Foothill Church v. Watanabe
| Decision Date | 24 August 2022 |
| Docket Number | 2:15-CV-02165-KJM-EFB |
| Parties | Foothill Church, et al., Plaintiffs, v. Mary Watanabe, in her official capacity as Director of the California Department of Managed Healthcare, Defendant. |
| Court | U.S. District Court — Eastern District of California |
From one vantage point, this case involves a dispute about whether the agency regulating insurance plans in California must consider religious exemption requests from individual enrollees and subscribers if the agency's ordinary practice is to consider requests from health insurance plans. Alternatively, the dispute centers on whether the agency can order insurance plans to cover abortions, even insurance plans who sell coverage to religious employers that oppose abortion except when the life, not the health, of a pregnant woman is at risk. Regardless, the complexity of the case warrants a bird's-eye review of the facts.
In August 2014, the California Department of Managed Health Care (DMHC or the State) 26 sent letters to seven private health insurers, directing them to remove any limitations on or 27 exclusions of abortion care services from the health care coverage they offered to various 28 employers, including plaintiffs Foothill Church, Calvary Chapel Chino Hills and Shepherd of the Hills Church (the Churches). Riess Decl., Ex. U, Aug. 22 2014 Letters from DMHC to seven plans (Aug. 22, 2014 Letters) at 2-15, ECF No. 110-24.[1] The DMHC's Director sent the letters after reviewing the relevant law and realizing the agency had “erroneously approved or did not object to health plans” with such limitations or exclusions. Id. at 2. Both non-religious and “religious employers,” as defined by the relevant statute, had enrolled in these health plans. Riess Decl. Ex. V at 5, ECF No. 110-25. The seven insurers readily complied with the State's directive. Def.'s Resp. to Pls.' Statement of Undisputed Material Facts ¶ 21, ECF No. 121-1.
After receiving the Director's letters and learning about the changes to their coverage, the Churches contacted their health insurance plans to ask if, as religious organizations they could obtain insurance that did not require them to provide coverage for “all legal abortions,” Rutherford Decl. ¶¶ 20-21, ECF No. 111-4, that only covered abortion care where the “pregnancy unquestionably threatens the life of the mother,” Lewis Decl. ¶¶ 9, 23, ECF No. 111-3, or that “exclude[d] abortion benefits,” Hibbs Decl ¶¶ 17-18, ECF No. 111-5. Two insurers explained they understood the State's letter to preclude even religious exemptions. Hibbs Decl. Ex. 4 (), ECF No. 111-5. The insurers were incorrect, as the DMHC had determined that “religious employers” could legally restrict abortion coverage consistent with their religious beliefs. Def.'s Resp. to Pls.' SUMF ¶ 39. Indeed, the DMHC later approved a request from a plan to exclude coverage for abortion care services for religious employers, except where a pregnant woman “suffers from” a condition “that would, as certified by a physician, place the woman in danger of death unless an abortion is performed,” or in the case of a pregnancy resulting from rape or incest. Galus Decl. Ex. 14 at 31, ECF No. 111-20. Nevertheless, under the impression they could not secure coverage that comported with their religious beliefs, the Churches filed the present action, alleging the Director's letters violate their constitutional rights under the First and Fourteenth Amendments. Compl., ECF No. 1.
Only after nearly three years of litigation, after this court had submitted the State's third and final motion to dismiss for decision, did the Churches decide to ask the DMHC for a religious exemption. Riess Decl., Ex. Y (Letter from Plaintiffs' counsel to DMHC) at 2, ECF No. 110-28. The Churches requested the DMHC exempt them from covering abortions except “when absolutely necessary to save the life of the mother,” even in “circumstances of rape and incest.” Id. at 2-3. The State's Attorney General replied that DMHC could only consider granting exemptions to health plans, not employers or other plan customers. Riess Decl., Ex. Y (Letter from DMHC's counsel to Plaintiffs' counsel) at 2-3, ECF No. 110-29. To date, no health plan has asked DMHC to approve a plan contract that does not cover abortion care services for a woman who becomes pregnant as a result of rape or incest. However, prior to 2014, at least one health plan offered such limited coverage, though not to the Churches. See Galus Decl. Ex. 9 at 6 & 11, ECF No. 111-15; Galus Decl. Ex. 10 at 4, ECF No. 111-16.
