In a unanimous decision, a panel of the US Court of Appeals for the Sixth Circuit ruled yesterday that the Affordable Care Act (ACA) birth control coverage benefit does not violate the Religious Freedom Restoration Act (RFRA) or the First Amendment, upholding two lower courts’ denial of a preliminary injunction against the law to a group of Catholic-affiliated non-profit entities.
The ACA requires health insurance providers to cover preventive health services – including all FDA-approved contraceptives, such as the pill, emergency contraceptives, and IUDs – without charging co-pays, deductibles or co-insurance. Religious employers, such as churches, are exempted from the requirement. Certain non-profits, who object to contraception on religious grounds, can obtain an accommodation that would allow these groups not to provide contraceptives to their employees. In that case, if the non-profit has an employer-provided group health insurance plan, then the employer would submit a certification to the insurance issuer. The issuer would then have to provide contraceptive coverage. If the non-profit employer has a self-insured plan, one that relies on employer-contributions without outside insurance contributions, then the employer would contract with a third-party administrator who would pay for and process claims for contraceptive services.
The non-profit groups in the case argued that the process to obtain the exemption or the accommodation unduly interfered with their religious beliefs and burdened their exercise of religion, violating both RFRA and the First Amendment.
The Sixth Circuit rejected these arguments, finding that the ACA did not substantially burden the religious exercise of any group eligible for either the exemption or the accommodation. The court noted that the law was specifically crafted so that these groups would not be required to “provide” contraceptives to anyone, to “pay for” contraceptive coverage, or to “facilitate” access to contraceptives.
Together with the National Women’s Law Center, the Feminist Majority Foundation and 20 other national, regional, and local groups submitted an amicus brief to the Sixth Circuit in support of the ACA birth control benefit. Nationwide, over 100 lawsuits have been filed in federal court challenging the benefit. The Supreme Court is expected to decide this month whether for-profit companies should be exempted from the contraceptive coverage requirement.
A majority of Americans support full coverage of birth control as a preventive service. As many as 88% of American women who have ever had sexual intercourse have used birth control pills, injectables, the contraceptive patch, or IUDs at some point in their lives, and at least 14% of women using the pill are doing so to treat painful conditions such as endometriosis, ovarian cysts, or severe cramps, and studies have shown that the pill reduces the incidence of ovarian and endometrial cancers. Birth control is basic health care for women.
Media Resources: United States Court of Appeals for the Sixth Circuit; National Women’s Law Center; Feminist Majority Foundation 11/26/13