By: Maggie Crosby, ACLU of Northern California

The California Department of Managed Health Care today clarified that health plans sold in the state must cover abortion. The agency’s straightforward instruction to insurance companies, based on decades of California law, contains three important concepts that have all but disappeared with the erosion of abortion rights:

Abortion is basic health care. A pregnant woman has two medical options: childbirth or abortion. Abortion is a safe medical procedure—indeed, safer than childbirth at every stage of gestation. The risk of death associated with childbirth is approximately 14 times higher than that with abortion. One in three women will have an abortion by age 45.

Abortion is a constitutionally protected personal decision. In California, our Constitution and our Reproductive Privacy Act guarantee that each woman has a right to decide about her own pregnancy. It’s not the boss’s business, it’s not the insurance company’s business, and it’s not the government’s business. Abortion and prenatal care must be treated equally.

Restricting abortion coverage is discrimination. Control over reproduction is fundamental to women’s ability to participate in social, economic and political life. Discriminatory policies (covering all prenatal care but only certain abortions) reinforces the archaic message that women’s role is motherhood.

In clarifying that insurance plans must treat abortion and prenatal care equally, the California agency aligns private insurance with public insurance. The state’s Medi-Cal program covers all pregnancy care for low-income women and girls—whichever option they decide. The state may not, and does not, weight that private decision.

The immediate effect of the agency’s guidance is to restore insurance benefits for the staff and faculty at Loyola Marymount University and to block efforts to restrict coverage at Santa Clara University. These large institutions, which receive public funds and employ people of different faiths, purchased plans that covered abortion only for life-threatening pregnancies. This restrictive definition of “medically necessary” abortions is a relic of the era when abortion was a crime. Approval to market such restrictive health plans in California was an error and an aberration in a state with a proud history of protecting reproductive health.

The long term effect of today’s decision is to ensure that as more California residents have health insurance, access to abortion will remain a reality. The Department of Managed Health Care deserves applause because in protecting abortion access, it conveys simple truths that have become obscured in the political effort to stigmatize abortion: childbearing is a personal decision, abortion is basic health care and control of reproduction is critical to women’s autonomy.

This is what it means to take seriously the principle that access to abortion is a fundamental right.

Maggie Crosby is senior staff attorney at the ACLU of Northern California.

By: Melissa Goodman, @mg718
When I get sick, I can take the day off from work and still get paid. And when my son gets sick, I can take the day off, care for him and still get paid. I don’t have to worry about my paycheck, who will take care of my child or that I might be fired if I don’t go to work.
This is not the reality for all working parents in California. Approximately 5 million Californians do not get paid sick days. So a huge number of working parents in our communities have to make an impossible choice: take care of themselves or their children when they are sick or lose a paycheck for the day. And losing a paycheck may mean not being able to pay the rent that month or buy enough food to feed their family.
The Los Angeles City Council will soon have the chance to right this wrong for L.A. hotel workers, many of whom currently do not get paid sick days. A bill is moving through the Council that would provide hotel workers with a living wage and five paid sick days.

The ACLU supports the Raise LA campaign because basic economic rights are inextricably intertwined with civil rights and civil liberties. When Californians lack basic economic security – when they are unable to or must struggle to fulfill basic human needs – they cannot fully exercise their civil liberties and civil rights.
But paid sick days and a living wage are also an important reproductive justice issue. Too often people think of reproductive freedom narrowly as only the right to decide not to have a child. But it is much more: it is the right to decide to become a parent and truly be able to raise your child in a happy, healthy and safe environment. True reproductive freedom – reproductive justice – means you have meaningful choices when it comes to parenting and that if you decide to have a child, you can actually meet their needs and tend to them when they are sick.
You lose your reproductive freedoms when you fear your employer will fire you or when you can’t take a small sliver of time off to care for your sick child without losing a needed paycheck. No parent should be forced to choose to tend to their sick child or put food on the table.
Anyone who cares about reproductive justice should take up the cause for living wage bills with paid sick days.
This blog was originally published on L.A. Progressive. Melissa Goodman is director of the LGBT, Gender & Reproductive Justice Project at the ACLU Southern California. Follow Melissa on Twitter.