Federal Court rejects employer challenge to ACA’s contraception coverage provision

Posted on October 2, 2012 | No Comments

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The U.S. District Court for the Eastern District of Missouri ruled on September 28, 2012 that the Affordable Care Act’s (ACA’s) requirement that employer-sponsored health care plans cover women’s preventive services, including contraception, does not violate the Religion Freedom Restoration Act or Fire Amendment Free Exercise, Establishment, or Freedom of Speech clauses in the O’Brien v. HHS case. The court’s ruling granted the Obama administration’s motion to dismiss the complaint. Judge Carol E. Jackson argued that the aforementioned regulations imposed no substantial burden on the plaintiff’s exercise of religious beliefs, and thus dismissed the complaint on its merits.

The plaintiff in the case is Frank O’Brien, the chairman and managing partner of O’Brien Industrial Holdings LLC (OIH). The company engages in mining, processing, distributing refractory and ceramic materials and products. O’Brien is Catholic and brought the action action the U.S. Department of Health and Human Services (HHS), claiming that his company should be exempt from the ACA contraception provision. O’Brien and OIH argued that the Religion Freedom Restoration Act (RFRA) protects a person’s right to exercise his religion and that the ACA provision violates this Act.

The court argued that the “RFRA is a shield, not a sword….It protects individuals from substantial burdens on religious exercise …; it is not a means to force one’s religious practices upon others.”

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The U.S. Department of Health and Human Services (HHS) published an interim final rule which provides an alternative process for an eligible organization to provide notice of its religious objections to providing contraceptive coverage.  It will allow qualifying organizations to notify HHS of their religious objections to providing coverage and the government will in turn contact their insurers, which are to provide contraceptive benefits to the employees without any cost sharing.  HHS additionally released a proposed rule which changes  the definition of an eligible organization that can avail itself of an accommodation with respect to coverage of certain preventive services. These rules come in response to recent decisions against the Affordable Care Act's (ACA) birth control mandate from multiple federal courts. HHS also released a coinciding fact sheet on the rules.
In a joint rule released by the US Department of Health and Human Services (HHS), the US Department of the Treasury (DoT), and the US Department of Labor (DoL), the administration finalized the requirement for employers to offer contraception coverage through their workplace health insurance policies. The rule defines a "religious employer" to include predominantly churches and houses of worship. For religiously-affiliated institutions, such as universities, the rule provides a simplified process by which insurance companies can cover contraceptives for employees. Religiously-affiliated entities using self-insured plans can use the same streamlined approach for a third-party administrator to provide contraceptives. In addition to the rule, the administration extended the safe harbor for religiously-affiliated hospitals and universities, which prevented those institutions from fines associated with non-compliance to the contraception mandate, through January.
The Obama administration issued proposed rules for public comment regarding contraceptive coverage with no cost sharing under the Affordable Care Act (ACA). The proposed rules provide women with coverage for preventive care that includes contraceptive services with no co-pays. Importantly, the rule accounts for concerns of some religious organizations by extending accommodations that provide enrollees separate contraceptive coverage with no co-pays, but at no cost to the religious organization. Insured plans: For insured plans, including student health plans, the religious organizations would be required to provide notice to their insurer. The insurer would then be responsible for notifying enrollees that it is providing them with no-cost contraceptive coverage through separate individual health insurance policies. Self-insured plans: For self-insured plans, as well as student health plans, religions organizations would be required to notify third party administrators. The third party administrator would then work with an insurer to arrange no-cost contraceptive coverage through separate policies. Additionally, the proposed rules provide a detailed definition of "religious employer” for the purposes of the exemption. Click here for a fact sheet.
The Department of Justice (DOJ) told the Supreme Court yesterday that they would not attempt to block requests to reopen a lawsuit against the Affordable Care Act (ACA). Such a lawsuit could potentially place the ACA in front of the Supreme Court again as early as next year. In 2010, Liberty University sued over the minimum coverage provision and other aspects of the ACA, but the case was set aside when the 26 states and NFIB case went before the Supreme Court. Because the court upheld the constitutionality of the individual mandate in its June 28th decision, it essentially tossed out Liberty's lawsuit. Liberty now wants the Supreme Court to review its other challenges to the ACA. Specifically, Liberty claims that the law's employer coverage requirements are unconstitutional, as the mandate's contraception coverage requirement violates the right to freely exercise religion. Over 30 such claims have been filed against the Obama administration. Solicitor General Donald Verrilli's letter to the court states that although the DOJ believes that the Liberty claims "lack merit," the DOJ does not oppose the courts reviewing the suit.
Preventive services are optional for traditional Medicaid beneficiaries[1] ages 21 and older who are covered under the standard Medicaid program. Young adults ages 18-21 remain entitled to EPSDT benefits, which encompass periodic and as-needed health exams, all age-appropriate immunizations, and other preventive services.
Hobby Lobby, a Christian-run arts and crafts chain, filed for an emergency injunction on December 21, 2012 with the Supreme Court to block President Obama's birth control coverage rules. Hobby Lobby's complaint surrounds the Affordable Care Act's (ACA's) requirement that most employers cover contraception without copay. Yesterday, the Supreme Court today denied Hobby Lobby's request, which was joined by the Christian book company, Mardel. The U.S. Supreme Court said it will not decide the case before lower courts have ruled. Justice Sonia Sotomayor argued that the petitioners did not meet the standards requisite for a preliminary injunction. The court also denied the request that the court take up the entire case, in which they argue that the ACA's contraceptive coverage requirement forces them to violate their religious beliefs. The case will return to the district court for a ruling on the merits of whether the Obama administration can require employers who have religious objections to contraceptive coverage to provide said insurance coverage in their employer plan.
The Supreme Court on Monday ordered the Fourth Circuit Court of Appeals to examine the constitutionality of the Affordable Care Act's (ACA's) employer requirement to cover contraceptives without a co-pay. This move could put the ACA in front of the Supreme Court again as early as next year. The order was in response to a request from Liberty University, one of the groups that sued over the mandate in 2010. After the June ruling, the Supreme Court dismissed Liberty's entire lawsuit. Over this past summer, Liberty asked the Supreme Court to reopen the arguments pertaining to the employer mandate and the contraceptive coverage mandate. The court agreed to the request and today's order instructs the Fourth Circuit to review both pieces of the argument.
On Friday, U.S. District Judge Reggie Walton granted a preliminary injunction to Tyndale House Publishers, enabling the company to reject the Affordable Care Act (ACA) provision which requires employers to provide its employees with contraceptive coverage. The company argued that it does not want to cover contraceptives, as it  views them as abortions. Plan B and IUDs are the contraceptives at issue in the case. If a woman is already pregnant, the Plan B pill has no effect. Plan B merely prevents ovulation or fertilization of an egg. Plan B can also prevent a fertilized egg from implanting on the uterine wall. IUDs mainly work by blocking sperm, but may also have the same anti-implantation effect. According to Tyndale, this implantation prevention is not morally different than abortion. Tyndale president and CEO Mark D. Taylor filed the lawsuit against the U.S. Department of Health and Human Services (HHS) last month, arguing that the provision causes employers to violate their religious beliefs. In his decision, Judge Walton acknowledged that the government has interests in promoting public health and ensuring that women have equal access to health care, but he said that the government has not offered proof that the ACA's contraceptive coverage provision furthers these interests.