Attorney General James Wins Suit, Stops Trump Administration from Raising Costs of Abortion Coverage

New Trump Administration Rule Would Have Also Threatened to Strip All Health Coverage from Women During National Pandemic 

Court Agrees That Trump Administration Rule Provided No “Reasoned Explanation” for Defying True Intent of ACA and Was “Arbitrary and Capricious”

NEW YORK – New York Attorney General Letitia James today announced a nationwide victory for women’s reproductive freedoms after a federal court threw out, late last night, a Trump Administration rule that would have made it more difficult for women in New York and across the nation to access abortion services under the Patient Protection and Affordable Care Act (ACA). In January, Attorney General James and California Attorney General Xavier Becerra co-led a coalition of eight attorneys general in filing a lawsuit to stop the U.S. Department of Health and Human Services (HHS) from implementing the rule, which threatened to potentially kick millions of women off their health plans if they failed to comply with a technical billing issue related to abortion coverage. In March, Attorney General James and Attorney General Becerra co-led the coalition in asking a federal court to provide today’s expedited decision when she filed a motion for summary judgment in the case.

“From the beginning, this rule was an egregious attempt by President Trump and his administration to control women, and make it harder for those struggling financially to exercise their constitutional right to access an abortion,” said Attorney General James. “This decision will immediately stop the Trump Administration’s anti-choice assault on women’s reproductive choices and will allow millions of women across New York and the rest of the nation to retain control over their bodies. While we celebrate this victory, we remain vigilant against the president’s continued attacks on women’s reproductive freedoms, and we will stand ready to fight to ensure every woman is able to make her own reproductive choices.”

The rule in question illegally reinterpreted Section 1303 of the ACA by requiring qualified health plans that participated in the state exchanges, like the New York State of Health, to send two separate monthly bills for payments of a health insurance premium — even if no abortion service was provided — and to have collected separate monthly payments for abortion services from all consumers. One bill would have been for the premium amount attributable to abortion coverage (and would have needed to be at least one dollar), and a second bill would have compromised the premium amount attributable to the remaining coverage, which may have included services like primary doctor appointments, hospital visits, and other services covered by insurance. If a consumer missed even a single one-dollar payment, that individual could have lost all health coverage on the exchange. HHS itself had conceded that requiring separate bills and separate payments would have inevitably led to confusion, putting more than 160,000 New Yorkers who already enrolled in a qualified health plan this year alone at risk of losing coverage if they inadvertently failed to make full premium payments on time. 

Late last night, the U.S. District Court for the Northern District of California granted Attorney General James’s motion for a summary judgment, ruling that the Trump Administration’s rule departed from prior HHS policy without “provid[ing] a reasoned explanation” or any “context for why [HHS’s] belief advances Congress’s intent.” The court went on to state that the new rule would have “increased costs, created enrollee confusion, and risked reduced health care coverage (which contravenes [with] the ACA’s purpose)” — concluding that the rule “is arbitrary and capricious.”

Additionally, in April, Attorney General James and Attorney General Becerra co-led a coalition of attorneys general in sending a letter to HHS, calling on the agency to withdraw or further delay the rule as the nation battled the coronavirus disease 2019 (COVID-19) public health crisis, and just earlier this month, Attorney General James and Attorney General Becerra co-led the sending of an additional letter to HHS after another interim rule did not delay this rule long enough.

Today’s action is just the latest in a long list of measures Attorney General James has taken to protect women’s reproductive freedom since taking office. In June, Attorney General James led a coalition in filing an amicus brief in the U.S. District Court for the District of Maryland — supporting the plaintiffs in an amicus brief filed in support of the plaintiffs in American College of Obstetricians and Gynecologists et al. v. FDA et al., asking the court to halt the Trump Administration from continuing to institute a requirement that forces women to appear in person in a clinical setting to receive the drug Mifepristone for an early abortion or for miscarriage care.

In April, Attorney General James led a coalition of attorneys general in filing an amicus brief in the U.S. Court of Appeals for the Sixth Circuit — supporting the plaintiffs in Adams & Boyle, P.C., v. Slatery — as they fought to ensure women across the state of Tennessee could continue to access an abortion after executive orders in the state banned abortion, using COVID-19 as an excuse.

Also, in April, Attorney General James led a coalition of attorneys general in filing an amicus brief in the U.S. Court of Appeals for the Eleventh Circuit — supporting the plaintiffs in Robinson v. Marshall — as they fought to preserve access to reproductive health care for women across Alabama, after an executive order banned nearly all abortions in the state, using the coronavirus as an excuse for the ban.

Earlier, in April, Attorney General James led a coalition of attorneys general in filing an amicus brief in the U.S. Court of Appeals for the Eighth Circuit — supporting the plaintiffs in Little Rock Family Planning Services v. In re Leslie Rutledge — as they fought to protect women’s access to procedural abortions in the state of Arkansas, after the state Department of Health used an emergency health order to ban all procedural abortions in Arkansas, using COVID-19 as the reasoning for the ban.

Additionally, in April, Attorney General James demanded that three health insurance companies — Aetna, MetroPlus Health, and Oscar Health — immediately provide coverage for 12-month supplies of contraceptives after the Office of the Attorney General found that these companies were refusing to comply with New York state law requiring all health insurance companies to provide this 12-month supply — especially troublesome in the midst of the COVID-19 pandemic, as many New Yorkers lose their jobs and health insurance coverage, and try to limit unnecessary trips to pharmacies. Attorney General James also sent letters to other insurers in New York, reminding them about their obligation to provide 12 months of contraceptive coverage to women under New York’s Comprehensive Contraception Coverage Act.

