YAKIMA — Attorney General Bob Ferguson today announced that an Eastern Washington federal judge declared the Trump Administration’s Double-Billing Rule “invalid, and without force in Washington” because it violates Washington State’s Reproductive Health Care Access for All Act. This is Ferguson’s second legal victory against the federal government this week. Ferguson is now 28-1 in litigation against the Trump Administration. Seventeen of those victories are final and cannot be appealed.
The ruling in the U.S. District Court for the Eastern District of Washington preserves an important protection passed by the Washington State Legislature in 2019 to protect Washingtonians’ access to reproductive health care.
In his written order, Judge Stanley A. Bastian wrote: “Washington State supports a woman’s right to choose, as well as her right to access safe and legal abortion care…The Double-Billing Rule attempts to intrude on the State’s right to do so by imposing onerous, arbitrary, and unnecessary billing practices that have little to do with providing efficient and effective medical coverage and everything to do with trying to prevent Washington’s State’s recognition of women’s right to access safe and legal abortions.”
The order sent a pointed message to the federal government: “The Court will not condone HHS’s blatant disregard of the rights of Washington citizens.”
“The Trump Administration illegally sought to undermine protections for Washington women adopted with bipartisan support by our Legislature — and we stopped them,” Ferguson said. “By now, this is becoming a familiar refrain — President Trump acted illegally, and my team had to go to court to protect the rights of Washingtonians.”
In 2019, the Washington State Legislature passed the Reproductive Health Care Access for All Act with bipartisan support. Senator Emily Randall (D-Gig Harbor) was the prime sponsor. Gov. Jay Inslee signed the bill into law and it became effective May 13, 2019.
Washington’s Reproductive Health Care Access for All Act includes a single-invoice provision requiring health insurance companies to bill enrollees with a single invoice for each coverage period.
In December 2019, the Trump Administration proposed the Double-Billing Rule to require health insurance companies to send consumers two separate bills for monthly insurance premiums: one for abortion coverage and another for all other coverage. The rule also directs insurers to demand two separate checks or two separate online transactions when paying the two bills.
Often, abortion coverage accounts for less than a dollar of a patient’s monthly premium. The rule requires insurers to charge enrollees at least one dollar for abortion coverage. All enrollees will receive the second bill, regardless of whether or not they received abortion services.
In January, Ferguson filed the lawsuit in the U.S. District Court for the Eastern District of Washington. His lawsuit asserted the rule would cause many Washington women to inadvertently fail to pay their premiums in full, jeopardizing their health coverage.
Ferguson argued the rule would cause unnecessary confusion for people who are likely to assume the second bill is a scam, an error or an optional fee that doesn’t apply to them. In fact, this second bill would be a part of the overall monthly premium for everyone enrolled in the plan, and a failure to pay it could result in a loss of insurance benefits. Forty percent of qualified health plan enrollees in Washington would lose coverage within 30 days of missing a payment.
“This scheduled federal rule will cause unnecessary confusion for consumers and is another attempt to chip away at reproductive health services,” Gov. Inslee said at the time Ferguson filed his lawsuit “I stand with Attorney General Ferguson and Insurance Commissioner Kreidler in their efforts to protect Washingtonians.”
Impacts of the Double-Billing Rule
Had it gone into effect, the Trump Administration’s rule would have applied specifically to qualified health plans sold to individuals on the state-run Health Benefit Exchange. More than 200,000 Washingtonians are covered under qualified health plans on the Exchange.
The Trump Administration’s own estimates show that the rule would increase health insurance costs by over $400 million in 2020 alone. Washington insurance companies estimated that this rule would raise their administrative costs by $100,000 to $500,000 each, a total of $3.5 million, leaving less funding available to cover health services.
The Double-Billing Rule would have gone into effect June 27.
Assistant Attorney General Kristin Beneski is leading the case for Washington, working with Assistant Attorneys General Laura Clinton and Spencer Coates.
Including this ruling, Ferguson has 28 legal victories against the Trump Administration and one defeat. Seventeen of those cases are finished and cannot be appealed. This legal victory is appealable.