the Supreme Court on June 30, 2014 before the justices sided with the evangelical owners of Hobby Lobby Stores Inc., ruling 5-4 that the arts-and-crafts chain does not have to offer insurance for types of birth control that conflict with company owners’ religious beliefs. Religion News Service photo by Heather Adams

RNS photo by Heather Adams

Demonstrators rallied at the Supreme Court on June 30, 2014 before the justices sided with the evangelical owners of Hobby Lobby Stores Inc., ruling 5-4 that the arts-and-crafts chain does not have to offer insurance for types of birth control that conflict with company owners’ religious beliefs. Religion News Service photo by Heather Adams

“Because insurers must offer comprehensive care, an employer can’t use a subpar health plan to deny a woman the full range of reproductive health care options,” Crosby said. “If an employer wants to deny its employees the comprehensive coverage required, it can self-insure.”

The question of whether abortion should be covered under health insurance was raised during debates over Obamacare. HHS crafted an accommodation to its contraception mandate for some religious employers that would require third-party administrators to pay for birth control services, but ongoing litigation focuses on whether the accommodation is sufficient.

“The ACLU didn’t ask for such an accommodation in California and DMHC didn’t create one,” Mattox said in a statement. “ACLU asked DMHC to require every health care plan in the state to include elective abortion coverage as ‘basic healthcare.’ DMHC agreed.”

A similar dispute is brewing in the nation’s capital.

On Thursday (Oct. 23), ADF and six other organizations sent the City Council of the District of Columbia a letter arguing that a proposed bill violates federal law by forcing the groups to provide abortion coverage through their insurance plans.

The group argues that the District’s proposed Reproductive Health Non-Discrimination Amendment Act prohibits employers from discriminating against employees for any reproductive health decision, including abortion, which would require employers to provide health insurance for abortions regardless of the employers’ beliefs or convictions.

The letter argues that the bill would violate the law since the Hobby Lobby ruling earlier this year, when the Supreme Court ruled that the Hobby Lobby chain and other closely held private businesses with religious objections could opt out of the birth control mandate.

Clashes between the government and religious groups have intensified over health care related to women in recent years. More than 100 for-profit and nonprofit groups have sued over the contraceptive coverage required under the federal Affordable Care Act; the Supreme Court ruling only applied to for-profit businesses.


About the author

Sarah Pulliam Bailey

Sarah Pulliam Bailey is a national correspondent for RNS, covering how faith intersects with politics, culture and other news. She previously served as online editor for Christianity Today where she remains an editor-at-large.


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  • If it comes from “Alliance Defending Freedom” this is probably a grossly exaggerated non-story. They are notorious for making dishonest press releases and filing frivolous lawsuits.
    [The Idaho wedding chapel Story on this site is a good example]

    Lying and exaggeration are a major part of anti-choice political and litigation action. Accommodation already exists for church employees and related non-profits to avoid covering this sort of thing.

    That being said, Hobby Lobby was still a boneheaded decision. An employer has no business micromanaging the healthcare choices of their employees based on personal peccadilloes.

  • Religious organizations aren’t being forced to do anything other than pay their portion of health insurance. Their employees, as the insured, have a right to use any of the services offered them under their coverage. That is not forcing anyone to do anything, both sides are simply complying with the law.
    To give anyone an exemption from a universal law is sheer idiocy and hypocrisy. If they are Americans and are covered by the same law as the rest of us, they should follow the law the same as the rest of us. By making an exception you open up a whole can of worms. A hardware store run by Seventh Day Adventists might oppose their employees seeing a doctor for any reason, would that be allowed?
    It’s time our government gave churches a little “tough love.” Tell them where to shove their objections!

  • Agree with you 100%. This is simply an example of Christians trying to exert an alleged privilege to ignore laws they find inconvenient.

    The story is being put out by the “Alliance Defending Freedom” a group which is actively trying to bring back discrimination under color of law in favor of Christians. This means any facts alleged here are probably bogus until otherwise verified by an outside source.

    In general these morons want Christians to be exempt from any laws which require them to show basic decency and respect for anyone else.

  • Your comments worry people like me — and I’m prochoice, btw — because if we keep forcing everyone into a one-size-fits-all world, we’re going to have civil strife. A lot of people on the right fear our government now and are preparing for who knows what. Whether that’s paranoia or rooted in reality won’t matter if we keep having these disputes. Abortion should have been left out of universal health. It’s simply too controversial to mandate coverage over. You can’t reconcile those who believe it’s murder with those who don’t. So let’s stop, please. There is plenty of prochoice money available to pay for abortions and we can set up funding streams that avoid compelling people to pay for something they don’t believe in. Abortion is a far more serious issue than the ones to which you allude in your post. For pro lifers it’s literally a life and death debate. Get that through your head — they will not take this lying down and the prochoice side will earn many more enemies than it’s ever had if it continues down this profoundly stupid path.

