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California churches don’t have to provide abortion coverage in health plans, court rules

A woman consults with a female doctor in a medical exam room.
A patient consults with a doctor about her medical care. Three California churches that sued the state of California after it sought to be excluded from a mandate that all healthcare plans must provide abortion services won their case in federal court Thursday.
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Three California churches no longer have to cover abortion services as part of their employee healthcare plans after winning a years-long legal battle against the state, a federal court ruled Thursday.

The case, based on a lawsuit filed by the churches in 2015, weighed their claims of religious discrimination against the state’s position that abortion services represent basic care that should generally be covered by all healthcare plans offered in the state.

U.S. District Chief Judge Kimberly Mueller, of the Eastern District of California, sided with the churches in her opinion for the court, writing that the California Department of Managed Health Care had violated the churches’ 1st Amendment right to freely exercise their religion when it denied their requests for exemptions from the coverage requirement.

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The churches had asked to be exempt from covering abortions except “when absolutely necessary to save the life of the mother.”

The department had argued that, while it may provide such religious exemptions, it only considers exemption requests that come directly from health plans, not from individual employers.

The state said it had a compelling interest in holding that position because it prevented a potential “flood of exemption requests” from millions of employers across the state. Considering individual exemption requests from so many employers would be impossible, it said in court filings.

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The state also argued that Department of Managed Health Care‘s oversight was limited to healthcare plans, appropriately, and limited its ability to hear claims from employers.

Mueller did not find those arguments persuasive, writing that department Director Mary Watanabe’s “denial of the Churches’ request for exceptions to accommodate their religious beliefs, based solely on the fact that those requests did not originate with a plan, was not narrowly tailored to serve a compelling interest.”

Mueller wrote that the department’s jurisdiction overseeing health plans would allow it to direct those plans to accommodate religious exemption claims from plan members. She also wrote that the state had not provided any evidence that it would face a deluge of exemption requests if it began accepting them from individual employers.

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“Even assuming similar religious challenges materialized in California in large numbers, [Watanabe] has not offered evidence showing that entertaining these religious objections would be so difficult and time-consuming that ‘DMHC’s operations would grind to a halt,’” Mueller wrote.

The ruling was a clear victory for the churches: Foothill Church in Glendora, Calvary Chapel Chino Hills in Chino and the Shepherd of the Hills Church in Porter Ranch. Jeremiah Galus, an attorney with the Alliance Defending Freedom who helped represent the churches in the case, praised the decision.

“The government can’t force a church or any other religious employer to violate their faith and conscience by participating in funding abortion,” Galus said in a statement. “For years, California has unconstitutionally targeted faith-based organizations, so we’re pleased the court has found this mandate unconstitutional and will allow the churches we represent to operate freely according to their religious beliefs.”

A spokeswoman for the Department of Managed Health Care said it was reviewing the decision. The California attorney general’s office, which represented the department in the matter, did not immediately respond to a request for comment late Thursday.

The decision was in part the result of a separate decision by the U.S. Supreme Court — though not Dobbs vs. Jackson Women’s Health Organization, which overturned the landmark Roe vs. Wade case and stripped women of the right to an abortion nationwide.

Mueller noted that the Dobbs decision did not apply in the churches’ case.

What did apply was the U.S. Supreme Court’s ruling in Fulton vs. City of Philadelphia, a 2021 decision in which the high court ruled that Philadelphia’s refusal to contract with Catholic Social Services for foster care services unless the organization allowed same-sex couples to serve as foster parents violated the 1st Amendment — and specifically the free exercise clause.

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The churches’ case against California had previously been rejected by the district court, in favor of the state, but the churches appealed. Based on the Supreme Court’s ruling in the Philadelphia case, a panel of judges on the U.S. 9th Circuit Court of Appeals vacated the lower court’s decision and remanded the case back to the district court to reconsider in light of the Philadelphia decision.

The decision is another example of the federal courts’ sway over California policy when it comes to abortion access, which California has increasingly sought to protect since the Dobbs decision and responding efforts by other states to severely restrict or outlaw abortions as a result.

Beyond declaring the state’s denial of exemptions to the churches unconstitutional, the exact implications of Mueller’s ruling are not entirely clear. The order directed the churches and the state to file briefs on the scope of relief that should be provided within 30 days.

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