Another ACA Contraceptive Coverage Challenge Filed By Catholic Diocese

Suits challenging the Affordable Care Act contraceptive coverage mandate continue to be filed by religious non-profits.  The Catholic  Diocese of Greensburg, Pennsylvania announced that on Tuesday it filed suit in a Pennsylvania federal district court challenging the requirement that its Catholic Charities and Catholic elementary schools sign a self-certification form that triggers contraceptive coverage being provided by their health plan's third-party administrator. Pittsburgh Tribune reports on the case.

Court Issues Preliminary Injunction Against ACA Contraceptive Mandate Enforcement Against Two Religious Colleges

In Dordt College v. Sebelius, (ND IA, May 21, 2014), an Iowa federal district court granted a preliminary injunction to two religiously-oriented colleges-- Dordt College (Christian Reformed Church) and Cornerstone University (Baptist)-- to prevent enforcement of the Affordable Care Act contraceptive coverage mandate rules against them. This is another of the many cases in which religious non-profits-- objecting to covering contraceptives that they believe to be abortifacients-- claim that their free exercise rights under RFRA are violated even under the government's compromise in which coverage is provided directly from their insurers or third-party administrators. (See prior related posting.) The court indicated that it was planning to wait for the U.S. Supreme Court's Hobby Lobby decision to issue an opinion, but the mandate takes effect against Dordt College on June 1 and the 8th Circuit (which includes Iowa) has issued injunctions pending appeal in two challenges to the contraceptive coverage mandate by for-profit businesses. ADF issued a press release announcing the decision. Des Moines Register reports on the decision.

Court Says ACA Contraceptive Coverage Rules For Religious Non-Profits Do Not Violate RFRA

In Diocese of Cheyenne v. Sebelius, (D WY, My 13, 2014), a Wyoming federal district court denied a preliminary injunction in a challenge to the Affordable Care Act contraceptive coverage mandate rules for religious non-profits. Wyoming Catholic schools and charitable groups object to the opt out self-certification form that results in the third-party administrator of their self-insurance plans furnishing contraceptive coverage directly to the non-profits' employees.  The court concluded that this does not impose a substantial burden on plaintiffs' religious exercise:

It is not Plaintiffs' self-certification that authorizes or obligates the TPA to ensure the objectionable contraceptive coverage; it is the ACA that does so.... Consequently, Plaintiffs' argument that completing the self-certification form requires them to enable access to objectionable contraceptive products and services is inaccurate and unconvincing....

While Plaintiffs hold very strong religious views that the TPA should not provide (or be forced by federal law to provide) contraceptive coverage, the TPA's provision of such coverage cannot be said to be a substantial burden on Plaintiffs'religious exercise....

Through the ACA's accommodation, Plaintiffs have the right to be exempted from participating in, providing, or paying for the costs associated with the objectionable contraceptive coverage based on their sincere religious beliefs, but they have no right to prevent a third party (who does not hold those same religious objections) from meeting the ACA's requirements.

AP reports on the decision. (See prior related posting.)

D.C. Circuit Hears Oral Arguments On Non-Profit Contraceptive Coverage Mandate Rules

Yesterday the U.S. Court of Appeals for the D.C. Circuit heard oral arguments in Priests for Life v. Department of Health and Human Services and in Roman Catholic Archbishop of Washington v. Sebelius. (Audio of oral arguments [mp3 file]).  Both cases were brought by religious non-profits challenging the Obama administration's compromise rules that allow religious non-profits to opt out of the Affordable Care Act contraceptive coverage mandate and have their employees receive coverage directly from the non-profit's insurer or third-party administrator.  In Priests for Life, the district court found no substantial burden was imposed by requiring the group to complete the self-certification opt out form. (See prior posting.) In the Archbishop of Washington case, the district court upheld the challenge to the compromise as to one of the plaintiffs that offered a self-insured plan, but not for the others who offered group insurance or church plans. (See prior posting). Los Angeles Times reports on the oral arguments.

Court Issues Preliminary Injunction and Halts Other Rulings in Non-Profit's ACA Challenge Until Supreme Court Decides Hobby Lobby

In Fellowship of Catholic Students v. Sebelius, (D CO, April 23, 2014), a Colorado federal district court issued a preliminary injunction barring enforcement of the Affordable Care Act contraceptive coverage mandate against a non-profit Catholic student organization. The court entered the order after the government failed to respond to the plaintiff's motion for a preliminary injunction. The court also stayed discovery and any ruling on plaintiff's summary judgment motion until after the U.S. Supreme Court issues its decision in the Hobby Lobby case. (Full text of orders.) CNS reports on the decision. (See prior related posting.)

