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Religious Freedom v. AB 2781

Grace Andleman

California State University, Channel Islands

HLTH308: Introduction to Health Law

Dr. Carol Mack

M12 May 2020

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Buffy Wicks is an Assembly member and representative of the 15th district of California,

(Assemblymember Buffy Wicks, 2019). She is an advocate for her community to help relieve

emerging issues such as homelessness, gun violence, flaws seen in our healthcare system,

education, etc. (Assemblymember Buffy Wicks, 2019). Wicks recently introduced AB 2781 this

past February of 2020 in “act to repeal and add Section 1374.55 of the Health and Safety Code,

and to repeal and add Section 10119.6 of the Insurance Code, relating to health care coverage”

(Health care coverage: treatment for infertility, AB 2781). Although many may be in favor of

this assembly bill, AB 2781 has both legal issues, as well as implications if this pending law is

enacted.

First and foremost, in order for a bill like AB 2781 to be considered, repealed, or

changed, a series of steps must be taken. Every state has their own set of rules when it comes

time to consider or enact bills. This process is also known as the legislative process and consists

of the idea, the author, the first reading, the committee hearings, the second and third reading,

the repeated process in the second house, the resolution of differences, and enrollment and

consideration by the governor (UCLA Law, n.d.). All pending legislations for the state of

California begin with an idea or concept usually based off of the needs of the people, one’s

beliefs, or one’s parties’ positions on certain issues or ideologies by a senator or assembly

member (UCLA Law, n.d.). Next, a legislator or the person who makes the laws, send the idea

for the bill to the legislative counsel. This is also known as drafting. From there the bill is

introduced by the legislator for the first reading. Following the first reading comes the committee
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hearing in which the bill is presented to the committee. Whether in support or opposition to the

bill each member of the committee must vote to pass or defeat the bill. A majority of the vote

will determine if the bill is passed or not. If the bill is passed, a second and third reading will

take place in the house of origin for approval of the bill, and also another time in the other house.

Lastly, the governor either signs, approves the bill without a signature, or vetoes the bill. Certain

steps must be taken based upon these decisions. Although this may not seem like a long process

to some, each step goes into further detail.

Existing law allows health insurance and health care service plans to exclude coverage,

for infertility treatments, if such coverage would violate the religious beliefs of the organizations

providing the coverage as well as those who buy the coverage. This bill that Assembly Member

Buffy Wicks is sponsoring removes that exemption, and furthermore adds a requirement for

coverage of in vitro fertilization.

As previously stated, Assembly member Buffy Wicks is not only a voice of/for her

community, but the state of California as well. She fights for equity, equality, diversity, and

inclusion for the residents of California. She promotes opportunity and financial stability. She

believes that a successful society is one where everyone has a purpose and counts equally

independent regardless of age, gender, race, etc. More specifically Wicks works on policies that

will aim to help both women and children. Recently Assembly member Wicks has voiced her

opinion on how California as a whole should begin to consider infertility as a diagnosed disease

because:
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Many families, from every background, experience challenges with fertility. Infertility is

a diagnosed disease – and as with other diseases, these treatments should be covered by

insurance. As it stands now, those with means can pay for these costly out-of-pocket

expenses, but most families find themselves spending their life savings, or forgoing

treatment. The ability to start a family should not be determined by your ability to afford

out-of-pocket expenses. (Aguilera, 2019, p. 39)

Big time health organizations such as the American Medical Association and the World Health

Organization already define infertility as a disease. This endeavor started several years ago when

she had discovered that she had a condition that affected her ovaries. With this problem of

possible infertility at hand, Wicks decided to preserve/freeze her eggs in hope to have children in

the future. Since she was living in Illinois at the time, all of these costs were covered by her

insurance. This is part of the reason why she believes AB 2781 is necessary. Unfortunately, in

many states, including California, not all fertility options are covered by insurance. By

acknowledging this misfortune as a disease, insurers will have to cover fertility treatments such

as in vitro fertilization.

On the other hand, many people do not support in vitro and other types of fertility

treatments, due to a handful of different reasons that have to do with personal beliefs or religious

reasons. According to Sallam and Sallam from the Department of Obstetrics and Gynecology

and Alexandria Fertility and IVF Center:

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Assisted reproduction is accepted in nearly all its forms by Judaism, Hinduism and

Buddhism, although most Orthodox Jews refuse third party involvement. On the contrary

assisted reproduction is totally unacceptable to Roman Catholicism, while Protestants,

Anglicans, Coptic Christians and Sunni Muslims accept most of its forms, which do not

involve gamete or embryo donation. (2016, p. 1)

The objections raised vary among different religious groups. For example, the Catholic Church

teaches that all forms of fertility treatment or assisted reproductive technology (i.e. insemination,

in vitro fertilization, surrogate motherhood) go against their beliefs (Roman Catholic Catechism

Section 2377, 1993). On the other hand, most non-Catholic Christians, depending on their

denomination, believe that fertility treatment is morally acceptable, as long as the embryo is not

discarded, and no life is harmed in the process (Grudem, 2019). Both of these religions could

potentially violate their beliefs.

The question comes down to whether or not it is acceptable to force these laws upon

those who have beliefs that may be violated. In September of 2012, both David and Barbara

Green, who founded Hobby Lobby and support other Christian organizations, filed a lawsuit

against the federal government. The Affordable Care Act mandated them to pay for employee

insurance that supply them contraceptives (Hodge, 2015). This mandate went against their

religious beliefs and became one of the most significant cases in history, after a ruling by the

Supreme Court that corporations could in fact refuse contraceptive coverage, due to religious

grounds under the Religious Freedom Restoration Act (Hodge, 2015). This case became known
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as Burwell v. Hobyy Lobby Stores. Based on legal precedent, AB 2781 would likely be struck

down if challenged due to the Supreme Court decision in the Burwell v. Hobby Lobby Stores

case.

The purpose of AB 2781is to remove the religious exemption, for fertility coverage, on

health insurance and health care service plans. Not only does it remove the existing religious

exemption, but to also removes any limitations on in vitro fertilization. As such it would be

considered a violation of the Religious Restoration Act of 1993 (Hodge, 2015). The Burwell v.

Hobby Lobby Stores Supreme Court decision sets a strong precedent for this interpretation. If

this bill became law in the state of California, it would quickly be challenged and very likely be

overturned. As evident there are many legal issues as well as implications if this bill happened to

move forward.
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References

Aguilera, E. (2019, September 4). California at odds over whether to make insurers cover

infertility treatments. https://calmatters.org/health/2019/09/fertility-coverage-california-\

ivf-health-insurance-legislature/.

Assemblymember Buffy Wicks. (2019, October 04). https://a15.asmdc.org/biography

Grudem, W. (2019, April 25). How IVF Can Be Morally Right. The Gospel Coalition.

https://www.thegospelcoalition.org/article/ivf-morally-right/.

Health care coverage: treatment for infertility, A.B. 2781. (2020).

Hodge J. G., Jr (2015). Respecting Religious Freedoms and Protecting the Public's

Health. Public health reports (Washington, D.C. : 1974), 130(5), 546–549.

https://doi.org/10.1177/003335491513000518

Roman Catholic Catechism, Section 2377. (1993).

Sallam, H. N., & Sallam, N. H. (2016). Religious aspects of assisted reproduction. Facts, views

& vision in ObGyn, 8(1), 33–48.

UCLA Law. (n.d.). California Legislative Advocacy: Overview of the Legislative Process.

https://libguides.law.ucla.edu/c.php?g=183363&p=1208863