WASHINGTONThe Trump administration told California it is violating federal law by requiring insurers to cover abortion and threatened to withhold federal funding if the state doesnt end its mandate, the latest move in a broader White House effort to establish religion-based exemptions to reproductive-rights statutes.Officials in the Republican administration signaled Friday that they could also take aim at similar policies in other states, potentially putting hundreds of billions of dollars in federal health funding at risk.
California Gov. Gavin Newsom,
a Democrat, pushed back in response to the administrations move against the nations most populous state.
California will continue to protect a womans right to choose, and we wont back down from defending reproductive freedom for everybodyfull stop, he said in a statement on Friday.
A broader legal battle between states and the White House is likely.
Religious groups say the mandates force them to violate their beliefs by purchasing health insurance that covers abortions or by using their premiums to help pay for other consumers abortions.
Abortion-rights groups say that states have the long-held right to regulate their own insurance markets. They say that abortion, which has been legal nationally for decades, is a medical procedure that should be covered just like prenatal and maternity care.
Under Fridays action, the Department of Health and Human Services Office for Civil Rights issued a notice of violation against California. In it, the agency said the states requirement violates federal law banning government entities that receive HHS funding from discriminating against health-care organizations because they dont provide abortion or abortion coverage. The state has 30 days to signal compliance before the agency takes action that could result in cutting HHS funds.
The Trump administration announced its plan on the day that thousands of antiabortion activists gathered on the National Mall for the annual March for Life rally. President Trump addressed the event Friday, making him the first president to do so in person.
Unborn children have never had a stronger defender in the White House, Mr. Trump said. We are fighting for those who have no voice and we will win because we know how to win.
Mr. Trump has appeared by video in previous years, following past Republican presidents who spoke by phone to the gathering that marks the anniversary of the Supreme Courts 1973 Roe v. Wade decision that recognized a nationwide right to abortion.
The President & VP are once again attacking womens health in order to grandstand at todays anti-choice rally, California Attorney General
Xavier Becerra
tweeted Friday. Make no mistake, this action against CA is just one more attempt to chip away at womens rights & access to abortion.
Hundreds of billions of dollars could be at stake. California gets $51 billion from HHS for its Medicaid program, according to the Kaiser Family Foundation. The six states that mandate abortion coverage get more than $100 billion annually in federal Medicaid funds alone, according to Kaiser.
Other states should expect the same actions,
Roger Severino,
director of the HHS Office for Civil Rights, said Friday, adding, Just as a government shouldnt force a kosher deli to serve ham, you shouldnt require nuns to pay for abortion.
Californias requirement that private health-insurance policies include abortion coverage was challenged by a Catholic mission, the Missionary Guadalupanas of the Holy Spirit. A three-judge panel of the California Court of Appeals in August dismissed that lawsuit.
Meanwhile, Oregon Right to Life this month said it had filed a suit against Oregons law, which was passed in 2017. A complaint against Illinoiss abortion-coverage requirement was filed in October on behalf of the Thomas More Society, an antiabortion legal group.
During his remarks Friday, Mr. Trump attacked Democratic support for abortion rights and stressed his record on restricting abortion access, noting his policy efforts and judicial appointments. He also framed the issue in a religious context, saying: Every human soul is divine, and every human lifeborn and unbornis made in the holy image of Almighty God.
The Trump administration has pushed to include religious rights in health-care policy. Last May, it issued a rule supporting health workers with moral or faith-based objections to certain medical procedures. The rule was later blocked in federal court.
Administration officials and religious groups say laws that mandate contraception or abortion coverage shouldnt stand because they violate deeply held beliefs. Their position is part of a broader effort to harness federal civil-rights laws to protect groups and individuals that oppose abortion.
Abortion rights groups say the federal government is attacking access to reproductive rights that are protected under Roe v. Wade and other court rulings. They add that letting insurers opt out of providing abortion coverage particularly harms lower-income women who cant afford abortions.
Alexis McGill Johnson,
acting president and chief executive of Planned Parenthood Action Fund, said, Since day one, this administration has carried out a full-out assault on our health and our rights.
Some legal experts say the Trump administration threat of withholding funds tramples on states right to regulate their own insurance markets. For example, eleven states ban abortion coverage in all private insurance plans regulated by the state, according to the Guttmacher Institute, an organization that supports abortion rights.
This sounds quite extraordinary, said
Nicholas Bagley,
a University of Michigan law professor of the administrations action against California. This is the kind of change youd normally see through rule making. To just go after California, it seems vindictive.
Mr. Trump has been at odds with California, which is dominated by Democrats and supported
Hillary Clinton
in 2016, on several fronts. He has criticized its policies on homelessness, and his administration has cited air-quality concerns in threatening to withhold federal highway funding. Mr. Becerra has filed a string of lawsuits on behalf of California against administration actions.
Mr. Trump and his campaign have been eager to court and expand support from antiabortion voters heading into the 2020 election. His campaign released a video Friday announcing the launch of Pro-Life Voices for Trump. The president has made a series of other moves aimed at conservative Christian voters, including a pledge to renew guidance on prayer in schools and the launch of an Evangelicals for Trump coalition.
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—Sadie Gurman contributed to this article.
Write to Stephanie Armour at stephanie.armour@wsj.com and Catherine Lucey at catherine.lucey@wsj.com
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