Judge vacates CMS rule forcing ACA insurers to bill separately for abortions

A federal judge in Maryland has vacated the Trump administration's 2019 rule that would require Affordable Care Act (ACA) marketplace insurers to bill separately for abortions.

Judge Catherine Blake for the District Court for the District of Maryland ruled Friday that the restrictions were "arbitrary and capricious" and violates the ACA. The case was brought by Planned Parenthood and the American Civil Liberties Union.

Under the ruling, the Department of Health and Human Services (HHS) will be enjoined from enforcing the provisions.

HHS' stated goal in the rule was to ensure that federal funds were not being used to pay for abortion coverage. But Blake argued that the agency didn't prove that there was a need for additional oversight on this.

"HHS provides no evidence that issuers are not appropriately segregating funds in accordance with the statute and does not rely on compliance issues as a justification for the rule," Blake wrote in the opinion.

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When it released the rule, the Centers for Medicare & Medicaid Services (CMS) estimated that health insurers in 18 states offer qualified health plans that include abortion services.

In addition, due to the pandemic, CMS delayed the implementation of the rule from June to August. But Blake also said that it didn't prove a timeline accelerated to that degree was necessary.

The Blue Cross Blue Shield Association argued, for example, that it would take two years for health plans to comply with the separate billing.

"Accordingly, because HHS failed to consider and adequately address specific, contrary evidence from regulated stakeholders, the implementation deadline is arbitrary and capricious," Blake wrote.

A second case challenging the rule was filed by several Democratic state attorneys general in California court.