Health Advocate: ACA Reproductive Health Litigation: Comments

Executive Summary

The Affordable Care Act’s (ACA) contraceptive coverage requirements have been the subject of a number of lawsuits and more than seventy groups and individuals have filed friend-of-the-court briefs defending the women’s health provisions. The May edition of the Health Advocate breaks down some the of these arguments and provides an update on where the cases stand.

The Affordable Care Act (?ACA?) requires new group health plans and health insurance issuers to cover all forms of Food and Drug Administration (?FDA?)-approved contraceptive drugs and devices without cost-sharing. This requirement is being challenged in more than 50 lawsuits that have been filed in courts across the country. The importance of the rule to women?s health and autonomy has motivated over 70 groups and individuals to file friend-of-the court briefs supporting the requirement. This issue of the Health Advocate delves into some of the points being made by these briefs.
Overview of the Lawsuits
The plaintiffs in these cases vary widely, but generally fall into three categories:
  1. religiously affiliated entities arguing that the requirement should not apply to them;
  2. religious entities arguing that they should not have to cover drugs they believe to be abortion-inducing, which they claim the rule requires; and
  3. for-profit corporations whose owners have religious objections to providing their employees with health insurance that covers contraception. Here, we focus on the last category of plaintiffs, as their challenges make up the majority of cases currently pending in federal appeals courts.
The lawsuits brought by for-profit corporations allege that the contraceptive coverage rule violates the plaintiffs? rights under the Constitution?s free exercise of religion clause and the Religious Freedom and Restoration Act of 1993 (?RFRA?). RFRA provides that the Government shall not ?substantially burden a person?s exercise of religion? unless the burden is ?(1) in furtherance of a compelling governmental interest; and (2) is the least restrictive means of furthering that compelling governmental interest.?

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