Courts Reproductive Rights

Supreme Court Considers Affordable Care Act Religious Exemption Rule

On Wednesday, the Supreme Court will consider yet another case regarding whether employers can decline to cover contraceptives in their health care plans. Reproductive rights groups warn that depending on the outcome of the case, tens of thousands of American women could lose vital contraceptive coverage.

The case, Little Sisters of the Poor and Paul Home v. Pennsylvania, involves a 2017 Trump administration rule change that significantly broadened who can claim an exemption to the Affordable Care Act (ACA) contraceptive coverage mandate. The 2017 rule change, issued without a notice of proposed rulemaking or public comment opportunity, expanded the scope of religious exemptions and added an additional moral exemption claim.

States had successfully challenged the rule, calling it a violation of the constitution, federal anti-discrimination law, and the Administrative Procedures Act (APA). A federal appeals court issued an injunction, preventing the Trump administration from enforcing the rule until the case was decided. Both the district court and the Third Circuit U.S. Court of Appeals affirmed that states were likely to succeed on their APA claim.

The court will now consider whether the Little Sisters of the Poor have standing and whether the Trump administration lawfully exempted religious objectors from the regulatory requirement to provide contraceptives. Like several other cases taking place during COVID-19, oral arguments for Little Sisters of the Poor will take place via teleconference and made available on C-SPAN.

The Justice Department argues that exceptions should be broadened, citing that many employers believe any use of their health plans to provide contraceptives to employees— even if the employer is not directly involved in the process — violates their religious beliefs.

Opponents argue that the Administration overstepped their bounds. In an interview with Roll Call, Pennsylvania Attorney General Josh Shapiro said, “They clearly overreached. They violated the rule of law. This case isn’t about forcing a church to provide access to birth control. Look, they’re already exempt, and we’re not challenging those exemptions.”

Additionally, opponents note the expanded rule would allow publicly traded companies and large universities to claim religious objections for refusing to provide the coverage. Furthermore, the rule would exempt employers and schools with any moral objections from the ACA requirement.

Reproductive rights organizations worry that if these changes to the mandate are upheld, tens of thousands of women could lose access to contraceptives. In their amicus brief, the Guttmacher Institute asserted, “More than 99% of the women aged 15–44 who have ever had sexual intercourse have used at least one contraceptive method … the Final Rules would make it more difficult, once again, for those receiving insurance coverage through companies or schools that use the exemption … to access the methods of contraception that are most acceptable and effective for them.”

Sources: SCOTUSBlog, 5/6/2020; NBC News 5/6/2020; C-SPAN 5/6/2020; Roll Call, 5/5/2020; Amicus Curiae, Guttmacher Institute 4/8/2020