In 2019, this court granted defendant's motion to dismiss all claims. Church v. Rouillard, 371 F.Supp.3d 742 (E.D. Cal. 2019). The Ninth Circuit affirmed the dismissal of plaintiffs' Establishment Clause claim, Foothill Church v. Watanabe, 854 Fed.Appx. 174 (9th Cir. 2021) (unpublished), but remanded for this court to consider plaintiffs' free exercise and equal protection claims in light of Fulton v. City of Philadelphia, Pennsylvania, 141 S.Ct. 1868 (2021). See Foothill Church v. Watanabe, 3 F.4th 1201 (9th Cir. 2021).[2] The parties have now filed and briefed cross-motions for summary judgment. See Def.'s Mot. for Summ. J. (Def.'s MSJ), ECF No. 110; Pls.' Mot. for Summ. J. , ECF No. 111-1; Def.'s Opp'n, ECF No. 121; Pls.' Opp'n, ECF No. 122; Def.'s Reply, ECF No. 123; Pls.' Reply, ECF No. 124. The court heard argument on the motions on June 15, 2022. ECF No. 127. Jeremiah Galus appeared for plaintiffs and Melissa Riess, Karli Eisenberg and Hayley Penan appeared for defendant. Id. Following the hearing, the court submitted the matters.
For the reasons below, the court grants summary judgment for plaintiffs on their Free Exercise Clause claim and grants summary judgment for defendant on plaintiffs' Equal Protection Clause claim.
The court first addresses the motion of the California Catholic Conference to file an amicus brief in support of the Churches' motion for summary judgment. Mot. to File Amicus Curiae, ECF No. 112.
The district court has broad discretion regarding the appointment of amici. Hoptowit v. Ray, 682 F.2d 1237, 1260 (9th Cir. 1982); In re RoxfordFoods Litig., 790 F.Supp. 987, 997 (E.D. Cal. 1991) (). “An amicus brief should normally be allowed” when, among other considerations, “the amicus has unique information or perspective that can help the court beyond the help that the lawyers for the parties are able to provide.” Cmty. Ass'n for Restoration of Env't (CARE) v. DeRuyter Bros. Dairy, 54 F.Supp.2d 974, 975 (E.D. Wash. 1999) (citing N. Sec. Co. v. United States, 191 U.S. 555, 556 (1903)).
While “[historically, amicus curiae is an impartial individual who suggests the interpretation and status of the law, gives information concerning it, and advises the Court in order that justice may be done, rather than to advocate a point of view so that a cause may be won by one party or another[,]” CARE, 54 F.Supp.2d at 975, the Ninth Circuit has said “there is no rule that amici must be totally disinterested,” Funbus Sys., Inc. v. State of Cal. Pub. Utilities Comm'n, 801 F.2d 1120, 1125 (9th Cir. 1986) (citation omitted); Hoptowit, 682 F.2d at 1260 ().
Here, the California Catholic Conference “is a California non-profit that serves as the official public policy voice of the Catholic Church in California . . . .” Mot. to File Amicus Curiae at 2. The Church “offers . . . a unique understanding of the missions Catholic religious bodies serve in California and the ways the policy at issue in this litigation affects them.” Id. The California Catholic Conference has “taken an interest in the policy at issue in this litigation for years,” and previously supported plaintiffs in another case challenging the policy at issue on different grounds. Id. The court finds the proposed brief provides helpful context about the interests animating this dispute. See Brief Amicus Curiae, ECF 122-1. For example, the California Catholic Conference explains why, in its view, extending the definition in the statutory framework exempting “religious employers” from the contraceptive coverage requirement to abortion care services would infringe on church autonomy. Id. at 13-14 (addressing Cal. Health & Safety Code § 1367.25(c)(1)(A)-(D)); NGV Gaming, Ltd. v. Upstream Point Molate, LLC, 355 F.Supp.2d 1061, 1067 (N.D. Cal. 2005) .
Accordingly, the motion to file an amicus brief is granted and the court has considered the brief in issuing this order.
In California, the DMHC and the California Department of Insurance (CDI) regulate the health care industry. The DMHC regulates 95 full-service “health care service plans” under the Knox Keene Health Care Service Plan Act of 1975, Cal. Health & Safety Code §§ 1340 et seq.[3]The Knox Keene Act defines “health care service plans” as “[a]ny person who undertakes to arrange for the provision of health care services to subscribers or enrollees, or to pay for or to reimburse any part of the cost for those services, in return for a prepaid or periodic charge paid by or on behalf of the subscribers or enrollees.” Cal. Health & Safety Code § 1345(f)(1). Health maintenance organizations like Anthem, Inc. and Cigna Corp., and other structured managed care...
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