Dobson's Family Talk Wins Preliminary Injunction Against ACA Contraceptive Coverage Rules

In Dobson v. Sebelius, (D CO, April 17, 2014), a Colorado federal district court issued a preliminary injunction preventing the government from enforcing the Affordable Care Act contraceptive coverage mandate against James Dobson's religious non-profit Family Talk.  The court concluded that the ACA regulations which allow religious non-profits to opt out, and call for contraceptive coverage to then be furnished directly by insurers or third party administrators, do not eliminate the free exercise burden:

Here, any myopic focus on the brevity of the Exemption Form and its ease of completion misses the mark. It is the de facto forced facilitation of the objectionable coverage that is religiously repugnant to the plaintiffs. The resultant moral abhorrence is not effectively extenuated by a transfer of responsibility via an Exemption Form from the plaintiffs to the TPA. For the plaintiffs, such legal legerdemain does not expiate the morally unacceptable means or end. The transformation of moral culpability from plaintiffs as principals to aiders and abettors does not absolve the plaintiffs from their immutable moral responsibility. Such a compelled concession – even by an ostensibly innocuous legal prophylactic – does not ameliorate the moral ignominy and obliquity created by the pressured participation in the process.

Further, it is of no moment that ultimately the decision by an employee to elect the objectionable coverage is optional. To the plaintiffs, it is the offer per se that is morally offensive regardless of the extent of its acceptance.

Thus, I conclude ultimately that there is a substantial likelihood that the plaintiffs can show that the pressure to execute the Exemption Form imposed on them by the ACA and the concomitant regulations constitutes impermissible pressure to act in violation of their religious beliefs.

Christian Post reports on the decision. (See prior related posting.)

Union University Files Challenge To ACA Contraceptive Coverage Rules

According to ABP News, Southern-Baptist affiliated Union University filed a lawsuit in federal district court in Tennessee last week challenging the application to it of the Affordable Care Act contraceptive coverage mandate and the opt out rule for religious non-profits. The lawsuit says that the University objects to coverage for Plan B, ella and IUD's that may prevent implantation of a fertilized egg. The suit was filed at this time because changes in the University's prior health plan ends its grandfathered status on May 1.

SCOTUS Denies Cert. In 2 Non-Profit Contraceptive Mandate Cases Seeking Review Ahead of Circuit Court Decisions

The U.S. Supreme Court today denied certiorari (Order List) in two cases in which Catholic non-profit organizations are challenging the Affordable Care Act compromise that allows them to opt out of providing their employees contraceptive coverage only if they sign a form that results in the employees receiving coverage directly from the health insurance company or third party administrator.  The two cases in which review was denied today were both ones in which the non-profit organization took the unusual step of seeking Supreme Court review before the appeal of the district court's decision was heard and decided by the Court of Appeals. The first of today's denials was in Roman Catholic Archbishop of Washington v. Sebelius, (Docket No. 13-829, cert. denied 3/31/2014) in which the D.C. federal district court upheld the challenge to the compromise as to one of the plaintiffs that offered a self-insured plan, but not for the others who offered group insurance or church plans. (See prior posting). The second denial was in Priests for Life v. Department of Health and Human Services, (Docket No. 13-891, cert. denied 3/31/2014) in which the D.C. federal district found that no substantial burden was placed on a pro-life group's free exercise by requiring it to complete the self-certification form to opt into the accommodation. (See prior posting.) Reuters reports on the denial of review.

Religious Non-Profits Win Injunction Against Contraceptive Coverage Mandate Opt-Out Rules

In a 91-page opinion in Roman Catholic Archdiocese of Atlanta v. Sebelius, (ND GA, March 26, 2014), a Georgia federal district court permanently enjoined the government from requiring Catholic Education of North Georgia and Atlanta Catholic Charities to execute and deliver a self-certification form to the third-party administrator of their health care plans.  Final Rules under the Affordable Care Act require the self-certification for objecting religious non-profits to opt out of the requirement to provide coverage for contraceptive services.

The court concluded that the Final Rules impose a substantial burden on plaintiffs' free exercise rights under RFRA:

... [T]he plain terms of the Final Rules show that the purpose and effect of the self-certification form is to enable the provision of contraceptive coverage. The self-certification form is an integral part of the Government’s contraceptive coverage scheme..... [I]t is a Government imposed device that pressures the Plaintiffs into facilitating the contraceptive coverage to which they have sincerely held religious objections.....

