Courts Block HHS Exemptions from Contraceptive Mandate

Allen Smith, J.D. By Allen Smith, J.D. January 14, 2019
Courts Block HHS Exemptions from Contraceptive Mandate

​A federal district court judge in California on Jan. 13 temporarily blocked 2018 rules providing exemptions to the Affordable Care Act's (ACA's) contraceptive mandate. The decision was followed on Jan. 14 by a federal district court in Pennsylvania temporarily barring the rules nationwide.

The ACA requires that group health insurance cover contraceptives. In one case, 13 states—California, Connecticut, Delaware, Hawaii, Illinois, Maryland, Minnesota, New York, North Carolina, Rhode Island, Vermont, Virginia and Washington, as well as Washington, D.C.—asked for the California district court to bar the U.S. Department of Health and Human Services (HHS) rules until their lawsuit challenging them was resolved, according to NBC News. The California district court's decision applies only to these 13 states and Washington, D.C. But the challenge brought by the Pennsylvania and New Jersey attorney generals in a separate case blocks the rules from taking effect across the country.

We've gathered articles from SHRM Online and other trusted media outlets on the final rules and recent decisions.

Final Rules Extended the Exemption

The HHS issued two final rules Nov. 7, 2018, that exempt certain entities from the ACA's contraceptive mandate if their opposition is based on religious or moral grounds. The Trump administration predicted no more than 127,000 women would lose access to free contraceptives such as birth control pills as a result of the rules. But critics of the rules predict more will be affected.

(CNN and HHS)

California District Court's Reasoning

The California district court judge who temporarily blocked the rules said that the religious exemption has the effect of "depriving female employees, students and other beneficiaries" of their right to "seamlessly provided contraceptive coverage at no cost." But Caitlin Oakley, a spokeswoman for HHS, said, "No American should be forced to violate his or her own conscience in order to abide by the laws and regulations governing our health care system." 


ACA Applies Despite Unconstitutional Ruling

The contraceptive mandate still applies despite a Dec. 14, 2018, district court ruling in Texas that the law  is unconstitutional. The ACA has been kept in place while the ruling is appealed. The HHS stated on Dec. 17, 2018, that it will "continue administering and enforcing all aspects of the ACA as it had before the court issued its decision."

(SHRM Online)

[SHRM members-only toolkit: Complying with and Leveraging the ACA]

Rules Briefly Took Effect Elsewhere

After the contraceptive exemption rules were blocked in 13 states and Washington, D.C., they briefly took effect elsewhere Jan. 14 before the Pennsylvania district court's afternoon decision. The religious exemption rule would let nonprofit and for-profit employers, including public companies, get an exemption based on their religious beliefs. The moral exemption rule would grant an exemption based on moral objections to all except public companies. Government employers cannot get exemptions from the contraceptive mandate.


Litigation Continues

After the Pennsylvania district court's preliminary bar on the rules, Fatima Goss Graves, president and CEO of the National Women's Law Center, said the center would keep fighting the Trump administration rules as the litigation continues. "Until these discriminatory rules are blocked for good, the health and livelihoods of millions across the country are still threatened," she said. Conservative and religious groups in favor of the rules support litigation to bring about the regulations' implementation.


Religious Private Corporations' Rights

The Obama administration defined the religious exemption as limited to places of worship. The Supreme Court decided in 2014 in Burwell v. Hobby Lobby Stores that the Obama administration's HHS could not enforce the contraceptive coverage requirement against corporations whose owners believe that four contraceptives induce abortion and that making them available violated their religious beliefs. As applied to closely held corporations—owned by one family and not publicly traded—the regulations imposing the contraceptive mandate violated the Religious Freedom Restoration Act, the high court decided. After the decision, the Obama administration revised the rules, providing an accommodation  to closely held corporations that let them  avoid providing contraceptive coverage. Instead, group health plans would provide it. Religious nonprofits then challenged this accommodation, which already was available to them, in another case that went to the Supreme Court, Zubik v. Burwell. The nonprofits argued that the accommodation process made them complicit in the use of medications they opposed for religious reasons. The court did not resolve the issue but sent the case back to the lower courts, urging the parties to settle.

(Deseret News and SHRM Online)



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