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Attorney Blog, Human Resources

Supreme Court Decides Administration Had Authority to Create Exemptions from Contraceptive Requirements for Employers with Religious and Conscientious Objections

Attorney Harrison Oldham

In the July 8, 2020 decision, Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania, the upheld a regulation that permits all employers with a “sincerely held religious or moral objection” to opt out of providing contraceptive coverage in their group health plans.

As a bit of background, the Affordable Care Act requires many employers to offer health plans that include, for women, “such additional preventive care and screenings … as provided for in comprehensive guidelines” issued by the Health Resources and Services Administration (HRSA). The statute does not define “preventive care and screenings” and does not include an exhaustive or illustrative list of such services. Starting in 2011, HRSA regulations required certain health plans to cover “contraceptive methods and sterilization procedures.”

The Supreme Court has faced questions that address the ACA’s mandate that employer-sponsored health insurance plans provide coverage for contraceptives. For example, the Supreme Court previously considered religious-based objections to this mandate in Burwell v. Hobby Lobby Stores.

The ACA originally permitted the HRSA to exempt churches from providing such coverage.   However, in Burwell v. Hobby Lobby Stores, Inc., 573 U.S. 682 (2014), the Supreme Court decided that closely held for-profit corporations could be exempt from a regulation its owners religiously object to, if there is a less restrictive means of furthering the law’s interest, according to the provisions of the Religious Freedom Restoration Act (RFRA). It was the first time that the Court had recognized a for-profit corporation’s claim of religious belief, but it was limited to closely held corporations.

For applicable companies, the Burwell decision directly struck down the contraceptive mandate.

When President Trump took over the Oval Office, one of the first orders he enacted (in 2017) was to order the HHS to issue a ruling to allow for conscious objections to the mandate, that allowed for for-profit religious organizations to claim exemption from the mandate on religious or moral grounds.  Thereafter, in 2017 and 2018 HRSA promulgated rules exempting a broad class of employers with religious objections from this contraceptive mandate.

As a result, several states sued the government, and multiple Circuit Courts placed injunctions on the new rules as arbitrary and capricious and required by neither the ACA or the RFRA,  This led to numerous state seeking further legal action on the new rules that lead to the case at hand, Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania, which was heard in May 2020.

At issue in Little Sisters of the Poor was that 2017 regulation that permits any employer – including religious organizations, non-profits, and even publicly traded companies – to opt out of the mandate if they have religious or moral objections to providing contraceptive coverage to their employees. The State of Pennsylvania had argued that this broad exemption exceeded the HRSA’s statutory authority. The Supreme Court disagreed, concluding that HRSA had the authority to define the scope of permissible exemptions to the contraceptive mandate.

The Court first rejected Pennsylvania’s argument that religious exemptions are not authorized by the Affordable Care Act. The Court held that on its face, the Affordable Care Act “is completely silent as to what” the preventive-care “guidelines must contain,” and therefore “gives HRSA broad discretion to define preventive care and screenings and to create the religious and moral exemptions.” The Supreme Court also held that it was appropriate for the government, in creating the exemption, to consider the “very broad protection for religious liberty” provided by the Religious Freedom Restoration Act.


About Harrison Oldham

Harrison grew up in Mansfield, Texas. He attended Texas A&M University for his bachelor’s degree, where he met his wonderful wife, Kelsey. After graduating magna cum laude from Texas A&M, he attended SMU Dedman School of Law, graduating with honors in 2012. Today, Harrison and his wife live in Dallas, Texas with their son, Teddy.

Since graduating from SMU Law, Harrison has worked exclusively in the field of business law. He has spent time in private practice and in-house, working with clients of every size; from single person startups to Fortune 250 companies. Today his practice focuses on serving the diverse needs of businesses and individuals throughout Texas. You can learn more about Harrison by visiting his website, at: http://lonestarbusinesslaw.com/.

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