Catholic Universities Face Ethical Concerns Over Health Plans that Covers Abortion
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California Catholic universities have found themselves at the intersection of faith, ethics, and legal mandates as they grapple with student health insurance plans that include coverage for abortion, sterilization, and "gender-affirming" care. While state law necessitates such coverage, industry experts in the insurance field suggest that universities might have avenues to circumvent these ethical quandaries.
Photo credit: Samuel Ramos
The spotlight recently turned to the University of San Diego (USD), a Catholic institution founded in 1949 by the Society of the Sacred Heart of Jesus, due to its student health plan provisions. The plan in question covers abortion and transgender procedures, a fact that has drawn media attention and raised concerns about the university's alignment with Catholic principles.
In response to inquiries about their policy, USD stated that they are bound by state law to offer coverage that falls within the definition of "health care" outlined by the same law. The university emphasized its obligation to conform to state regulations, which extend to both student and employee health insurance plans.
Students enrolling at USD are required by federal law to possess health insurance. They can either subscribe to a student health plan through Aetna or present evidence of existing insurance coverage.
The USD student plan's benefits summary reveals that abortion expenses are entirely covered, while voluntary male sterilization costs are reimbursed at 80%. Furthermore, "gender-affirming treatment" aimed at affirming transgender individuals' self-identified gender, including surgical procedures, hormone replacement therapy, and counseling, is included in the plan's coverage.
Around 18% of USD's total enrollment, approximately 1,600 students, opted for the Aetna plan during the fall semester of 2022.
A survey of California's Catholic colleges and universities indicates a pattern in student health plans' coverage. Institutions such as the University of San Francisco and Loyola Marymount University share similar coverage features with USD, encompassing abortion, male sterilization surgery, and gender-affirming treatment.
The University of Santa Clara's student health plan includes coverage for female sterilization and gender-affirming care, but abortion coverage is not explicitly mentioned. A representative from Santa Clara University, a Jesuit establishment, asserted that their health plans adhere to California law. The university's classification as a "religious employer" according to the applicable state law prevents them from claiming an exemption.
California's redefinition of abortion as basic health care emerged as a response to efforts by Catholic and pro-life advocates to secure health plans devoid of abortion coverage. Initially, Loyola Marymount University and Santa Clara University had removed elective abortion from their employee health care plans. However, opposition from abortion advocates led to changes in regulations.
In 2014, California authorities mandated health plans to cover abortions, citing it as essential health care and labeling it discriminatory to cover maternity services while excluding abortion.
Legal battles surrounding mandatory abortion coverage have resulted in varying outcomes. While non-Catholic churches have secured legal victories asserting their First Amendment right to withhold elective abortion coverage from employee health insurance plans, Catholic universities have faced more complex scenarios.
The University of San Diego does not qualify as a "religious employer" under state statute, hindering their eligibility for religious exemptions. Other Catholic institutions have sought alternative solutions. John Paul the Great Catholic University and Thomas Aquinas College, for example, do not provide student health plans. Instead, students typically remain on their parents' plans until the age of 26.
Thomas Aquinas College operates a self-insured health plan, exempt from California regulations. This exemption enables them to offer health care in accordance with Catholic moral teachings.
Catholic institutions in California grappling with these issues face challenges in aligning their policies with both their religious convictions and state mandates. Expert insights suggest potential avenues, such as ERISA health plans compliant with federal regulations, to ensure that institutions can maintain their commitment to Catholic principles while adhering to state and federal laws.
As Catholic universities seek to provide comprehensive health insurance options that align with their values, they navigate a delicate balance between faith, ethics, and legal obligations in a rapidly evolving landscape.
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