In
Real Alternatives, Inc. v. Burwell, (MD PA, Dec. 10, 2015), a Pennsylvania federal district court, in a 76-page opinion, rejected two related challenges to the Affordable Care Act contraceptive coverage mandate. The first challenge was brought by a non-profit, non-religious, pro-life organization that claimed equal protection principles require that it be extended the same exemption from furnishing its employees contraceptive coverage as is given to religious employers. The court held that the government's interest in protecting religious freedom is a rational basis for distinguishing religious from non-religious groups, and that the group here differs significantly from a religious organization:
Here ... we confront only Real Alternatives’ mission statement – a brief, single sentence explaining that Real Alternatives is a business which “exists to provide life-affirming alternatives to abortion services throughout the nation.”... Though based on moral beliefs, this single mission statement is not “equivalent to religion.” ... It does not provide a comprehensive code to guide individuals in their day-to-day life challenges. It does not operate to fill the same position in one’s mind that religion can occupy. More akin to a political position with moral underpinnings than a coherent ideology, Real Alternatives’ single mission statement is simply not comparable to a philosophic belief system such as Janism or Buddhism....
The court also held that various provisions in federal law that protect conscience rights of those that object to abortion are inapplicable here:
Though Plaintiffs may believe that certain FDA-approved contraceptives cause abortions, federal law has never equated emergency contraceptives with abortion.
The second challenge was by the three employees of Real Alternatives (all lawyers) who argued that the government violated RFRA by forcing them to obtain insurance that includes coverage for drugs and devices to which they are religiously opposed. The court rejected this contention, finding that the requirement does not impose a "substantial burden" on their religious exercise because it does not cause them to modify their behavior in violation of their beliefs:
[W]e cannot in good conscience find that a burden which ... requires no independent affirmative act on the Plaintiffs’ part, is substantial enough to run afoul of the RFRA.
The court went on to hold that the mandate furthers the government's compelling interests in gender equality and public health. It added another consideration:
Often, as is the case with Plaintiffs today, entire families are covered by one plan. Health care coverage decisions therefore are not left wholly to the individual but are often made in the context of the family. Yet there is no guarantee that every member of a family covered by a plan feels similarly regarding contraceptive services. If families with religious objections to contraceptive coverage are able to opt out of such coverage, the determination of whether to do so is left to the collective family unit. This collective decision could create untold tension and familial strife should disagreement over contraceptive coverage arise, which is more likely now that children up to the age of twenty-six may be covered by their parents’ plans.
