Contraception Coverage Under ACA Not Religious Burden, Court Rules

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Contraception Coverage Under ACAA federal appeals court yesterday ruled that the Affordable Care Act’s (ACA) accommodations for contraceptive coverage did not impose a substantial burden on the religion of an order of Roman Catholic nuns.

The United States Court of Appeals for the Tenth Circuit, located in Denver, heard the appeal brought forth by the Little Sisters of the Poor, that the ACA’s contraceptive accommodation—the ability to opt-out by reporting their objections to the health insurance company or secretary of health and human services—imposed a substantial burden in violation of the Religious Freedom Restoration Act. The Sisters argued that, since using the opt-out process resulted in the government attempting to arrange an alternate means of contraceptive coverage, it would make the nuns “complicit.”

Judge Scott Matheson, who presided over the case, found almost the exact opposite. He found that the “[p]laintiffs do not ‘trigger’ or otherwise cause contraceptive coverage because federal law, not the act of opting out, entitles plan participants and beneficiaries to coverage.” Contrary to the plantiffs’ assertions, he found that under this model, the act of opting out relieves the religious organization of complicity, rather than coerces it.

The opt-out process itself was also deemed not to be onerous or otherwise burdensome. Judge Matheson likened it to routine administrative activities like “obtaining a parade permit, filing a simple tax form, or registering to vote.”

This ruling is consistent with the findings of four other federal appeals courts in D.C., Philadelphia, Chicago, and New Orleans, which have delivered similar decisions when the contraceptive accommodation has been challenged.

Judge Matheson was joined in his ruling by Judge Monroe McKay, and only partially joined by Judge Bobby Baldock. Judge Baldock’s partial dissent focused on religious organizations who served as their own insurers and that the accommodation could be considered a substantial burden in those cases.

Sources for Today’s Article:
Little Sisters of the Poor Home for the Aged v. Sylvia Mathews Burwell, 2015, United States Court of Appeals for the Tenth Circuit, No. 13-1540.
Pear, R., “Health Law’s Contraceptive Coverage Isn’t Burden on Religion, Court Rules,” The New York Times web site, July 14, 2015;


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Adrian has been working in the information publishing world since 1997. But when it comes to health information, he’s a self-admitted late bloomer. A couch potato since pre-school, Adrian was raised on TV, video games and a lifestyle that led to childhood obesity that followed him well into adulthood. But when he hit his forties, he decided enough was enough. He had a family to take care of and his days of overeating, under-exercising and inactivity were going to lead... Read Full Bio »