Appeals court rejects religious challenge to Obamacare

A federal appeals court on Friday upheld an accommodation offered by the Obama administration to religious nonprofit groups that object to the required provision of contraceptives as part of the president’s health care reform law.

The three-judge panel of the US Court of Appeals for the District of Columbia Circuit ruled unanimously that the accommodation did not impose a substantial burden on the religious groups’ exercise of their faith under the Religious Freedom Restoration Act.

The case is being closely watched because it is the first of many such challenges to the so-called contraception mandate of the Affordable Care Act to be decided by an appeals court following last June’s US Supreme Court decision in the Hobby Lobby case.

The high court voted 5 to 4 in that case to require the government to offer a religious accommodation when the owner of a closely held, for-profit corporation objects for religious reasons to including contraceptives in a company-provided health care plan.

The next big issue in this area for the courts is whether the religious accommodation offered by the administration is acceptable or doesn’t go far enough.

On Friday, the appeals court in Washington effectively endorsed the administration’s approach.

The judges also ruled that the accommodation did not violate the groups’ right to freely exercise their religious beliefs under the First Amendment, and did not require them to engage in government-compelled speech.

“All plaintiffs must do to opt out is express what they believe and seek what they want via a letter or two-page form,” Judge Nina Pillard wrote for the court.

“Religious non-profits are excused from playing any role in the provision of contraceptive services, and they remain free to condemn contraception in the clearest terms,” Judge Pillard said. “The ACA shifts to health insurers and administrators the obligation to pay for and provide contraceptive coverage for insured persons who would otherwise lose it as a result of the religious accommodation.”

The lawsuit was filed by the Roman Catholic Archbishop of Washington and the nonprofit groups Priests for Life and the Association of Gospel Rescue Missions.

Under the ACA, churches and other religious institutions are exempt from compliance. But religious nonprofit groups are not. Some of these groups oppose the inclusion of contraceptives as part of the required coverage within the ACA.

The groups consider contraception a “grave sin.” They argue that the ACA requires them to provide services to their employees and students that make them complicit in acts that they consider immoral.  

In response to their concerns, the administration fashioned an accommodation, allowing nonprofit religious groups to opt out of the contraceptive mandate.

To opt out, the group must notify the insurance administrator or the Department of Health and Human Services that it objects to the coverage requirement. That act extinguishes any obligation by the religious group to offer and/or pay for what it deems religiously offensive health-care coverage.

In their lawsuit, the groups charged that the accommodation did not go far enough. The groups argued that any notification from them would serve to trigger contraceptive coverage and thereby still make them complicit in the provision of health-care services that they consider immoral. 

In rejecting that argument, the appeals court said the accommodation was the least restrictive means available to fulfill the government’s compelling interest in providing women the ability to plan for healthy births and avoid unwanted pregnancies.

“A confluence of compelling interests supports maintaining seamless application of contraceptive coverage to insured individuals even as plaintiffs are excused from providing it,” Pillard said.

“The accommodation requires as little as it can from the objectors while still serving the government’s compelling interests,” she said.

Two of the judges, Pillard and Robert Wilkins were appointed by President Obama. The third judge, Judith Rogers, was appointed by President Clinton. 

The case is Priests for Life v. US Department of Health and Human Services (13-5368).