Reproductive Rights

Federal Appeals Court Rejects Challenge to Affordable Care Act Birth Control Benefit

In a victory for women’s health, a unanimous panel of the US Court of Appeals for the DC Circuit on Friday rejected a challenge to the Affordable Care Act (ACA) contraceptive coverage benefit brought by Priests for Life, the Roman Catholic Archbishop of Washington and other religiously affiliated non-profit organizations.

via Shutterstock
via Shutterstock

Judge Nina Pillard, a former law professor who was nominated to the DC Circuit by President Obama and confirmed by the Senate in December, wrote the opinion for the Court, which found that the ACA birth control benefit did not substantially burden or violate non-profits’ religious freedom.

Under the Affordable Care Act, health insurance companies must cover the full cost of all FDA-approved contraceptives – including the pill, IUDs, and emergency contraception – without requiring co-pays or cost-sharing. Religious employers, like churches, are entirely exempt from this requirement. Religiously affiliated non-profit organizations that object to providing birth control coverage to their employees, are entitled to an accommodation. These non-profits must only inform their health insurance issuer, third party administrator, or the Department of Health and Human Services (HHS) of its objection. At that point, these organizations are no longer required to play a role in providing or subsidizing birth control. The insurance issuer or third party administrator would be solely responsible for providing birth control benefits to affected employees.

The DC Circuit panel found that this accommodation – which the plaintiffs in Priests for Life claimed would violate their religious beliefs – put no substantial burden on religious non-profits exercise of religious freedom.

“All Plaintiffs must do to opt out is express what they believe and seek what they want via a letter or two page form. That bit of paperwork is more straightforward and minimal than many that are staples of nonprofit organizations’ compliance with law in the modern administrative state,” wrote Judge Pillard. “Religious nonprofits that opt out are excused from playing any role in the provision of contraceptive services, and they remain free to condemn contraception in the clearest terms.”

The fact that others may provide contraceptive coverage to these religious non-profits’ employees did not mean that the non-profits were aggrieved under the Religious Freedom Restoration Act (RFRA). According to the Court, there is “no RFRA right to be free from the unease” of knowing that third parties may “act in ways their religion abhors.”

The decision also pointed out that the religious accommodation provided the least restrictive means to achieve a compelling government interest – namely, ensuring women’s health and providing to women the equal benefit of the preventive care coverage guaranteed by the ACA. Judge Pillard specifically noted that “The contraceptive coverage requirement derives from the ACA’s prioritization of preventive care, and from Congress’ recognition that such care has often been modeled on men’s health needs and thus left women underinsured.”

Directly after the ruling, Rev. Frank Pavone, National Director of Priests for Life indicated that the group would continue to challenge the law. “The court is wrong,” he said, “and we will not obey the mandate.” 

The DC Circuit is the third federal appeals court to reject non-profits’ challenge to the accommodation. This decision is the first appeals decision since the US Supreme Court decided Burwell v. Hobby Lobby this summer. The Feminist Majority Foundation, along with 12 other national and local organizations, joined an amicus brief, submitted by the National Women’s Law Center in support of the birth control benefit rule in the DC Circuit case.

Media Resources: US Circuit Court of Appeals for the DC Circuit 11/14/14; PBS NewsHour 11/14/14; National Women’s Law Center; Centers for Medicare and Medicaid Services; Feminist Newswire 7/1/14

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