Californians this fall will have a chance to vote on whether parents should be notified if their minor daughter seeks an abortion. Florida just implemented such a law and across the country there are more than thirty states with some form of parental notification in effect.

But what about contraception and children? Would a health insurance company, the federal government, or a state government pay for contraception for a minor without a parent ever knowing? And would parents know if their private insurance carrier paid for their daughter to have an abortion?

Mike O’Dea is a national leader in bringing faith-based health care back to Americans. He is attempting to reform health insurance coverage by finding ways to provide Americans, particularly Catholics, with health insurance coverage that does not violate Church teachings.

O’Dea founded Christus Medicus Foundation, and he serves as its executive director as well as senior health consultant of ValuSure Corporation. The organization’s mission statement is: Reclaim Christ-centered health care by reforming corporate and public policy to allow God's people a "conscientious choice" in selecting health insurance. Its website’s home page features this verse: "Walk as children of light…Take no part in the unfruitful works of darkness" (Eph 5:8, 10, 11).

IgnatiusInsight.com recently spoke with O’Dea about faith-based healthcare, recent legislation, and related issues:

IgnatiusInsight: Can my child have an abortion, receive contraception, be sterilized or treated for anything else without my knowledge? Is there a difference depending on the state where I live?

Mike O’Dea: Many states allow surgical abortion for any reason to be provided children of any age without parental consent. A judicial bypass is required by the U.S. Supreme Court for all state parental consent or parental notification laws. Whether or not a parent will be notified depends on whether parental notification laws are in effect. At last count, they were in effect in a little more than 30 states.

Contraception is available to children of any age in all 50 states, without parental consent. Contraception includes all FDA approved chemicals (e.g., the morning after pill), and Intrauterine Devices (IUDs) that induce abortion. Contraception also includes diaphragms, Norplant, and injectable contraceptive drugs (such as Depo-Provera).

RU 486 has been defined in Michigan law as causing an abortion. Therefore in Michigan RU 486 should not be given to children, without parental consent. In the states that have mandated contraception in health plans that provide prescription coverage, RU 486 is considered a FDA approved drug and could be given to children, without parental consent. Contraceptive drugs and devices that are available to adults in health plans are also available to children at any age, without parental consent.

Sterilization is an area that needs to be investigated state by state. In the Michigan Medicaid program, it is against state law to cover sterilization. However, when the Michigan State Children Health Plan (S-CHIP), known as MIChild, was first made available in 1997, sterilization was offered. When I discovered this to be the case, I formed a group of concerned Michigan parents that successfully challenged the Gov. Engler Administration and removed sterilization coverage from MIChild in December 1998.

It is not a requirement of the federal government or most states that abortion for any reason be covered in S-CHIP, private employer sponsored, individual health plans or HMOs.

IgnatiusInsight: What about private health insurance, paid by a company, or an HMO, or insurance bought by an individual? Would a parent know if one of their children was receiving insured services such as abortion, contraception, or sterilization?

O’Dea: Yes, they could receive contraception in most plans and no, a parent would not be informed. In the case of abortion, it depends on state parental notification law or lack of it.

If you are in an HMO or traditional health plan in the private sector, most likely you are paying for abortion and contraception for children. The reason most people do not know that abortion for children is covered in their health plan is because either they have not asked or they have been told their insurance plan does not pay for "elective", "voluntary" or "medically unnecessary" abortion.

Here’s the catch: "elective", "voluntary", "medically unnecessary" are terms that do not have any definition. What these terms mean in a health plan are that if an adult woman or pregnant teenager can find a doctor who will agree to perform an abortion, it will be paid for by the health plan, without parental consent. For a plan to exclude abortion, the health plan has to clearly define what these terms mean in the plan design filed by the insurance company with the state or federal government.

The reason most people do not know that contraception for children is covered in health plans is that contraception has only recently become popular coverage in most private health plans.

IgnatiusInsight: There are three ways that children can receive subsidized or free health care--through public health clinics, through the State Children's Health Insurance Program (S-CHIP), Medicaid, Medicare. How are contraception and abortion covered under those programs?

O’Dea: During the Clinton Administration, the federal government made it a requirement to include abortion in Medicare and Medicaid for rape, incest and life of the mother exceptions. In addition, beginning in the late 1990's until the present, twenty-two (22) state governments have mandated that all FDA approved contraceptive chemicals and devices that induce abortion be included in all health insurance plans that include prescription coverage.

Although the Hyde Amendment bars using federal funds for abortion, it does allow funding abortion for rape, incest and life of the mother. The government routinely funds chemicals and devices that induce abortion in Medicaid, Medicare and S-CHIP.

IgnatiusInsight: What is the State Children's Health Insurance Program? Do all states receive the federal funds for this?

O’Dea: The State Children’s Health Insurance Program expands health insurance for five million children under 19 years of age, at or below 200% of the federal poverty level in working families, who do not have creditable health insurance. This program is run by the states, but is heavily funded by the federal government under Title XXI of the Social Security Act. S-CHIP receives both federal and state funds. For every one dollar the state contributes, the federal government contributes two dollars.

