Pennsylvania and New Jersey challenged the exemptions, arguing that they would place a burden on state agencies, since women would turn to them for help.
(*Updated at 3:43 pm. on 7/8/20, to include comment from the Women’s Law Center)
WASHINGTON — The U.S. Supreme Court on Wednesday upheld a Trump administration effort to exempt employers with religious or moral concerns from complying with a “birth control mandate” in the Affordable Care Act, the Obama-era law that requires employer-provided insurance plans to cover contraceptives.
Reproductive rights advocates say the ruling potentially affects hundreds of thousands of people seeking birth control and vastly expands the universe of potential exemptions to the law.
It was one of a pair of 7-2 decisions the court issued on Wednesday in which liberal justices Elena Kagan and Stephen Breyer joined the court’s conservative majority. In the other, the court threw out a pair of workplace discrimination lawsuits filed by teachers at religious schools.
Justices Ruth Bader Ginsburg and Sonia Sotomayor dissented in both.
The birth control provision in the ACA dates to 2011 when the Obama administration said employers and insurers had to provide birth control at no cost. Houses of worship were exempted but not nonprofits affiliated with religious organizations.
The Trump administration finalized new rules in 2018 that expanded exemptions to employers based on religious or moral beliefs. Pennsylvania and New Jersey challenged the new exemptions, arguing that they would place a burden on state agencies as women would turn to them for help. A federal judge in Philadelphia agreed and issued a nationwide injunction in January 2019 to block the rules from taking effect.
A federal appeals court upheld that decision, prompting the Trump administration and the Roman Catholic organization at the heart of the case — Little Sisters of the Poor Saints Peter and Paul Home in Pittsburgh — to appeal to the Supreme Court.
“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,” Justice Clarence Thomas wrote in the majority opinion.
The federal government, he continued, “has arrived at a solution that exempts the Little Sisters from the source of their complicity-based concerns — the administratively imposed contraceptive mandate. Therefore, we reverse the judgment of the Court of Appeals and remand.”
Chief Justice John Roberts joined the opinion, as did Justices Samuel Alito, Neil Gorsuch and Brett Kavanaugh. Kagan and Breyer agreed that the case should be remanded back to the lower court but did not join the majority opinion.
In her dissent, Ginsburg said the decision “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,” The “free exercise clause in the First Amendment of the U.S. Constitution, she added, “does not call for that imbalanced result.”
Adam Sonfield, associate director of policy analysis at the Guttmacher Institute, a pro-choice think tank, said the ruling severely undermines contraceptive coverage guarantee under the Affordable Care Act. “This would be a harmful outcome under any circumstances, and particularly during a pandemic and a recession,” he said in a statement.
“If we step back, we can see the pattern and the underlying, coercive motivations behind the Trump administration’s actions. This attack on private insurance coverage of contraception is tied to the administration’s destructive overhaul of the Title X national family planning program, its relentless attempts to gut the Affordable Care Act, its harmful ‘refusal of care’ rules, and its ongoing efforts to ‘defund’ Planned Parenthood and undermine Medicaid coverage of family planning care.”