The Supreme Court of the United States (7:2) has upheld the 'religious and moral' exemptions granted to contraceptive mandate.
The Patient Protection and Affordable Care Act of 2010 (ACA) obligates certain employers to provide contraceptive coverage to their employees through their group health plans (this requirement is called 'Contraceptive Mandate'). Later in 2017, the Department granted exemption to certain employers who have religious and conscientious objections.
This exemption clause was challenged by the Commonwealth of Pennsylvania who filed an action seeking declaratory and injunctive relief, before the District Court. The District Court issued a nationwide preliminary injunction against the implementation of the final rules. The Government and Little Sisters (an international congregation of Roman Catholic women religious) appealed before the Third Circuit which affirmed the District Court findings. It was held that the Departments lacked authority to craft the exemptions. It was held that the 2018 final rules providing religious and moral exemptions to the contraceptive mandate are both substantively and procedurally invalid.
The Little Sisters hold the religious conviction "that deliberately avoiding reproduction through medical means is immoral and that is why they challenged the self-certification accommodation, claiming that completing the certification form would force them to violate their religious beliefs by "taking actions that directly cause others to provide contraception or appear to participate in the Departments' delivery scheme."
The Supreme Court, while considering the appeal filed by Little Sisters, observed that the ACA gives Health Resources and Services Administration broad discretion to define preventive care and screenings and to create the religious and moral exemptions. The Court also held that the Department did not err by looking to the Religious Freedom Restoration Act of 1993 (RFRA) as a guide when framing the religious exemption. Under RFRA, a law that substantially burdens the exercise of religion must serve "a compelling governmental interest" and be "the least restrictive means of furthering that compelling governmental interest." It also observed that the contraceptive mandate is capable of violating RFRA. It said
"Under RFRA, the Departments must accept the sincerely held complicity-based objections of religious entities. That is, they could not "tell the plaintiffs that their beliefs are flawed" because, in the Departments' view, "the connection between what the objecting parties must do . . . and the end that they find to be morally wrong . . . is simply too attenuated."
Concluding the judgment for the majority, Justice Thomas observed thus::
"For over 150 years, the Little Sisters have engaged in faithful service and sacrifice, motivated by a religious calling to surrender all for the sake of their brother. "[T]hey commit to constantly living out a witness that proclaims the unique, inviolable dignity of every person, particularly those whom others regard as weak or worthless." Complaint ¶14. But for the past seven years, they—like many other religious objectors who have participated in the litigation and rulemakings leading up to today's decision— have had to fight for the ability to continue in their noble work without violating their sincerely held religious beliefs. After two decisions from this Court and multiple failed regulatory attempts, the Federal Government has arrived at a solution that exempts the Little Sisters from the source of their complicity-based concerns—the administratively imposed contraceptive mandate. We hold today that the Departments had the statutory authority to craft that exemption, as well as the contemporaneously issued moral exemption. We further hold that the rules promulgating these exemptions are free from procedural defects. "
Concurring with the Court's opinion, Justice Alito added that the Departments were required by RFRA to create the religious exemption (or something very close to it). Justice Ginsburg expressed her dissent thus:
"The blanket exemption for religious and moral objections to contraception formulated by the IRS, EBSA, and CMS is inconsistent with the text of, and Congress' intent for, both the ACA and RFRA. Neither law authorizes it. The original administrative regulation accommodating religious objections to contraception appropriately implemented the ACA and RFRA consistent with Congress' staunch determination to afford women employees equal access to preventive services, thereby advancing public health and welfare and women's well-being. "
Case name: LITTLE SISTERS OF THE POOR SAINTS PETER AND PAUL HOME v. PENNSYLVANIA
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