US Supreme Court Upholds Religious and Moral Exemptions from ACA Contraceptive Mandate

July 21, 2020

On July 8, 2020, the U.S. Supreme Court issued a 7-2 decision in Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania that upheld the current administration’s religious and moral exemptions from the employer mandate to provide birth control to employees.

This decision is the result of long-running litigation that began when the previous administration promulgated rules that clarified the ACA’s requirement that employers provide group health plans to their employees that includes preventive care and screening services to women without cost sharing. The previous administration defined “preventive care” to include birth control. In doing so, the previous administration created an exemption for religious institutions and gave nonprofits affiliated with those institutions an exemption if those nonprofits self-certified that offering birth control coverage in their health plans would violate sincerely held religious beliefs.

Employers with religious objections to birth control took the previous administration to court, asserting that the requirement would keep them from exercising their religious beliefs in violation of the Religious Freedom Restoration Act. The current administration later issued interim rules that expanded the exemption to any employer, including publicly traded employers, which objected on religious grounds. Employers that are not publicly traded can also object for broader moral reasons.

Two states, Pennsylvania and New Jersey, filed suit against the federal government, alleging that the federal government did not follow administrative procedure in promulgating the interim rules that expanded the exemptions and lacked the statutory authority to do so. The federal district court agreed with the states and issued a national preliminary injunction preventing the exemptions from going into effect pending the resolution of the litigation. The U.S. Court of Appeals for the Third Circuit affirmed that judgment and the injunction.

However, the Supreme Court disagreed and ruled that the ACA gave the federal government wide latitude to grant the exemptions, in that the law does not expressly require that contraceptives be covered by an employer’s group health plan. The Court also concluded that the current administration substantially followed administrative procedure when promulgating the interim rules and that any errors made during that process did not substantially harm the states. Accordingly, the Court reversed the Third Circuit’s judgment and remanded the case back to the district court for further proceedings.

Note that the exemptions at issue in this case were created in interim rules promulgated by the federal government. These exemptions can also be found in the final rule promulgated by the federal Health and Human Services Department, which we covered in the June 23, 2020, edition of Compliance Corner.

Employers intending to avail themselves of a religious or moral exemption from offering contraceptives should consult with their legal counsel about the implications of this Supreme Court decision.

Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania »