December 14, 2022
State of Reform
By Soraya Marashi
The California Future of Abortion Council (CA FAB Council), comprised of elected officials and over 40 organizations across the state, released 16 new policy recommendations for state leaders and lawmakers aimed at continuing the state’s support for equitable and safe abortion care during next year’s legislative session.
Some of the key recommendations included to improve access to abortion care, support abortion providers, and address gaps in abortion access in the state healthcare system, are detailed below.
“Monitor disbursement of state funding for sexual and reproductive health, the rate at which the funds are disbursed and spent, and barriers to getting funds to organizations to support their work.”
The CA FAB Council recommends that the $200 million in ongoing and new funding for sexual and reproductive health, including funding for abortion care services, infrastructure, workforce, and education, reach the intended recipients in a timely manner and are adequate to support their work.
“Continue to identify gaps in funding or additional needs to support California’s abortion network.”
The council recommends that state leaders continue to address ongoing needs to protect patients and providers from increased legal risks in light of the recent overturning of Roe v. Wade, and expand the state’s abortion provider and support network.
“Align Medi-Cal coverage of medication abortion with evidence-based clinical guidelines.”
The council recommends that the Department of Health Care Services (DHCS) align its billing policies to support full reimbursement for the provision of medication abortions, provided after 70 days gestation, in order to be consistent with the most up-to-date clinical guidelines.
“Provide ongoing funding of Medi-Cal abortion equity and infrastructure payments and expand eligibility to include additional safety net abortion providers.”
Another recommendation is for the state ensure that supplemental payments for abortion services in Medi-Cal included in the 2022 budget are ongoing and include Medi-Cal abortion providers like federally qualified health centers (FQHCs), rural health centers, and tribal clinics. The legislature allocated $15 million in one-time funding for these supplemental payments in one-time funding through June 2024, and this funding is currently limited to community health centers not designated as FQHCs.
“Clarify Presumptive Eligibility for Pregnant Individuals (currently called PE4PW) coverage policies and ensure PE4PW patients can access abortion services regardless of other health coverage.”
The council recommends that policies in the PE4PW program be updated to clarify the authorization of Medicaid coverage of abortion services and prenatal care services for patients with other health coverage, as well as to better reflect that all pregnant individuals may be eligible for this coverage regardless of their gender identity.
The council says services that do not receive federal funding, including abortion, should be exempt from restrictions preventing Medicaid coverage of services received by a patient with other health coverage, so that other health coverage is not a barrier to care.
“Provide additional safeguards for California abortion providers and other entities and individuals that serve and support abortion patients that reside in states with hostile abortion laws.”
While protections against civil and criminal liability for abortion patients, providers, and other entities that assist someone in obtaining an abortion have been established in the past year, the council recommends that the state establish additional measures to protect against criminal prosecution and third-party civil enforcement of abortion restrictions, protect property assets from out-of-state civil judgements, and protect individuals assisting a patient from another state obtaining an abortion.
The CA FAB Council also recommends protecting abortion providers from adverse actions related to their participation in public benefit programs, health plan contracts, and credentialing due to enforcement of another state’s abortion restrictions.
“Enhance privacy protections for medical records related to abortion, pregnancy loss, and other sensitive services through electronic health record sharing and health information exchanges.”
The council recommends that the state establish additional confidentiality protections so patient medical information related to sensitive services, such as abortion, is not automatically shared with out-of-state electronic health record systems and providers that are in a state with anti-abortion laws.
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