  • @A,


    If it is not bigoted to preach Jesus to a non-believer
    It CANNOT BE BIGOTED to preach against Jesus to a believer.

    People have rights, but ideas do not have rights.
    Religion is just an idea.

    “Bigot” is a word for someone who is prejudiced against someone else for features they are born with: skin color, hair color, eye color, ethnicity, etc.
    That kind of prejudice is unfair and wrong.

    Doctors are against Cancer, not cancer patients.
    Anti-theists against Christianity, not Christians.

  • To hell with that.

    The conservatives already turned the healthcare bill into a compromised form which barely performs its intended function. They openly opposed any efforts at dealing with healthcare in a rational and sane manner. They had their chance to make compromises on the subject and took the opportunity to attack the very concept.

    I don’t need to reconcile with pro-lifers or compromise with them. Their position is an open attack to born people and reflects a position which brooks no middle ground. Any accommodation given is used as a way to attack the right to choose.

    They may be dogmatic, but it doesn’t mean that their position has merit. They even acknowledge how irrational their POV is by making religious or emotional appeals or constantly engaging in “sl1ut shaming” to support their views.

    Btw when someone states their alleged position at the beginning and then proceeds to refute it, it lacks credibility.For an alleged pro-choice person, you are parroting the anti-choice tropes and rhetoric. So Mr. Bewildered, when have you stopped lying?

  • It is worrisome how easily many Americans become willing to throw out key Constitutional rights for religious people and organizations when their values conflict with contemporary liberal values. If we really don’t need “freedom of religion” what other Constitutional freedoms do we not need that get in the way of the collective/progressive/liberal agenda? Speech? Press? (oh that message…its hate speech), Assembly (oh that group…they are domestic terrorists because of what they stand for).

  • Wow. What humanity there. The unborn are not human. They are disposable.

    Like in Orwell’s Animal Farm — all the animals are equal it is just that some are more equal than others… in this case “the born”.

    Perhaps Nietsche and Foucault are right about human society. Down deep we really are just animals where the strong finish off the weak and get to determine what kind of society we are going to live in. Maybe we are just kidding ourselves that there is something special and noble about being human when we can so easily discard our own young.

  • @John,

    I see. So are you in favor of the State owning your body – literally deciding what you can do with it?
    Don’t want to give up your kidney to save someone’s life? So the state should come and take it against your will?

    Don’t want to give blood today? Too bad – the state needs to save some lives so they are sending a crew right over to seize your body and take your blood.

    Why force women to endure a pregnancy against their will? You don’t have that right and you can’t force the state on them!
    Whether you like it or not a woman MUST have the right to own her body and make decisions over her body.

    Life isn’t perfect – but it isn’t made more perfect by forcing women to endure a pregnancy which they have decided not to. It simply is NOT your place to make that decision for them.

    Otherwise roll up your sleeve and we’ll let the state force things on YOUR body too! All to save lives!

    You have no clue what freedom is.

  • Its even more worrisome that people confuse religious freedom with simply pouting and bullying to get one’s way. Freedom of religion like every other freedom has limits. Usually when it is employed to attack similar rights of others. Freedom of religion does not grant one right to make decisions over the lives of others.

    These alleged Christians don’t want freedom, they want license to run roughshod over anyone who believes differently than they do.

    Besides, the story is more likely than not, a complete fabrication. Lying for the Lord appears to be the MO of the “Alliance Defending Freedom”.

  • When someone lied as baldly as Mr. Bewildered did, they deserved little courtesy. Who the hell are you kidding here? Your concern for life ends after birth.

    “Disposable life” to you being that of women who carry pregnancies they do not want/can’t bring to term. Their concerns ignored, minimized or attacked as not being worthy of consideration.

    They are unborn. Thanks to biology, it is ridiculous to grant them greater rights than born people. Especially greater than the person who keeps them alive. It is always the mother’s will which keeps a fetus alive. This means the all too common equating of a fetus with a born child is inherently dishonest. Although any human being can keep a born infant alive, the mother and only the mother keeps a fetus alive, at her own personal bodily risk.

    What kind of society would we have if we have to forcibly restrain pregnant women, treat them as non-people, and outright attack them in order to bring a fetus to term, whose life you will treat with so much contempt and indifference?

  • just another form of Christian persecution .. yet its our own fault not making sure the person we voted for was a conservative Christian..

  • Jack and others – if any portion of the insurance coverage that provides for abortion services must be paid by the employer then the government is violating that employers religious rights. In principle, this is no different than Nazi Germany requiring, by law, that certain groups of people be turned over to the state for eventual execution.