Even earlier, in April, Attorney General James led a multistate coalition in filing an amicus brief — in the U.S. Court of Appeals for the Tenth Circuit supporting the plaintiffs in Southwind Women’s Center LLC v. Stitt — as they fought to preserve access to reproductive health care for women across the state of Oklahoma and work to stop the state from banning almost all abortions in Oklahoma, using the COVID-19 public health crisis as an excuse.

Prior to that, in April, Attorney General James and a coalition of attorneys general filed an amicus brief in the U.S. Supreme Court — in Little Sisters of the Poor v. Pennsylvania — supporting a lawsuit defending the contraceptive coverage and counseling requirement previously mandated by rules under the Affordable Care Act that have now been limited by broad religious and conscience exemptions created by the Trump Administration. The old contraceptive rules benefited more than 62 million women across the country.

At the beginning of April, Attorney General James led a multistate coalition of attorneys general from around the nation in filing an amicus brief supporting the plaintiffs in Planned Parenthood v. Abbott, after the state of Texas issued a directive banning nearly all abortion services in the state, using the coronavirus as an excuse.

In late March, Attorney General James sent a letter to both the U.S. Department of Health and Human Services and the U.S. Food and Drug Administration requesting that the Trump Administration waive or utilize its discretion not to enforce a specific designation, which dictates and subsequently impedes women’s access to the medical-abortion prescription drug known as Mifepristone. Attorney General James called on the Trump Administration to ensure that women across the country can more easily access this critical health care service while the pandemic leaves many women unable to seek in-person care.

Also, in March — at the onset of the COVID-19 pandemic — Attorney General James called on the federal government and states across the country to ensure women’s access to safe, legal abortions are not jeopardized or curtailed as a result of the spread of COVID-19.

In January, Attorney General James filed an amicus brief, in Reproductive Health Services v. Planned Parenthood of St. Louis, challenging the constitutionality of several recently enacted abortion bans in the state of Missouri. 

Before that, in January, Attorney General James secured a victory for women in Rochester seeking to have an abortion without being harassed, threatened, or blocked before entering a clinic when a district court judge dismissed a lawsuit by anti-abortion activists seeking to bypass a 15-foot “buffer zone” outside a local Planned Parenthood facility.

Even earlier, in January, Attorney General James filed a multistate amicus brief in support of a lawsuit that seeks to protect a woman’s right to safe and legal abortion care without the burdensome restrictions imposed by Arkansas laws. The brief — filed in support of the plaintiffs in Little Rock Family Planning Services v. Leslie Rutledge, now before the U.S. Court of Appeals for the Eighth Circuit — supports the last surgical abortion clinic in Arkansas as it challenges four state laws that would restrict the ability for women in Arkansas to access abortions by banning abortions after 18 weeks and otherwise restricting women’s access to reproductive care. 

In December 2019, Attorney General James filed an amicus brief defending the right to maintain full and equal access to birth control guaranteed under the Affordable Care Act for tens of thousands of women nationwide

Also, in December 2019, Attorney General James led a multistate amicus brief in support of a challenge by petitioners in the case June Medical Services v. Gee, challenging a Louisiana law that requires abortion providers to maintain admitting privileges at a local hospital. In June, Attorney General James helped score a major victory at the U.S. Supreme Court that overturned the Louisiana law and that will protect the ability of women across the nation to maintain access to safe, legal abortions, as is their constitutional right.

In October 2019, Attorney General James filed a multistate amicus brief in support of a lawsuit filed by the Jackson Women’s Health Organization against the state of Mississippi, challenging a law that would prohibit abortions after as early as six weeks of pregnancy.

In September 2019, Attorney General James led a multistate amicus brief in support of a challenge filed by Kentucky clinics and physicians, challenging a Kentucky law that would ban physicians from providing second-trimester abortion services, using the most common and safest procedure available for women after 15 weeks of pregnancy. In June 2020, the U.S. Court of Appeals for the Sixth Circuit affirmed the district court's permanent injunction against the law.

In August 2019, Attorney General James filed a multistate amicus brief in support of a lawsuit filed by the Whole Woman’s Health Alliance against the state of Indiana after the state denied the clinics application for a license to open an abortion clinic that would provide medical abortions in South Bend.

In March 2019, Attorney General James co-led a coalition of 21 states in a lawsuit challenging the Trump Administration’s regulations that threaten essential services provided under federal Title X funding. The rule — also known as the “gag rule” — places an unlawful and unethical restriction on health care providers’ ability to fully inform patients of the reproductive health services available to them by disallowing referrals for abortions and restricting counseling related to abortions. Another provision would require those who perform abortions to physically segregate their services — an expensive and potentially impossible requirement. In May 2020, Attorney General James and a coalition filed an amicus brief in the U.S. Court of Appeals for the Fourth Circuit in a similar lawsuit brought by the city of Baltimore against the Trump Administration’s Title X rule.

Finally, Attorney General James is litigating the appeal in People ex rel. James v. Griepp to ensure that women who enter the Choices Women’s Medical Center in Jamaica, Queens are not harassed, obstructed, or threatened by protestors.

Joining Attorney General James in filing this lawsuit were the attorneys general of California, Colorado, Maine, Maryland, Oregon, Vermont, and the District of Columbia.