{ "id": "R45928", "type": "CRS Report", "typeId": "REPORTS", "number": "R45928", "active": true, "source": "EveryCRSReport.com", "versions": [ { "source": "EveryCRSReport.com", "id": 623168, "date": "2020-04-28", "retrieved": "2020-04-28T22:13:27.844642", "title": "The Federal Contraceptive Coverage Requirement: Past and Pending Legal Challenges", "summary": "When Congress enacted the Patient Protection and Affordable Care Act (ACA) in 2010, it required employment-based health plans and health insurance issuers to cover certain preventive health services without cost sharing. Those services, because of agency guidelines and rules, would soon include contraception for women. The \u201ccontraceptive coverage requirement,\u201d or \u201ccontraceptive mandate\u201d as it came to be known, was heavily litigated in the years to follow, and exemptions from the requirement are currently the subject of a pending Supreme Court case.\nThe various legal challenges to the contraceptive coverage requirement primarily concerned (1) what types of employers and institutions should be exempt from the requirement based on their religious or moral objections to contraception; (2) what procedures the government can require for an entity to invoke a religious-based accommodation; and (3) how much authority federal agencies have to create exceptions to the coverage requirement. As originally formulated, only houses of worship and similar entities were exempt from the requirement, but the government later added an accommodation process for certain religious nonprofit organizations. On June 30, 2014, the Supreme Court held in Burwell v. Hobby Lobby Stores, Inc. that the contraceptive coverage requirement violated federal law insofar as it did not also accommodate the religious objections of closely held, for-profit corporations. The law at issue in that case\u2014the Religious Freedom Restoration Act of 1993 (RFRA)\u2014prohibits the federal government from \u201csubstantially burden[ing] a person\u2019s exercise of religion\u201d except under narrow circumstances.\nSince Hobby Lobby, the agencies tasked with implementing the ACA have faced numerous hurdles in their attempts to accommodate the interests of sincere objectors while minimizing disruptions to the provision of cost-free contraceptive coverage to women. The lower courts split on whether the accommodation process\u2014which required eligible objecting entities to notify their insurers or the government that they qualified for an exemption\u2014substantially burdened the objectors\u2019 exercise of religion. Initially, most circuit courts rejected the view that such an accommodation triggered, facilitated, or otherwise made objectors complicit in the provision of coverage, denying their RFRA claims. After consolidating some of these cases for review, the Supreme Court ultimately vacated and remanded the decisions when the government and the objecting parties suggested that a solution might be reached so that the objectors\u2019 insurers could provide the required coverage without notice from the objecting parties.\nFollowing a change in presidential administration, the implementing agencies reevaluated and reversed their position on the legality of the then-existing accommodation process, concluding that it violated RFRA when applied to certain entities. The agencies opted to automatically exempt most nongovernmental entities that objected to providing coverage for some or all forms of contraception on religious or moral grounds. These expanded exemptions sparked a new round of litigation based on claims that the agencies exceeded their authority under the ACA or violated federal requirements for promulgating new rules. Federal courts, including the U.S. Court of Appeals for the Third Circuit, preliminarily enjoined the government from implementing the expanded exemptions. The Supreme Court is slated to hear arguments on the Third Circuit\u2019s decision in May in Little Sisters of the Poor v. Pennsylvania. Meanwhile, the government is largely precluded from relying on the prior accommodation process as a result of a nationwide injunction issued by a federal district court.\nLittle Sisters of the Poor marks the fourth Supreme Court term in six years in which the Court has granted certiorari in a dispute about the federal contraceptive coverage requirement. During that time period, the Executive Departments promulgated six different rules concerning the requirement, a change in presidential administration marked a turning point in the Departments\u2019 RFRA calculus, and the Supreme Court underwent its own changes with the appointment of two new Justices. A Supreme Court decision in Little Sisters of the Poor could inform Congress\u2019s next steps with regard to the contraceptive coverage requirement. From a legal perspective, Congress has several options for clarifying the requirement\u2019s scope, including through amendments to the ACA and RFRA. An opinion in Little Sisters may also provide additional direction to lawmakers and federal agencies asked to accommodate the religious and moral beliefs of regulated entities when enacting or implementing laws of broader applicability.", "type": "CRS Report", "typeId": "REPORTS", "active": true, "formats": [ { "format": "HTML", "encoding": "utf-8", "url": "https://www.crs.gov/Reports/R45928", "sha1": "7150457d9e615d8694257fbc772dc8ca185f8c22", "filename": "files/20200428_R45928_7150457d9e615d8694257fbc772dc8ca185f8c22.html", "images": { "/products/Getimages/?directory=R/html/R45928_files&id=/1.png": "files/20200428_R45928_images_a17bbaed5a118e390dcb15eff1bab5cd312d65af.png", "/products/Getimages/?directory=R/html/R45928_files&id=/0.png": "files/20200428_R45928_images_5e49e7d9e9635a4e9231fb30271da505b89be5ff.png" } }, { "format": "PDF", "encoding": null, "url": "https://www.crs.gov/Reports/pdf/R45928", "sha1": "b140b01765820938a9a48ac2cf734342f1b6a00f", "filename": "files/20200428_R45928_b140b01765820938a9a48ac2cf734342f1b6a00f.pdf", "images": {} } ], "topics": [] }, { "source": "EveryCRSReport.com", "id": 605378, "date": "2019-09-23", "retrieved": "2019-10-10T22:27:40.156486", "title": "The Contraceptive Coverage Requirement and Legal Challenges Five Years After Hobby Lobby", "summary": "When Congress enacted the Patient Protection and Affordable Care Act (ACA) in 2010, it required employment-based health plans and health insurance issuers to cover certain preventive health services without cost sharing. Those services, because of agency guidelines and rules, would soon include contraception for women. The \u201ccontraceptive coverage requirement,\u201d or \u201ccontraceptive mandate\u201d as it came to be known, was heavily litigated in the years to follow. These challenges primarily concerned (1) what types of employers and institutions should be exempt from the requirement based on their religious or moral objections to contraception; (2) what procedures the government can require for an entity to invoke a religious-based accommodation; and (3) how much authority federal agencies have to create exceptions to the coverage requirement. As originally formulated, only houses of worship and similar entities were exempt from the requirement, but the government later added an accommodation process for certain religious nonprofit organizations. \nOn June 30, 2014, the Supreme Court held in Burwell v. Hobby Lobby Stores, Inc. that the contraceptive coverage requirement violated federal law insofar as it did not also accommodate the religious objections of closely held, for-profit corporations. The law at issue in that case\u2014the Religious Freedom Restoration Act of 1993 (RFRA)\u2014prohibits the federal government from \u201csubstantially burden[ing] a person\u2019s exercise of religion\u201d except under narrow circumstances. Since Hobby Lobby, the agencies tasked with implementing the ACA have faced numerous hurdles in their attempts to accommodate the interests of sincere objectors while minimizing disruptions to the provision of cost-free contraceptive coverage to women. The lower courts split on whether the accommodation process\u2014which required eligible objecting entities to notify their insurers or the government that they qualified for an exemption\u2014substantially burdened the objectors\u2019 exercise of religion. Initially, most circuit courts rejected the view that such an accommodation triggered, facilitated, or otherwise made objectors complicit in the provision of coverage, denying their RFRA claims. After consolidating some of these cases for review, the Supreme Court ultimately vacated and remanded the decisions when the government and the objecting parties suggested that a solution might be reached so that the objectors\u2019 insurers could provide the required coverage without notice from the objecting parties. \nHowever, following a change in presidential administration, the implementing agencies reevaluated and reversed their position on the legality of the then-existing accommodation process, concluding that it violated RFRA when applied to certain entities. The agencies opted to automatically exempt most nongovernmental entities that objected to providing coverage for some or all forms of contraception on religious or moral grounds. These expanded exemptions sparked a new round of litigation based on claims that the agencies exceeded their authority under the ACA or violated federal requirements for promulgating new rules. Federal courts have preliminarily enjoined the government from implementing the expanded exemptions. At the same time, the government is largely precluded from relying on the prior accommodation process as a result of a nationwide injunction issued by a federal district court. \nFrom a legal perspective, Congress has several options for clarifying the scope of the contraceptive coverage requirement, including through amendments to the ACA and RFRA. For now, the implementing agencies and the courts will likely continue to grapple with the extent of the mandate and its compliance with RFRA and other legal protections.", "type": "CRS Report", "typeId": "REPORTS", "active": true, "formats": [ { "format": "HTML", "encoding": "utf-8", "url": "https://www.crs.gov/Reports/R45928", "sha1": "074d76c57de1f6f07a2d8b558e781465957d759e", "filename": "files/20190923_R45928_074d76c57de1f6f07a2d8b558e781465957d759e.html", "images": { "/products/Getimages/?directory=R/html/R45928_files&id=/1.png": "files/20190923_R45928_images_a17bbaed5a118e390dcb15eff1bab5cd312d65af.png", "/products/Getimages/?directory=R/html/R45928_files&id=/0.png": "files/20190923_R45928_images_5e49e7d9e9635a4e9231fb30271da505b89be5ff.png" } }, { "format": "PDF", "encoding": null, "url": "https://www.crs.gov/Reports/pdf/R45928", "sha1": "9ccfc1a2fa594883c1603fc5645176ac118ad5ac", "filename": "files/20190923_R45928_9ccfc1a2fa594883c1603fc5645176ac118ad5ac.pdf", "images": {} } ], "topics": [] } ], "topics": [ "Domestic Social Policy" ] }