Attorney General Becerra Co-leads Letter Urging Trump Administration to Safeguard Americans’ Healthcare Coverage, Halt Implementation of Their Abortion Separate Payment Rule

Tuesday, April 7, 2020
Contact: (916) 210-6000,

Implementing the rule during the COVID-19 pandemic irresponsibly puts more than 1.4 million enrollees in California at risk of losing coverage when they need it most

SACRAMENTO – California Attorney General Xavier Becerra and New York Attorney General Letitia James, leading a coalition of seven attorneys general, sent a letter urging the U.S. Department of Health and Human Services (HHS) to delay the implementation of its rule that unlawfully reinterprets Section 1303 of the Affordable Care Act (ACA). Implementing the rule would limit healthcare coverage, including reproductive care, and endanger Americans’ health as the nation works to combat the COVID-19 pandemic. In the letter, the attorneys general argue that HHS should halt implementation of the rule to aid states’ response to COVID-19 and protect the healthcare coverage that Americans rely on. 
“The Trump Administration’s separate payment rule puts Americans’ healthcare coverage at risk, and burdens states and health plans at a time when we should be streamlining our response to the global COVID-19 crisis,” said Attorney General Becerra. “This burdensome rule is intended to limit access to women’s reproductive care, but it will foolishly endanger access to all healthcare when people need it most. The Trump Administration should do the right thing and protect Americans’ healthcare coverage during this unprecedented public health crisis.”
Under California law, all health plans regulated by the state are required to offer abortion coverage as part of their basic healthcare services. On December 27, 2019, HHS issued a final rule requiring qualified health plans participating in the state exchanges like Covered California to separately bill for the portion of health insurance premiums attributable to abortion coverage. This would require consumers to make a separate payment of at least one dollar for these services. Failure to pay the separate bill puts individuals at risk of losing all of their healthcare coverage. HHS itself has conceded that requiring separate bills and separate payments will inevitably lead to confusion, putting more than 1.4 million enrollees in California alone at risk of losing coverage if they inadvertently fail to make full premium payments on time. The rule also burdens states with unnecessary administrative costs and harms consumers who may face higher insurance premiums as a result of increased costs to carriers. 
In the letter, the attorneys general argue that implementing the rule during this public health and economic crisis is irresponsible and harmful to people across the country. Over the past several weeks, the U.S. has experienced a significant increase in the need for aid, funding, and other support to help various states respond to the pandemic. Pressing ahead with implementation of this rule during the global health crisis would impose additional financial burdens on state agencies; require countless personnel hours, funds, and resources to come into compliance; and jeopardize the health of consumers more in need of health coverage than ever. Furthermore, HHS has recognized that implementing the rule will have significant economic consequences. According to HHS’s own estimates, the one-time costs to bring all affected health plans into compliance would include over 2.9 million hours of work and approximately $385 million for insurers across the nation. These costs would likely result in increased prices for consumers, who are already suffering from the economic impacts of the COVID-19 pandemic. The attorneys general call on HHS to halt implementation of the rule to protect the health and economic security of consumers across the nation.
In sending the letter, Attorney General Becerra joined the attorneys general of New York, Colorado, Maryland, Oregon, Vermont, and the District of Columbia. 

A copy of the letter is available here

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