Missionary Guadalupanas of the Holy Spirit v. RouillardAnnotate this Case
This case presented a narrow issue of whether respondent Michelle Rouillard in her capacity as director of California’s Department of Managed Health Care (Department) violated the California Administrative Procedure Act (APA) when she sent letters to seven health care service plans directing them to comply with California law in their coverage of abortion services. The issue reduced to whether a “voluntary” abortion was a “medically necessary” procedure that health care service plans were required to cover. The letters told the recipients that health care plans could not limit or exclude coverage for termination of pregnancies. Petitioner Missionary Guadalupanas of the Holy Spirit, Inc., claimed that by sending out the letters interpreting “basic health care services” to include abortions, respondent ignored the APA rulemaking process. The Court of Appeal concluded petitioner’s argument set forth a false dichotomy between a “voluntary” service and a “medically necessary” health care service, which health care plans were required to cover under California Code of Regulations, title 28, section 1300.67."This false assumption led petitioner to the flawed conclusion that the Department’s letters were for the purpose of clarifying an ambiguity in the statute, and that compliance with the rulemaking procedures of the APA was necessary." The Court determined the application of the regulation to the facts of this case was unambiguous, and the Department was not required to comply with the APA.