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11th Circuit rejects challenge to contraceptive coverage rules; lawmakers file brief with Supreme Court supporting rules

A three-judge panel of the 11th U.S. Circuit Court of Appeals on Thursday ruled 2-1 to uphold the federal contraceptive coverage rules in two separate legal challenges, the AP/Sacramento Bee reports.

According to the AP/Bee, the appeals court has delayed the implementation of its decision pending the outcome of a Supreme Court ruling on the matter (Brumback, AP/Sacramento Bee, 2/18).

Background

The rules, implemented under the Affordable Care Act (PL 111-148), require most employers to offer contraceptive coverage to their workers. Houses of worship are exempt from the requirement, and not-for-profits that hold themselves out as religious, as well as certain closely held corporations, are eligible for an accommodation that ensures they do not have to pay for or directly provide the coverage for their employees. Instead, employees will be able to receive coverage directly from their insurers. To claim the accommodation, the not-for-profits may either complete a form to send to the insurers or third-party administrators or send a letter to HHS stating that they object to offering contraceptive coverage in their health plans.

Not-for-profits that hold themselves out as religious and oppose contraception have challenged the rules in federal courts throughout the country. Most appeals courts have dismissed the challenges, finding that the federal rules do not impose a "substantial burden" on the religious beliefs of the not-for-profits. However, the 8th U.S. Circuit Court of Appeals in September 2015 upheld a ruling against the contraceptive coverage rules, countering all other rulings issued by circuit courts on the subject.

In November 2015, the Supreme Court announced it would hear a challenge to the rules. In agreeing to review the matter, the high court consolidated seven challenges to the rules into a single case, referred to as Zubik v. Burwell. The seven cases granted an appeal include: Geneva College v. Burwell, Little Sisters of the Poor v. Burwell, Priests for Life v. Department of HHS, Roman Catholic Archbishop v. Burwell, Southern Nazarene University v. Burwell, East Texas Baptist University v. Burwell and Zubik (Women's Health Policy Report, 2/16).

11th Circuit challenges

The two cases before the 11th Circuit were filed by Catholic-affiliated not-for-profits in Georgia and by Eternal Word Television Network (EWTN), an Alabama-based Catholic broadcaster (AP/Sacramento Bee, 2/18). EWTN asked the 11th Circuit to consider their appeal after U.S. District Judge Callie Granade denied the organization's request for an exemption from the rules (Women's Health Policy Report, 6/19/14).

According to the AP/Bee, the Georgia-based not-for-profits and EWTN claimed that the contraceptive coverage rules and accommodation violated their rights under the federal Religious Freedom Restoration Act (RFRA) of 1993 (PL 103-141) (AP/Sacramento Bee, 2/18). RFRA requires the government to provide a "compelling reason" for measures that "substantially burden" religious beliefs. Under RFRA, the government must also demonstrate that the measure in question is the least burdensome method of reaching the underlying goal (Women's Health Policy Report, 11/9/15).

Ruling details

The 11th Circuit issued a single opinion in response to two legal challenges, rejecting the groups' claims that the rules violated RFRA.

In the majority opinion, 11th Circuit Court Judge Jill Pryor wrote, "Congress included the contraceptive mandate in the ACA to improve women's health and public health generally. There is no evidence whatsoever that the mandate was enacted in an attempt to restrict religious exercise" (AP/Sacramento Bee, 2/18).

Lawmakers file brief supporting contraceptive coverage rules

In related news, a group of liberal congressional lawmakers on Wednesday filed an amicus brief urging the Supreme Court to uphold the rules, CQ News reports.

According to CQ News, House Minority Leader Nancy Pelosi (D-Calif.), Rep. Diana DeGette (D-Colo.), Rep. Jerrold Nadler (D-N.Y.) and Rep. Louise Slaughter (D-N.Y.) submitted the brief on behalf of 33 senators and 90 members of the House.

The brief contends that a ruling against the rules could endanger the law's intent to promote women's equality in the workplace. It states that any means of accommodating petitioners' religious beliefs should not compromise the balance between the right to freedom of religion and Congress' aim in passing the law to bar discrimination against women and protect public health.

The brief stated, "In light of the expanded number of organizations, including certain for-profit employers, that may object to providing cost-free contraception following the Hobby Lobby decision, it is essential than an effective mechanism remain in place to ensure women receive the benefit conferred on them by the (health care law) when their employers choose not to provide that coverage" (Ruger, CQ News, 2/17 [subscription required]).

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