ACA and Healthcare Reform

Top Court Rejects Religious Groups’ Challenges In Birth Control Cases

WASHINGTON, D.C. — (Mealey’s) The U.S. Supreme Court on March 31 denied petitions for certiorari from two nonprofit religious groups claiming that the contraceptive mandate contained in the Patient Protection and Affordable Care Act (ACA) violates the Religious Freedom Restoration Act (RFRA) (Priests for Life, et al. v. Kathleen Sebelius, et al., No. 13-891, U.S. Sup., Roman Catholic Archbishop of Washington, et al. v. Kathleen Sebelius, et al., No. 13-829, U.S. Sup. [lexis.com subscribers may access Supreme Court briefs for these cases] ).

The ACA requires all group health plans and health insurance issuers that offer non-grandfathered group or individual health coverage to provide coverage for certain preventive services without cost-sharing, including, “all Food and Drug Administration approved contraceptive methods, sterilization procedures, and patient education and counseling for women with reproductive capacity.” 

Certification

Certain exemptions exist for religious employers.  Nonprofit religious organizations that do not qualify for the exemption may qualify for an accommodation.  Under the accommodation, a nonprofit religious organization can self-certify to its health insurance issuer that it has a religious objection to providing coverage for contraceptive services as part of its health insurance plan.  Once the issuer receives the self-certification, the nonprofit organization is exempt from the mandate.  The organization’s employees will receive coverage for contraceptive services, but that coverage will be provided directly through the issuer.  The coverage is excluded from the employer’s plan of benefits, and the issuer assumes the full costs of coverage and is prohibited from charging any co-payments, deductibles, fees, premium hikes or other costs to the organization for its employees. 

Priests for Life, a nonprofit religious organization, and three of its employees sued the federal government in the U.S. District Court for the District of Columbia, saying that the self-certification accommodation allowed by the mandate violates their rights under the RFRA and the First and Fifth Amendments to the U.S. Constitution. 

Consolidation

The plaintiffs moved for summary judgment, and the defendants moved to dismiss.  On Dec. 19, the District Court dismissed the case, saying accommodations made to the mandate for religious employers do not violate their religious rights. 

The plaintiffs appealed to the District of Columbia Circuit U.S. Court of Appeals, which on Dec. 31 granted an emergency motion for an injunction pending appeal.  The court also consolidated the case with Roman Catholic Archbishop of Washington, et al. v. Kathleen Sebelius, et al. (No. 13-1441, D.C. Cir.). 

Violation

The plaintiffs’ petitions asked the Supreme Court “[w]hether the contraceptive-coverage mandate of the Affordable Care Act as applied to non-exempt, nonprofit religious organizations violates the Religious Freedom Restoration Act.” 

The plaintiffs contended that the mandate directly forces them “to provide the means and mechanism by which contraception, sterilization, and abortifacients (and related education and counseling) are provided to its employees (i.e. its healthcare plan participants and beneficiaries), which is unacceptable to Petitioners because it compels them to violate their sincerely held religious beliefs.” 

The plaintiffs also argued that they are pressured to choose between violating their religious beliefs in managing their selected health care plan by authorizing — via self-certification — coverage of contraceptive services or paying onerous penalties. 

The federal government filed a joint opposition to the Priests for Life petition and the Roman Catholic Archbishop petition, saying that given the numerous cases pending in the courts of appeal involving RFRA challenges to the accommodations, it was not clear that taking the extraordinary step of granting writs of certiorari before judgment would expedite the court’s resolution of the question. 

Robert J. Muise of the American Freedom Law Center in Ann Arbor, Mich., represents the plaintiffs in Priests for Life.  Eric S. Dreiband and Noel John Francisco of Jones Day represent the plaintiffs in Roman Catholic Archbishop of Washington.    Solicitor General Donald B. Verrilli Jr., Assistant Attorney General Stuart F. Delery and attorneys Mark B. Stern and Alisa B. Klein, all of the U.S. Department of Justice in Washington, represent the defendants.

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