Skyline Wesleyan Church v. Cal. Dep't of Managed Health Care

313 F. Supp. 3d 1225
CourtDistrict Court, S.D. California
DecidedMarch 9, 2018
DocketCase No.: 3:16–cv–0501–CAB–(DHB)
StatusPublished

This text of 313 F. Supp. 3d 1225 (Skyline Wesleyan Church v. Cal. Dep't of Managed Health Care) is published on Counsel Stack Legal Research, covering District Court, S.D. California primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Skyline Wesleyan Church v. Cal. Dep't of Managed Health Care, 313 F. Supp. 3d 1225 (S.D. Cal. 2018).

Opinion

Hon. Cathy Ann Bencivengo, United States District Judge

This matter comes before the Court on Plaintiff's Motion for Summary Judgment [Doc. No. 67] and on Defendants' Cross Motion for Summary Judgment, or in the Alternative for Summary Adjudication, of Claims (or Defenses) [Doc. No. 68]. The motions have been fully briefed and the Court held oral argument on February 26, 2018. For the following reasons, Defendants' motion is granted and Plaintiff's motion is denied.

BACKGROUND

In California, the Department of Managed Health Care ("DMHC") is one of two state entities charged with overseeing the health coverage market, enforcing California laws and regulating health care service plans. Its responsibilities include ensuring that health care plans in California comply *1228with the Knox-Keene Health Care Service Plan Act by providing "enrollees with access to quality health care services and protect and promote the interests of enrollees." CAL. HEALTH & SAFETY CODE § 1341(a) ; [Doc. No. 67-6 at 246-2481 ]. Defendant Rouillard is the Director of the DMHC. [Doc. No. 67-6 at 432.]

Plaintiff is a non-profit Christian church located in La Mesa California, organized exclusively for religious purposes within the meaning of Section 501(c)(3) of the Internal Revenue Code. [Doc. No. 67-3 at 7-14.] Skyline Church believes that abortion is a sin and is incompatible with the Bible's teachings. [Id. at 2, ¶ 9.] As a member of the Wesleyan denomination, Skyline Church follows and operates in accordance with The Discipline of the Wesleyan Church. [Id. at 2, ¶ 6.] Thus, it agrees with the Wesleyan Church's position that an abortion is only permissible in:

rare pregnancies where there are grave medical conditions threatening the life of the mother, which would raise a serious question about taking the life of the unborn child. In such a case, a decision should be made only after very prayerful consideration following medical and spiritual counseling.

[Id. at 44.]

On August 22, 2014, Defendant Rouillard sent letters to seven group health plans2 that had limited or excluded coverage for termination of pregnancies. [Doc. No. 67-9 at 56-57; Doc. No. 68-5 at 8-21.] The letters explained that the "DMHC has reviewed the relevant legal authorities and has concluded that it erroneously approved, or it did not object to such discriminatory language in some evidence of coverage (EOC) filings." [Doc. No. 67-9 at 56-57; Doc. No. 68-5 at 8-21.] Further, the stated purpose of the letters was to:

remind plans that the Knox-Keene Health Care Service Plan Act of 1971 (Knox Keene Act) requires the provision of basic health care services and the California Constitution prohibits health plans from discriminating against women who choose to terminate a pregnancy. Thus, all health plans must treat maternity services and legal abortion neutrally.
Exclusions and limitations are also incompatible with both the California Reproductive Privacy Act and multiple California judicial decisions that have unambiguously established under the California Constitution that every pregnant woman has the fundamental right to choose to either bear a child or have a legal abortion. A health plan is not required to cover abortions that would be unlawful under Health & Safety Code § 123468.

[Doc. No. 67-9 at 56; Doc. No. 68-5 at 8, 10, 12, 14, 16, 18, 20.]3 The letter informed *1229the issuers of the health care plans that the plans must be amended to "remove discriminatory coverage exclusions and limitations," including but not limited to, "any exclusion of coverage for "voluntary" or "elective" abortions and/or any limitations of coverage to only "therapeutic" or "medically necessary" abortions." [Doc. No. 67-9 at 57; Doc. No. 68-5 at 9, 11, 13, 15, 17, 19, 21.] Upon receipt of the letters all of the issuers amended their health plan filings to eliminate the abortion exclusions. [Doc. No. 78-3 at 156.]

Before August 22, 2014, Skyline Church had an employee health plan that restricted abortion coverage consistent with the Church's religious beliefs. [Doc. No. 67-6 at 45-46, 132-33.] On September 3, 2014, Aetna, Skyline Church's health insurance provider at the time, responded to the DMHC's letter by removing reference to voluntary termination of pregnancy exclusions. [Doc. No. 67-9 at 63-64.]

In October of 2014 and 2016, Skyline Church contacted its insurance broker, Mr. Himmer, to discuss the possibility of obtaining a religious exemption from the abortion coverage requirement and purchasing a plan that restricted abortion coverage consistent with the Church's religious beliefs. [Doc. No. 67-4 at 2, ¶¶ 4-5; Doc. No. 67-6 at 50, 130-133, 186-188.] Mr. Himmer informed the Church that all of the available employee health care plans were required to provide coverage for elective abortion. [Doc. No. 67-4 at 2, ¶¶ 4, 5; Doc. No. 67-6 135-136, 186-187.] Daniel Grant, the executive pastor and chief financial officer of Skyline Church, did not make inquiries with any other churches as to the medical care plans they subscribe to and saw no reason "to try and seek out any other insurance because it would have been against the law to have any insurance that didn't cover" abortion but did contemplate joining a medical sharing ministry and self-insurance. [Doc. No. 67-6 at 83-84, 135-139.]

Subsequently, the DMHC informed the health care plans that it would grant them an exemption from the requirements it had detailed in the August 22, 2014 letter for products offered exclusively to entities that meet the definition of a "religious employers" as defined in the California Health and Safety Code 1367.25(b)(1). [Doc. No. 67-6 at 360-367; Doc. No. 68-5 at 31.] DMHC also allowed Anthem Blue Cross to offer a plan to religious employers which limits termination of pregnancy to situations involving rape, incest or where the woman's life is in danger. [Doc. No. 67-1 at 6-35; Doc. No. 67-6 at 359-368; Doc. No. 67-6 at 477; Doc. No. 68-5 at 5 ¶ 5; Doc. No. 78-3 at 156.] A declaration from Sarah Ream, the Deputy Director of the Office of Plan Licensing at the DMHC, executed on November 15, 2017, attests "[t]o date, no plan has requested an exemption that would mandate that women who become pregnant as a result of rape or incest be forced to carry to term." [Doc. No. 68-4 at ¶ 2.]

On February 4, 2016, Plaintiff filed a complaint for declaratory and injunctive relief and nominal damages in San Diego County Superior Court against Defendants, alleging claims for (1) violation of the Free Exercise Clause of the First Amendment of the United States Constitution; (2) violation of the Equal Protection Clause of the Fourteenth Amendment of the United States Constitution; (3) violation of the Establishment Clause of the First Amendment of the United States Constitution; (4) violation of the Establishment and Free Exercise Clauses of Article I, Section 4 of the California Constitution ; (5) violation of the Equal Protection Clause of Article I, Section 7 of the California Constitution ; and (6) violation of the California Administrative Procedure Act *1230("APA"), California Government Code § 11340 et seq. [Doc. No.

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Bluebook (online)
313 F. Supp. 3d 1225, Counsel Stack Legal Research, https://law.counselstack.com/opinion/skyline-wesleyan-church-v-cal-dept-of-managed-health-care-casd-2018.