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California鈥檚 Top Lawyer Cements His Role As Health Care Defender-In-Chief

California Attorney General Xavier Becerra scores a win for California and other states in his effort to block Trump administration birth control rules.

(Science Photo Library/Getty Images)
Listen to KHN’s Samantha Young discuss the birth control ruling with WNPR’s Lucy Nalpathanchil on the program “.” Can’t see the audio player? Click here to download.

SACRAMENTO, Calif. 鈥 Xavier Becerra, the political savvy Democratic attorney general of California, has sued the Trump administration 45 times in the past two years, often with much fanfare.

In winning a legal challenge Sunday against new government rules limiting birth control, he once again cemented himself as a national figure leading a fight against the administration across a range of issues 鈥 especially health care.

The 12 other states and the District of Columbia that had joined Becerra鈥檚 also gained a last-minute reprieve from the federal that would have taken effect Monday. They would have allowed most employers to refuse to provide insurance coverage for workers’ birth control by raising a religious or moral objection.

Those rules were also halted for the rest of the country on Monday when a Pennsylvania judge in a similar lawsuit.

The contraception case is one of several fronts where Becerra has led聽state coalitions to defend the Affordable Care Act in lawsuits in Texas, California and Washington, D.C.

鈥淭he Trump administration is trying to chip away at those protections,鈥 said Andrew Kelly, an assistant professor at the Department of Health Sciences at California State University-East Bay. 鈥淚t鈥檚 left to states like California and Attorney General Becerra in taking a lead in confronting these efforts.鈥

Becerra is perhaps best known for leading the opposition to the lawsuit. In that suit, the Texas attorney general argued that the Affordable Care Act should be rendered unconstitutional because Congress eliminated the tax penalty on the uninsured. A federal judge last month sided with Texas, ruling that the federal health care law is unconstitutional.

Becerra, who said he helped write the health care law, said he felt compelled to step in when the Trump administration decided not to defend the law. Sixteen states and the District of Columbia joined that lawsuit, which is now on appeal.

The multistate strategy is one that attorneys general have used often in the past few decades when they don鈥檛 agree with policies coming out of Washington, legal and political experts say. And it鈥檚 not unique to one political party.

Republican attorneys general, for example, sued the Obama administration to block the expansion of Medicaid in their states. When George W. Bush was president, the state of Massachusetts led Democratic states in an effort to force the Environmental Protection Agency to regulate greenhouse gas emissions from cars.

The legal tit for tat is what Nicholas Bagley, a professor at the University of Michigan Law School, described as a disconcerting 鈥渕ilitarization鈥 of the state attorneys general offices to press an agenda in the courts.

鈥淎t a time of polarized politics, there鈥檚 every incentive to pull whatever levers are available to you to try to advance your goals,鈥 Bagley said. 鈥淥ver time, the state attorneys general have come to the view that the courts are an important forum to have these fights over important questions.鈥

The behavior of the attorneys general also comes in response to an administration that is using its executive authority to push initiatives that it can鈥檛 get Congress to approve.

President Donald Trump is left 鈥渢o try to use either the regulatory process or executive order to accomplish his goals,鈥 said Gerald Kominski, a professor of health policy at UCLA. 鈥淎nyone who opposes those goals has to proceed through the legal process to challenge them.鈥

Becerra, the first Latino to serve as California attorney general, has sued the Trump administration on a wide range of issues: health care, immigration, the Muslim travel ban, citizenship questions on the census, the border wall, climate change and clean-water rules.

When the former congressman was sworn in to his second term last week, he declared that he had 鈥渂een a little busy keeping the dysfunction and insanity in Washington, D.C., from affecting California,鈥 and defending the state from the 鈥渙verreach of the federal government.鈥 And he doesn鈥檛 have any plans to let up.

鈥淲hether it鈥檚 the criminals on our streets or the con man in the boardrooms or the highest office of the land,鈥 Becerra said, 鈥渨e鈥檝e got your back.鈥

But Becerra鈥檚 record has been mixed.

The victory in court Sunday was limited. Oakland-based U.S. District Judge Haywood Gilliam Jr. blocked the rules from taking effect in the District of Columbia and the 13 states that challenged them, but he refused to stop them from taking effect in the rest of the country. That national reprieve came a day later in a Pennsylvania court, with U.S. District Judge Wendy Beetlestone describing the harm to women as 鈥渁ctual and imminent.鈥

If the administration appeals, as expected, Pennsylvania, along with California and its legal coalition would move ahead with their cases to permanently throw out the rules, arguing that the Affordable Care Act guaranteed women no-cost contraception as part of their preventive health care, a provision that they say has benefited more than 62 million women since 2012, when the regulations went into effect.

The Trump rules, California argued in legal , would 鈥渢ransform contraceptive coverage from a legal entitlement to an essentially gratuitous benefit wholly subject to an employer鈥檚 discretion.鈥 In its proposed regulations, the U.S. Department of Health and Human Services described the exemption as narrow and one that would affect a fraction of women 鈥 no more than 127,000.

That鈥檚 a number Becerra disputes.

In claiming victory on the birth control lawsuit, Becerra said Sunday that his coalition will continue to advocate for women鈥檚 access to reproductive health care.

How much more will Becerra fight during the next four years? Addressing the crowd who gathered this month to see him sworn in to a second term, he conveyed a simple response:

鈥淭he sky is the limit.鈥

This story was produced by聽, which publishes聽, an editorially independent service of the聽.

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California Courts States The Health Law