California’s Supreme Court on Wednesday dismissed a Catholic women’s organization’s challenge to state health regulators’ designation of voluntary abortions as “medically necessary” procedures that must be covered by state health care service plans.

The California Department of Managed Health Care in 2014 sent letters to seven health care service plans directing them not to limit or exclude coverage for abortions, including those abortions that are not required to save the life of the mother. The letters ordered the state-licensed health care service plans to eliminate any language in their agreements that “may discriminate against women by limiting or excluding coverage for termination of pregnancies.”

Since then, the Missionary Guadalupanas of the Holy Spirit have sought legal remedies to the rule, arguing that California flouted the Administrative Procedures Act by neglecting to give the rule a public hearing and comment period.

A state appeals court in Sacramento in August upheld the state agency’s designation of a pregnant woman’s choice to have an abortion as “medically necessary.” The missionaries did not appeal that ruling but did request that California’s Supreme Court withdraw it as a published decision binding in trial courts throughout the state. The high court unanimously rejected that request.

Planned Parenthood, however, was allowed to comment on the rule. The nation’s largest abortion provider met with state health regulators and urged adoption of the rule barring employer health plans that exclude abortion, as shown in emails between the agency and Planned Parenthood that were used as evidence in the missionaries’ lawsuit.

“California regulators appear to have deliberately ignored the deep moral and ethical objection to abortion held by so many in the state,” said Andrew Rivas, executive director of the California Catholic Conference. “Debate is healthy and should never be suppressed in this manner or any issue in which so many citizens feel so passionate about.”

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