Unfortunately, the Clinton Administration and government bureaucrats used this as a way to slip in many provisions that provide abortion, contraception and sterilization even to young children without parental involvement.

IgnatiusInsight: What are the federal requirements regarding abortion, contraception and other treatments under S-CHIP? 

O’Dea: Although contraception, sterilization and abortion for any reason are not required by Congress in S-CHIP, it appears most state plans cover contraception, sterilization and abortion for rape, incest and life of the mother. The states had three options in determining the program. They could elect to: a) expand Medicaid, b) design their own plan, or c) establish some type of combined plan. The only known exception to not covering family planning services, from its inception, was the state of Pennsylvania. Presently, Michigan is the only other state that I know of that does not cover sterilization and only covers abortion when the mother’s life is in immediate danger.

IgnatiusInsight: Can you explain what happened with state health insurance requirements and provisions for HMOs and other insurance plans—why are they allowing contraception and abortion for children?

O’Dea: The squeaky wheel gets the grease. Private sector policy leaders and plan designers listened when the Alan Guttmacher Institute, Planned Parenthood, National Organization for Women, NARAL Pro-Choice America, healthcare consultants and other "reproductive rights" groups quietly, subtly and incrementally pushed confidential abortion, contraception and sterilization in all health plans.

Attorneys and health care consultants advised employers to take the path of least resistance and include this coverage in health plans. Whenever questioned about conscience, these plan designers would say "they can opt out of this coverage, so what's the big deal?" The problem with this thinking is that we are deprived of our parental right to be the primary educators of our children and our right to have the freedom to exercise our right of conscience.

To opt out means, parents and their children can decide not to use this coverage.They are however still paying for these procedures in their health plan. And, even if parents opt out—their children have access to them without parental consent because of the way the plans are filed with the state and federal insurance agencies. By our absence in this debate, the enemies of life, liberty and justice for all have imposed their agenda on us.

IgnatiusInsight: What is the history on this loss of parental rights and general coverage of abortion and contraception under federal, state and private insurance plans?

O’Dea: Insurance coverage for contraception without parental consent was spearheaded by the U.S Supreme Court, in the 1980-81 term, when the Supreme Court upheld an appeals court ruling in Michigan that the parents had no right to be notified before a county-run health center gave contraception to their teenage children. This is why it is so important to let all Americans know the serious consequences of contraception in health plans.

The Health Insurance & Accountability Act (HIPAA) under the Clinton Administration required parents to get permission from their children for access to their children's medical information. Christus Medicus provided the leadership in 2001-2002 to get President Bush to reverse this position at the federal level.

Since President Bush's policy did not overrule the states requiring children's permission before parents can get their children's medical information, we must fight for parental rights legislation at the state level or for federal legislation requiring it nationwide.

The recent Parents Right to Know Act introduced by Senator Tom Coburn (R-OK) and Rep. Todd Akin (R-MO) is a great place for parents to start demanding their right to know what is available to their children in health plans and in public health clinics. This legislation will not just affect public clinics, but it could have an immediate impact on protecting parents’ rights over their children in CHIP, Medicare, Medicaid and eventually private health plans.

Until now, pro-lifers and faith-based organizations have not been involved in the fight for a healthcare "culture of life". I think many Americans are finally waking up to the realization that to win the war that's waging between a "Culture of Life " and "Culture of Death", we must aggressively be in the fight to create a new healthcare "Culture of Life".

IgnatiusInsight: Some states have parental notification laws for abortion. Florida’s just took effect this summer and California voters will have an opportunity to enact a parental notification law in November. Does that mean that in those states, parents will know if their child seeks an abortion? What about emergency contraception or RU-486?

O’Dea: The parental notification laws for abortion that I have seen up to this point have included a judicial bypass (required by the U.S. Supreme Court). But if the child does not seek a judicial bypass, then her parents are to be informed.

In general, parental notification laws do not affect contraception but the jury is still out on RU 486 and depends on the state law's phrasing . The morning after pill and the IUD are viewed as FDA approved drugs that qualify in the contraceptive state mandates. In Medicaid, Medicare and CHIP, the morning after pill and the IUD are also viewed as contraceptives. Since RU 486 is viewed as a FDA approved drug for the contraceptive mandate, the jury is still out on whether it is included in CHIP, Medicare and Medicaid.

I think it is critical that all state pro-life leaders demand to see the number of times the morning after pill, the IUD and RU 486 have been provided under CHIP, Medicare and Medicaid.

IgnatiusInsight: Anything else you want to add?

O’Dea: Finally, I must bring to your attention that the Christus Medicus Foundation will be aggressively educating all Michigan citizens on our Catholic Governor Granholm and our supposedly pro-life State Senator Beverly Hammerstrom's support for Michigan Senate Bills 431 and 432, which would force all health insurance prescription drug coverage plans in Michigan to include coverage for all FDA approved contraceptives. This legislation could be used to cover the so-called morning after pill, which can sometimes cause abortions, without parental consent. It could also be used to eventually cover the dangerous abortion drug RU 486.