Health insurance abortion coverage mandate affirmed by New York's top court

New York's top court on Tuesday upheld state regulations requiring certain employer-sponsored health plans to cover medically necessary abortions, teeing up a potential fight before the U.S. Supreme Court.

The Court of Appeals, which is the highest court in New York, ruled that fully-insured health plans provided by employers must include coverage for medically necessary abortions, unless an employer qualifies for a religious exemption.

The Roman Catholic Diocese of Albany and other religious groups challenged the process for obtaining an exemption, claiming it violated religious protections embedded in the U.S. Constitution. However, Tuesday's unanimous decision noted that the exemption process did not discriminate among or against specific religious beliefs, affirming its constitutionality.

"The proposition that a state has the authority to cabin, through specific criteria, who qualifies as a 'religious employer' is consistent with Supreme Court and other state court precedent," the decision said.

In a statement, the state Department of Financial Services, which issued the regulations, celebrated the decision.

"Today’s decision rightfully upholds DFS’s regulatory authority, further cementing New York’s leadership in protecting women’s healthcare choices," said DFS Superintendent Adrienne Harris. "DFS’s actions have ensured that women in New York have control over their reproductive choices, and that insurers cover abortions and contraceptives with no copayments, deductibles or any out-of-pocket costs."

But the Court of Appeals ruling may not be the final word on the subject. Several Supreme Court justices have suggested they would be open to overturning the legal precedent that underlies the Court of Appeals' decision.

Justice Neil Gorsuch, for instance, wrote in a concurring opinion in 2020 that this legal precedent "was mistaken as a matter of the Constitution’s original public meaning."

The Supreme Court has already indicated it would not hesitate to weigh into the abortion debate after it overruled the constitutional right to access abortion care in 2022. The attorney representing the religious employers, Noel Francisco, served as solicitor general during the Trump administration and frequently litigates cases at the Supreme Court.

A spokesperson for the employers said they are "evaluating our options at the moment."

Asher Stockler is a reporter for The Journal News and the USA Today Network New York. You can send him an email at astockler@lohud.com. Reach him securely: asher.stockler@protonmail.com.

This article originally appeared on Rockland/Westchester Journal News: Abortion insurance coverage mandate affirmed by New York's top court