The Supreme Court ruled 7-2 Wednesday that employers with religious or moral objections to birth control do not have to provide insurance coverage for contraceptives under the Affordable Care Act. The decision represents a victory for one senior housing provider as well as other organizations.
The case, Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania, was brought by 17 states, led by Pennsylvania and New Jersey, that challenged a 2018 regulation from the Department of Health and Human Services that exempted any employer with a religious or moral objection to contraception from providing coverage in an employee’s health insurance plan.
Under rules adopted during the Obama administration, coverage of preventive health services and screenings included a requirement that employers and insurers must provide women coverage — at no cost — for all forms of contraception approved by the Food and Drug Administration.
Houses of worship were exempt from the requirement, but nonprofits — such as religiously affiliated universities, charities, hospitals and schools — were not. The Obama administration enacted an opt-out provision for employers with religious objections, requiring them to notify the government or their insurance providers so the insurer could provide free birth control options to individuals employees separate from the employer’s plan.
Some religious organizations, however, including the Little Sisters of the Poor, a Catholic nonprofit that operates about 30 affordable senior housing, senior living and long-term care homes in approximately 20 states, challenged the rules under the Religious Restoration Act of 1993, saying the use of the opt-out form would force them to violate their religious beliefs by “taking actions that directly cause others to provide contraception.”
Health and Human Services Secretary Alex Azar said the ruling “is a major victory for President Trump’s defense of religious liberty and protects Americans of faith who provide vital healthcare and social services to millions of Americans, especially the needy and vulnerable.”
The American College of Physicians, with members who are internal medicine doctors who care for adults, objected to the ruling, saying it “drastically broadens the types of employers who can seek an exemption to requirements to cover contraception. And it will harm access to health care for every woman employed by a company who decides to limit their coverage.”
In a dissenting opinion, Justice Ruth Bader Ginsburg wrote, “Today, for the first time, the Court casts totally aside countervailing rights and interests in its zeal to secure religious rights to the nth degree.”
She called the opinion “destructive” of the Women’s Health Amendment to the ACA. “This Court leaves women workers to fend for themselves, to seek contraceptive coverage from sources other than their employer’s insurer, and, absent another available source of funding, to pay for contraceptive services out of their own pockets.”
