California Insurance Commissioner Acts to Protect Abortion

The Commissioner’s Bulletin confirms the obligation of insurance companies to provide coverage for abortion and abortion under current and soon-to-be-effective laws.

July 25, 2022 – LOS ANGELES – As part of his efforts to protect access to reproductive health care and abortion coverage in California, Insurance Commissioner Ricardo Lara last week. has been given a Story to remind insurers of their current obligations to provide abortion care and abortion-related services, and to alert insurers to recent and upcoming changes in California state law.

“Protecting all people’s right to health care, including reproductive rights, is very important to me and the California Department of Insurance,” said Commissioner Lara. “I want to make sure that consumers and insurers have accurate information about abortion access and access in California and know that the Department of Insurance is there to protect consumers’ access to reproductive health.”

California law is clear that abortion care is essential health care and is covered by most health insurance. Commissioner Lara Story He explains that new and existing laws require insurance companies to provide this in three key areas:

  • Abortion is a medically necessary procedure: Health insurance that covers medical care must cover medical abortion when provided by a provider as well as abortion. As of July 1, 2022, major health insurance groups are now required to provide essential health services in accordance with Senate Bill 280 (Limón, Chapter 636, Statutes of 2021), a measure that Commissioner Lara supported last year.
  • Medical abortion provided by pharmacies is necessary for medicine: In accordance with the law of Insurance section 10123.201, insurance policies that are provided with medicine given to outpatients must be provided with the necessary medicine, including the abortion medicine that is given in the store.
  • Patient cost-sharing and reductions in abortion care will be illegal in the new year: Starting January 1, 2023, Senate Bill 245 (Gonzalez, Chapter 11, Laws of 2022), will prohibit the provision of any patient cost-sharing for any abortion or abortion-related service provided by health insurance. In addition, health insurers are prohibited from imposing utilization management on abortion and related services. SB 245 applies to both medical and surgical abortions. Commissioner Lara supported this in the legislative process.

“I was proud to partner with Insurance Commissioner Lara last year to ensure that all health insurance in California covers maternity,” said Senator Monique Limón, who authored SB 280, which now requires federal policies to provide essential health care including abortion. “Now more than ever it is important to protect the access of all Californians to affordable and accessible health care.”

“The recent decision by the United States Supreme Court to remove the constitutional right to abortion after nearly 50 years of standing law is a major challenge to reproductive rights in our country,” said Senator Lena Gonzalez, who authored SB 245. sad to see us go backwards as a nation, but in California, we will continue to fight. That’s why I’m proud that my bill, the Abortion Accessibility Act (SB 245), is now law and will be implemented by all federal health and disability insurance policies to ensure access to legal, affordable abortion care. I pledge to continue to fight and engage in dialogue with stakeholders, friends, and the community to protect the reproductive rights of all Californians.”

Commissioner Lara encourages all insurers that offer or offer health insurance, except for private health insurers, to comply with the new SB 245 law before the start of the new year. They also encourage insurers to start making any necessary documents with the department to work quickly. The Department shall make this rule effective immediately upon its effective date, which shall be issued or amended on or after January 1, 2023.

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