The Court’s conclusion does not change even if the Government had argued, as it did in other cases, that it has no ERISA authority to require a church plan to contract with a TPA to provide contraceptive coverage.... It is the fact of the requirement that is important, not whether the Government will or will not choose to enforce it....

The court also concluded that the government had not shown a compelling interest for imposing the substantial burden:

The Government claims that exempting CENGI and Catholic Charities from the contraceptive mandate would hinder its ability to effectively and uniformly administer the requirements of the ACA. That claim is discredited by the Government’s advocacy in other church plan cases in which it has argued that plaintiffs lack standing because self-certification will not necessarily result in the delivery of contraceptive products and services..... 

The Government’s interests in promoting public health and providing women with equal access to health care also cannot be compelling because the contraceptive mandate does not apply to the insurance plans of millions of women in this country.... Grandfathered health plans, small businesses and religious employers are all exempt from the contraceptive mandate....

Finally the court concluded that the provision barring non-profits from seeking to influence the third party administrator's decision to provide contraceptive services is a presumptively invalid, content-based restriction on speech. Daily Report covers the decision.

Transcript and Summaries of Hobby Lobby Arguments In Supreme Court Today

The full transcript of the oral arguments earlier today in Sebelius v. Hobby Lobby Stores and Conestoga Wood Specialties v. Sebelius is now available from the Supreme Court's website.  Extensive reports on the oral arguments are available from Lyle Denniston (SCOTUS Blog) and the Washington Post,

UPDATE: Here is the audio of the oral arguments.

Background Sources For Tomorrow's Supreme Court Arguments in Hobby Lobby/ Conestoga

Tomorrow the U.S. Supreme Court hears oral arguments in the Hobby Lobby Stores and Conestoga Wood Specialties, Inc. cases-- two high profile religious freedom challenges by for-profit businesses to the Affordable Care Act contraceptive coverage mandate.  For those who want an introduction, a refresher, or further resources on the numerous and difficult legal and political issues involved in the cases, here are some sources:

• All briefs (parties and amici) in Hobby Lobby.
• All briefs (parties and amici) in Conestoga Wood Specialties.
• Lyle Denniston, Argument preview: Religion, rights, and the workplace (Scotus blog).
• Scotus blog's Contraceptive Mandate Symposium.
• Becket Fund's Resource Page on Hobby Lobby.
• Marty Lederman's Compendium of posts on Hobby Lobby and related cases from Balkinization blog.

New Lawsuit Challenging Contraceptive Mandate Filed By Multi-employer Catholic Organization and Others

Catholic News Service and a press release from Catholic Benefits Association report on the latest lawsuit that has been filed to challenge the Affordable Care Act contraceptive coverage mandate. Plaintiffs in the lawsuit filed yesterday in federal court in the Western District of Oklahoma are Catholic Benefits Association and its captive insurance company, the Archdiocese of Oklahoma City and its Catholic Charities, All Saints Catholic School in Oklahoma, Archbishop William E. Lori and the Archdiocese of Baltimore, Cathedral Foundation in Baltimore, Villa St. Francis Catholic Care Center in Kansas City, KS, and Good Will Publishers in North Carolina.

Catholic Benefits Association is a recently-formed organization comprised of nearly 200 Catholic employers and 1000 parishes from around the United States.  The organization makes self-insurance plans with back-up stop loss insurance (with coverage consistent with Catholic values) available to members, and "provides a cost-effective strategy for Catholic employers seeking protection from the HHS contraception, abortion-inducing drugs or devices, sterilization, or related counseling ... Mandate and other similar state or federal mandates." (CBA FAQs).

With the U.S. Supreme Court about to hear arguments in the Hobby Lobby case on whether corporations can assert free exercise rights, it is interesting to note Catholic Benefits Association's criteria for becoming an employer member:

For-profit employers can become CBA members if (i) Catholics (or trusts or other entities wholly controlled by Catholic) own 51 percent or more of employer; (ii) 51 percent or more of the members of the employer’s governing body, if any, is comprised of Catholics; and (iii) either the employer’s owners or governing body has adopted a written policy stating that the employer is committed to providing no benefits to the employer’s employees or independent contractors inconsistent with Catholic values.

UPDATE: The complaint (full text) in Catholic Benefits Association v. Sebelius,(WD OK, filed 3/12/2014) is now available.

