Contraception-Insurance Case Faces New Round at Top Court

WASHINGTON (CN) — The Supreme Court agreed Friday to again take up a dispute over whether religious groups are exempt from the requirement that health insurance plans cover contraception.  

 Most of the justices will already be familiar with the issue, as the court has repeatedly weighed in over the past decade on the interplay between requirement in the Patient Protection and Affordable Care Act that employer health plans cover contraception and the rights of people who have religious objections to contraception.

In the twin cases taken up Friday, the court agreed to decide the fate of a Trump administration rule from 2017 that expanded the exemption to the mandate for employers with religious or moral objections to contraception.

Little Sisters of the Poor outside the U.S. Supreme Court in March 2016 after oral arguments for their case against the contraception mandate in the federal health care law. (Photo courtesy of the Becket Fund for Religious Liberty via CNS)

The Affordable Care Act, often known as Obamacare, and its accompanying regulations require employers with more than 50 employees to provide health insurance that covers, among other services, contraception. The initial regulations carved out an exemption for certain types of religious employers.

But a host of religious employers did not qualify for the exemption and launched a firestorm of litigation in courts across the country. In 2013 the Obama administration issued new regulations that gave churches a full exemption from the contraceptive mandate, while requiring for-profit religious employers to provide the coverage.

Religious nonprofit groups fell somewhere in the middle, with the regulations allowing them to submit a form stating a religious objection, at which point employees could get coverage of contraception directly from the insurance provider or administrator.

In the 2014 Burwell v. Hobby Lobby decision, the Supreme Court ruled that closely held corporations could deny coverage of contraception that would violate the owner’s religious beliefs.

Two years later, in Zubik v. Burwell, the court vacated lower-court rulings in challenges to the religious nonprofit accommodation, though it did not reach the merits of those disputes.

With a new administration after the 2016 election, the already uncertain landscape shifted again. Shortly after entering the White House, President Donald Trump signed an executive order that broadened the religious exemption to the mandate.

Pennsylvania, joined by New Jersey, quickly filed suit, claiming the administration had overstepped its authority with the new regulations.

The Little Sisters of the Poor, a Catholic religious order, intervened to defend the Trump administration rule. The Little Sisters were involved in the Zubik litigation, as they argued the mechanism for getting the religious non-profit exemption made them complicit in providing contraception, a sin under the church’s teaching.

A federal judge in Pennsylvania sided with the states and blocked the regulation, saying the administration did not have the authority to issue the new rules and beating back claims that the Religious Freedom Restoration Act gave the government such authority.

The Third Circuit upheld the injunction in July 2019, and both the Trump administration and the Little Sisters appealed to the Supreme Court.

A court in California also enjoined the regulations in a separate challenge from a group of states led by California.

The Little Sisters are represented by the Becket Fund for Religious Liberty.

“It is disappointing to think that as we enter a new decade we must still defend our ministry in court,” Mother Loraine Marie Maguire, who is a member of the Little Sisters of the Poor, said in a statement Friday. “We are grateful the Supreme Court has decided to weigh in and hopeful that the justices will reinforce their previous decision and allow us to focus on our lifelong work of serving the elderly poor once and for all.”

The Justice Department did not immediately return a request for comment on the high court’s decision to take up the case.

Pennsylvania Attorney General Josh Shapiro expressed confidence ahead of what will be a closely watched fight at the high court.

“The Trump administration’s rule allows employers to deny contraceptive services to any employee for any reason — including the belief that women don’t belong in the workforce,” Shapiro said in a statement. “Two federal courts have blocked this rule and we are confident the Supreme Court of the United States will do the same. I look forward to making our case before the justices.”

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