Relevant state health codes define a “religious employer” as a nonprofit entity whose purpose is the inculcation of religious values and which primarily employs and serves those who share its religious tenets. A spokesperson for the Department of Managed Health Care told CNA that it reviews exemption requests based on the requirements of California law and the Health and Safety Code.
Weldon Amendment appeals have stalled
California’s mandatory abortion coverage in employee health plans drew legal challenges based on the federal Weldon Amendment. The amendment, first passed in 2005, bars states that accept federal funds from discriminating against institutions and health care entities that do not provide coverage of abortion or refer for abortions.
In theory, the Weldon Amendment could protect Catholic universities that reject health plans that cover abortion.
In practice, the protections have proved elusive. As CNA previously reported, pro-life advocates including the U.S. bishops have called for stronger “conscience protections” that would allow them to contest pro-abortion state mandates. At present, they depend on federal authorities to enforce the rules.
The California Catholic Conference filed a Weldon Amendment complaint against California with the U.S. Department of Health and Human Services’ Office of Civil Rights, which was rejected by the Obama administration in June 2016.
In January 2020, the Trump administration sided with another Weldon Amendment complaint from a Catholic mission and a Wesleyan church. The Trump administration demanded that the state comply with the Weldon Amendment and threatened to cut all HHS funding from California.
The current U.S. Secretary of Health and Human Services is Xavier Becerra, the strongly pro-abortion rights former attorney general of California. In his former role, he refused to comply with the Trump administration’s demands.
Alliance Defending Freedom told CNA that the Biden administration reversed the Trump administration’s decision.
In an Aug. 13, 2021, letter to California Attorney General Rob Bonta, Robinsue Frohboese, acting director and principal deputy of the HHS Office for Civil Rights, said that the Office of Civil Rights would withdraw its notice of violation against the state of California and close the complaints regarding the Weldon Amendment.
Have other Catholic institutions found a way?
Some Catholic colleges do not provide student health plans in California.
“Most students remain on their parents’ plans until they are 26, so most have no need for an alternative plan,” Anna Velasco, vice president of human relations at John Paul the Great Catholic University in Escondido, told CNA.
“As mandated by law, we offer a variety of health plans for employees to choose from,” she said.
To the question of whether these health plans include coverage of abortion, male sterilization, and gender-affirming care, Velasco responded: “California plans, by law, unfortunately, include these objectionable services.”
Thomas Aquinas College in Santa Paula also does not provide a student health plan. Students are required to have their own health plan, and this is their parents’ health plan “in nearly all instances,” Chris Weinkopf, the college’s executive director of college relations, told CNA.
“The college provides full health care — which includes dental and vision care, as well as zero monthly premiums — to all its full-time employees and their families,” Weinkopf said. “We consider providing medical coverage an essential part of our character as a Catholic institution.”
However, this health plan isn’t bound by California rules mandating abortion because it is self-insuring — one of the few exemptions in California regulations. This means the employer funds its own health plan, collects premiums, and pays enrollee health claims.
“Since we self-insure, the college is exempt from California insurance law and regulations that require insurance coverage that is at odds with Catholic moral teaching,” Weinkopf said.
The college is a member organization of the Reta Trust, a national health benefits trust based in Walnut Creek, California. Among other employee benefits, Reta provides employee health plans that follow Catholic social and moral teachings, including the U.S. Conference of Catholic Bishops’ Ethical and Religious Directives for Catholic Health Care.
California’s hostile legal environment a barrier
Kathryne McGowan, CEO of Reta Trust, spoke with CNA about the regulatory situation in California.
“It’s a very difficult environment for employers and student health plans to be able to offer Catholic-compliant benefits because, as a result of the local environment, you just can’t offer compliant benefits,” she said.
With some exceptions, Catholic institutions offering a fully insured health plan in California must include the coverage benefits for drugs and procedures that violate Catholic teaching.
Qualified California entities can organize church plans under state law, which can allow greater flexibility but still require legal fights with any coverage mandated by state laws or rules, according to McGowan.
Another option is an ERISA health plan compliant with federal rules and laws under the Employee Retirement Income Security Act of 1974 (ERISA). These are regulated by the federal Department of Labor and don’t have to comply with state laws’ requirements for abortion coverage.
“Employers will often use an ERISA plan so that they can offer benefits that are compliant with their belief sets,” McGowan said. “For most employers, state laws are the problem.”
In theory, federal legislation could still mandate coverage that conflicts with religious beliefs, but McGowan said she was not aware of any interference.
Another option for Catholic institutions is to join a group like Reta Trust, which is bound by federal law, not state law.
“Reta makes it very simple and easy to move over,” McGowan said. “The pricing is competitive, and we have a very high touch service model and are very successful in moving groups over and minimizing disruption.”
CNA sought comment from all Catholic colleges and universities in California but as of publication had received comment only from John Paul the Great Catholic University, Santa Clara University, Thomas Aquinas College, and the University of San Diego.