7th Circuit Affirms Denial of Preliminary Injunction to Notre Dame In Contraceptive Coverage Challenge

In University of Notre Dame v. Sebelius, (7th Cir., Feb. 21, 2014), the U.S. 7th Circuit Court of Appeals on Friday, in a 2-1 decision, denied a preliminary injunction to Notre Dame University in its challenge to the Affordable Care Act contraceptive coverage mandate as applied to religious non-profits. Handing down its decision only 9 days after hearing oral arguments, the majority in an opinion by Judge Posner affirmed the district court, saying in part:

We imagine that what the university wants is an order forbidding Aetna and Meritain to provide any contraceptive coverage to Notre Dame staff or students pending final judgment in the district court.  But we can’t issue such an order; neither Aetna nor Meritain is a defendant (the university’s failure to join them as defendants puzzles us)..... Furthermore, while a religious institution has a broad immunity from being required to engage in acts that violate the tenets of its faith, it has no right to prevent other institutions, whether the government or a health insurance  company, from  engaging in acts that merely offend the institution..

If the government is entitled to require that female contraceptives be provided to women free of charge, we have trouble understanding how  signing the form that declares Notre Dame’s authorized refusal to pay for  contraceptives for its students or staff, and mailing the authorization document to those companies, which under federal law are obligated to pick up the tab, could be thought to “trigger” the provision of female contraceptives....

The novelty of Notre Dame’s claim—not for the exemption, which it has, but for the right to have it without having to ask for it—deserves emphasis. United States law and public policy have a history of accommodating religious beliefs....  What makes this case and others like it involving the contraception exemption paradoxical and virtually unprecedented is that the beneficiaries of the religious exemption are claiming that the exemption process itself imposes a substantial burden on their religious faiths. The closest  analogues we have found  are  cases in which  churches seeking rezoning or variances claim that the process for obtaining permission is so cumbersome as to constitute a substantial burden on religious practice....  

The process of claiming one’s exemption from the duty to provide contraceptive  coverage is the opposite of cumbersome. It  amounts  to signing  one’s  name  and  mailing  the signed form to two addresses. Notre Dame may consider the process a  substantial burden, but substantiality—like  compelling  governmental  interest—is  for  the court  to  decide.

The majority also rejected Notre Dame's establishment clause challenge, and left its free speech challenge for further development in the district court.

Judge Flaum dissenting said in part:

Having to submit the EBSA Form 700, Notre Dame maintains, makes it “complicit in a grave moral wrong” by involving it with a system that delivers contraceptive products and services to its employees and students.

The majority has trouble accepting this position, in part due  to  the  university’s  statement  that  its  signature  will “trigger”  contraceptive  coverage, because the majority understands federal law to require contraceptive coverage regardless of what Notre Dame signs or does not sign.... Yet we are judges, not moral philosophers or theologians; this is not a question of legal causation but of religious faith. Notre Dame tells us that Catholic doctrine prohibits the action that the government requires it to take. So long as that belief is sincerely held, I believe we should defer to Notre Dame’s understanding.

Wall Street Journal reports on the decision.

7th Circuit Hears Oral Arguments In Notre Dame's Contraceptive Mandate Accommodation Challenge

The U.S. 7th Circuit Court of Appeals heard oral arguments (audio of full arguments) yesterday in University of Notre Dame v. Sebelius.  In the case, an Indiana federal district court rejected Notre Dame's claim that its rights under RFRA and the 1st Amendment are infringed by applying the Affordable Care Act contraceptive coverage mandate accommodation to its self-insured employee plan and its health insurance policies offered to students.  (See prior posting.) The exchanges in yesterday's arguments between Notre Dame's counsel Matthew Kairis and Judge Richard Posner were particularly contentious. (Note-- there is no sound for the first 2:30 minutes of the audio.) Chicago Tribune reports on the oral arguments.  [Thanks to Stephen Blakeman for the lead.]

Wyoming Diocese Sues To Challenge Contraceptive Mandate Accommodation

The Catholic Diocese of Cheyenne, Wyoming announced yesterday that along with Catholic Charities, a children's home and two Catholic schools, it has filed a federal lawsuit challenging the Affordable Care Act contraceptive coverage mandate accommodation. In his announcement, Bishop Paul Etienne said in part:

The message of the mandate is clear; keep your religious beliefs private or face financial penalties.  This is one of the strongest reasons the decision was made by the diocese and the plaintiffs to resist this mandate, even knowing that other similar lawsuits are now making their way through the court system.

AP reports on the lawsuit.

UPDATE: Here is the full text of the complaint in Diocese of Cheyenne v. Sebelius, (D WY, filed 1/30/2014).

80+ Amicus Briefs Filed In Hobby Lobby Case

More than 80 amicus briefs have been filed in the U.S. Supreme Court in Sebelius v. Hobby Lobby and Conestoga Wood Specialties v. Sebelius, the cases challenging the Affordable Care Act contraceptive coverage mandate. Becket Fund has links to the full text of all the amicus briefs.

