Issues — Contraceptive Coverage
Legal Action
More than 100 lawsuits have been filed challenging the Affordable Care Act's (ACA) contraceptive coverage requirement, brought primarily by for-profit corporations or nonprofit organizations that object to covering some or all contraceptives in their employer-sponsored health insurance plans — largely alleging that the requirement infringes upon religious liberty.
NFPRHA's Role: NFPRHA educates its membership and the public about key developments in the contraceptive coverage cases and how they might affect the family planning network and the safety net. NFPRHA works with national partner organizations as cases are considered by the Supreme Court to ensure that the voices of safety-net providers and their patients are heard.
For-Profit Cases
In 2014, one line of challenges — brought by closely held for-profit corporations — reached the US Supreme Court. On June 30, 2014, the Court ruled in Burwell v. Hobby Lobby Stores, Inc. that under the Religious Freedom Restoration Act (RFRA), closely held corporations do not have to comply with the contraceptive coverage requirement. The Court held that the requirement is not the least restrictive means of furthering a compelling governmental interest, in large part because the government has an existing approach — the accommodation for religiously affiliated nonprofit organizations — that could be used for closely held for-profit corporations. That accommodation allows certain nonprofits to opt out of directly arranging or paying for contraceptive coverage, with the insurance plan or third-party administrator (TPA) instead offering coverage directly to enrollees without cost-sharing.
Nonprofit Cases
In March 2016, the Supreme Court heard oral arguments in Zubik v. Burwell, a consolidation of seven cases brought primarily by religiously affiliated nonprofit organizations eligible for the accommodation. These organizations argued that the accommodation itself imposes a substantial burden on their religious freedom in violation of RFRA — contending that opting out triggers the insurer or third-party payer to provide contraceptive coverage, thereby forcing them to facilitate coverage against their beliefs. In May 2016, the Supreme Court sent the cases back to the appellate courts without ruling on the merits, leaving the issue unresolved nationally and open to continued litigation.