As part of the Affordable Care Act’s implementing regulations, group health plans were required to include coverage for various forms of preventative care, including all FDA-approved methods of contraception. Houses of worship were exempted from these requirements, and the Department of Health and Human Services later created a broader accommodation for certain nonprofit organizations. In particular, religious nonprofit organizations could opt out of providing contraceptive coverage by certifying their religious objection; upon receiving this certification, the organization’s insurance company—or in the case of self-insured plans, its third-party administrator—would step in to provide the coverage.
Two dioceses, two bishops, several religious nonprofits, and a religiously affiliated college brought three separate lawsuits in federal court challenging the accommodation, claiming that even using the accommodation substantially burdened their religious exercise. In late 2013, the trial courts ruled in favor of the plaintiffs and issued an order prohibiting the government from enforcing the contraceptive-coverage mandate and accommodation process against the plaintiffs.
The government appealed to the U.S. Court of Appeals for the Third Circuit, where the court heard the cases together. In June 2014, Americans United submitted an amicus curiae brief to the Third Circuit in support of the accommodation. (During that time period, we also filed several similar briefs in other federal courts of appeals in similar cases.) In February 2015, the Third Circuit agreed with us and upheld the accommodation, finding that it did not impose a substantial burden on the religious-exercise rights of organizations that chose to opt out of providing contraceptive coverage.
The Supreme Court agreed to review the Third Circuit’s decision (along with similar decisions from the Fifth Circuit, Tenth Circuit, and D.C. Circuit), and we submitted an amicus brief to the Court on behalf of 240 students, faculty, and staff at religiously affiliated universities. Our brief argued that the accommodation process was the least restrictive means for the government to achieve its interests in decreasing the number of unintended pregnancies, preserving women’s opportunities for educational and professional participation, and improving women’s health. Meanwhile, the proposed alternatives to the accommodation would make it harder for employees and their dependents to access contraception, impermissibly forcing employees to bear the costs of their employers’ religious beliefs.
In May 2016, the Court returned the case to the Third Circuit so that the parties would have the opportunity to come to a settlement agreement. In October 2017, after the Trump administration issued new rules allowing sweeping religious exemptions from the contraceptive coverage mandate without requiring any accommodation process to ensure employees would still have access to cost-free coverage, the parties filed a joint motion to dismiss the cases, which the court granted in April 2018. Americans United is currently litigating a challenge to those exemptions in Irish 4 Reproductive Health v. U.S. Department of Health and Human Services.