Cert. Petition Seeks Contraceptive Mandate Accommodation Review By Supreme Court Before Circuit Court Decides Appeal

Last week, the Catholic non-profit pro-life organization Priests for Life filed a petition for certiorari (full text) with the U.S. Supreme Court in Priests for Life v. U.S. Department of Health and Human Services, (filed 1/23/2014).  The petition asks for high court review even though the Court of Appeals for the D.C. Circuit has not yet ruled in a pending appeal.  In the case, a federal district court held that no substantial burden was placed on the group's free exercise by requiring it to complete the self-certification form to opt into the Affordable Care Act contraceptive coverage accommodation for religious non-profits. (See prior posting.) AFLC issued a press release announcing the filing of the petition.

Supreme Court Enjoins Enforcement of Contraceptive Mandate Against Religious Non-Profit Contingent On Alternative Filing During Appeal

On New Year's Eve, U.S. Supreme Court Justice Sonia Sotomayor issued a temporary injunction to prevent immediate enforcement of the Affordable Care Act contraceptive coverage mandate compromise against the Little Sisters of the Poor. (See prior posting.) Now that the Supreme Court has received the government's response in the case, today the full Supreme Court issued the following unusual order , creating its own sort of compromise as the case proceeds on appeal:

The application for an injunction having been submitted to Justice Sotomayor and by her referred to the Court, the Court orders: If the employer applicants inform the Secretary of Health and Human Services in writing that they are non-profit organizations that hold themselves out as religious and have religious objections to providing coverage for contraceptive services, the respondents are enjoined from enforcing against the applicants the challenged provisions of the Patient Protection and Affordable Care Act and related regulations pending final disposition of the appeal by the United States Court of Appeals for the Tenth Circuit. To meet the condition for injunction pending appeal, applicants need not use the form prescribed by the Government and need not send copies to third-party administrators. The Court issues this order based on all of the circumstances of the case, and this order should not be construed as an expression of the Court’s views on the merits. 

7th Circuit Allows Notre Dame Students To Intervene In Appeal of Contraceptive Mandate Rule Challenge

The Chicago Tribune reported this week that the U.S. 7th Circuit Court of Appeals has granted a motion filed earlier this month by three female Notre Dame University students seeking to intervene anonymously in the appeal by Notre Dame of the ruling requiring it to comply with the Affordable Care Act contraceptive coverage mandate final rules relating to religious non-profits. (Memorandum supporting motion to intervene.) The 3 students say that their access to contraceptives turns on the outcome of the case.

Commentary: Little Sisters of the Poor Case Generating Heated Political Debate

The New Year's Eve temporary injunction issued by Justice Sonia Sotomayor to prevent immediate enforcement of the ACA contraceptive coverage mandate compromise against the Little Sisters of the Poor has quickly generated extensive debate.  At one level, the case itself turns on the kind of legal technicalities that usually cause the non-lawyer's eyes to glaze over--the exact wording of the fine print on a government form; the difference between self-insured health plans administered by third party administrators and group health insurance plans offered to employees through insurance companies; and the exemption under ERISA for group health plans that qualify as "church plans."  Yet despite this, the case is becoming the symbol for a much broader, and to some extent uglier, political debate.  Here are two essays from the blogosphere that illustrate the political dimensions that this free exercise issue has taken on:

From American Thinker yesterday, Lloyd Marcus posts an essay titled Will King Obama Throw Nuns into the Lion's Den?, saying in part:

We are witnessing a modern-day version of King Darius ordering that Daniel be thrown into the lion's den for refusing to deny his faith. Displaying deceit characteristic of our Liar-in-Chief, Obama's DOJ have offered the Little Sisters a serpent disguised as an olive branch.

From All Voices yesterday, John Thomas Didymus writes in a post titled Does filling out a contraception mandate exemption form violate Catholic religious rights?:

When properly understood, the Little Sisters’ argument is cynical hairsplitting with the intention of picking a fight with and prolonging confrontation with a government they have identified as an ideological foe.... The confrontational attitude of the Little Sisters illustrates the dog-in-the-manger attitude common to religious ideologues through which they exercise socially disruptive influence. The religious dog-in-the-manger attitude can be summarized as: "If our religion says we can't have it, and then no one should have it".... An extreme form of this pattern of socially disruptive religious chauvinism is expressed by Nigeria's Boko Haram.

Of course, much of the debate is calmer than these examples, but in the highly charged atmosphere surrounding all aspects of the Affordable Care Act, louder voices tend to drown out other more nuanced analyses.