Appeals Court: Contraceptive Coverage Rules Violate Religious Rights

In a pair of decisions issued Thursday, the 8th U.S. Circuit Court of Appeals in St. Louis said that the Affordable Care Act's contraceptive coverage rules violate the religious rights of several not-for-profit organizations, Reuters reports (Pierson, Reuters, 9/17).

Background

The contraceptive coverage rules, which are being implemented under the ACA, require most employers to offer coverage to their workers. Houses of worship are exempt from the requirement (California Healthline, 5/12). Not-for-profits that hold themselves out as religious also are eligible for an accommodation that ensures they do not have to pay for or directly provide the coverage for their employees (California Healthline, 8/25).  

The circuit court on Thursday issued rulings in two separate suits filed by not-for-profit groups that argue the accommodation violates the Religious Freedom Restoration Act.

The suits were filed by two Missouri groups -- Heartland Christian College and CNS International Ministries, a not-for-profit offering substance use services -- and two Iowa organizations -- Dordt College and Cornerstone University (Reuters, 9/17).

Decision Details

In its rulings, the 8th Circuit Court panel upheld a lower court's decision that the federal government cannot force not-for-profits that hold themselves out as religious to comply with the accommodation for such organizations under the contraceptive coverage rules (Schencker, Modern Healthcare, 9/17).

U.S. Circuit Judge Roger Wollman wrote in one of the decisions, "The question here is not whether CNS and HCC have correctly interpreted the law, but whether they have a sincere religious belief that their participation in the accommodation process makes them morally and spiritually complicit in providing abortifacient coverage," adding, "Their affirmative answer to that question is not for us to dispute."

Wollman added that financial penalties imposed for non-compliance with the contraceptive coverage mandate would impose a substantial burden on the organizations and that the federal government had not demonstrated that there was no other way to provide women with contraceptive coverage  (Barnes, Washington Post, 9/17).

Potential for Supreme Court Review

Circuit courts throughout the country have ruled in favor of the contraceptive coverage rules, meaning the latest rulings could set up the issue for review by the Supreme Court (Modern Healthcare, 9/17). According to the Wall Street Journal, the rulings increase the likelihood that the Supreme Court will review such a case because the high court is more apt to become involved when lower courts reach conflicting decisions (Radnofsky/Kendall, Wall Street Journal, 9/17).

Douglas Laycock, a law professor at the University of Virginia, said, "Even though it's 7:1, it becomes nearly certain that the Supreme Court will take one of these cases." He added that while seven circuit courts have sided with the federal government on the contraceptive coverage mandate, other judges have strongly dissented to the policy in their opinions.

Similarly, James Blumstein, a professor at Vanderbilt Law School, said, "You never want to predict what the court's going to do, but I think this has such high visibility, and if there's a split in the circuits … they may want to resolve the issue."

The Supreme Court's next session begins in October. Plaintiffs in seven similar cases have already petitioned the high court for review, and the Supreme Court has issued stays to temporarily block enforcement of the mandate in some instances (Modern Healthcare, 9/17).  

Reaction

Lori Windham -- senior counsel at the Becket Fund for Religious Liberty, which is supporting plaintiffs in similar legal challenges -- in a statement said, "The government keeps telling the Supreme Court 'Move along, nothing important here' in hopes that the court will ignore this crucial issue," adding, "But with today's decisions, the court will have great reason to decide this issue in the next term" (Washington Post, 9/17).

Meanwhile, an Obama administration spokesperson said federal officials were "disappointed" in the ruling but believe the contraceptive coverage mandate will ultimately be upheld. The spokesperson added, "As all of the other seven courts of appeals to address this issue have held, the contraceptive accommodation process strikes the proper balance between ensuring women have equal access to health care and protecting religious beliefs" (Ferris, The Hill, 9/17).