ACA Contraceptive Mandate Upheld by Federal Appeals Court
Author: Marta Moakley, XpertHR Legal Editor
November 17, 2014
In a unanimous ruling by a three-judge panel, the Circuit Court of Appeals for the District of Columbia Circuit has upheld the Affordable Care Act's (ACA's) birth-control mandate. Priests for Life v. U.S. Dep't of Health and Human Services involved the ACA's requirement that employees be provided with a range of contraceptive services, including birth-control pills, at no cost. Although a nonprofit religious institution is allowed to opt out of the requirement by providing notice to the government declaring that it has a religious objection to the mandate, a number of institutions have filed legal challenges to the ACA requirement, claiming that it is an unjustified burden on their exercise of religion.
New rules were published in August in response to the Supreme Court's decision in Hobby Lobby, which sided with a closely held for-profit corporation's objections to the contraceptive coverage mandate. The new rules provide alternate ways to provide notice of religious objections to contraception coverage: either notifying the government by letter or by filing a two-page form.
However, these rules, aimed at quelling objections, have not gone far enough to satisfy certain religious nonprofit organizations. As a result, a number of challenges have been filed in various federal courts.
Priests for Life involved a consolidated appeal from several nonprofit organizations affiliated with the Roman Catholic Archbishop of the District of Columbia. The organizations argued that the regulatory accommodation of opting out, in and of itself, infringes on their free exercise of religion.
The organizations argued that the accommodation does not go far enough. Because an organization must provide the government with notice of its religious objection, the burden then shifts to health insurers and administrators to ensure that contraceptive coverage be provided. Therefore, the nonprofit organizations argued that they continued to play a role in enabling contraceptive coverage for employees. The organizations maintained that they were entitled to exclude contraceptive coverage from employees' plans without notice.
However, the appeals court rejected the organizations' arguments. In siding with the Obama administration's defense of the regulatory accommodation, the appeals court reasoned that the ACA itself, and not any action of an employer (such as filing a two-page form), creates the contraceptive coverage mandate.
In fact, the decision referred to the notice requirement as "a bit of paperwork," requiring "minimal" compliance efforts when compared to other administrative requirements for nonprofits.
The Priests for Life case will not be the last word on the contraceptive mandate debate. At least one case involving a religious nonprofit organization is ripe for consideration by the Supreme Court: the University of Notre Dame, a Roman Catholic post-secondary institution, has filed a petition for Supreme Court review of its objections to the contraceptive coverage mandate.