Supreme Court Upholds Exemption to ACA’s Contraception Coverage Requirement

In June, the U.S. Supreme Court voted 5-4 to allow a key exemption to the Affordable Care Act’s contraception coverage requirements, meaning closely held, for-profit businesses can assert a religious objection. Under the ACA, health insurance plans (except those that are grandfathered) are required to cover all U.S. Food and Drug Administration (FDA)-approved contraception methods (birth control pills, intrauterine devices and sterilization procedures) for women without any cost-sharing such as deductibles or co-payments. Employers with 50 or more workers that offer coverage that doesn’t meet that standard would face fines of $100 a day per worker, and if they don’t offer any coverage, they face a fine of $2,000 per employee per year.

The Supreme Court’s ruling was in response to a lawsuit filed by Hobby Lobby Stores and Conestoga, both family-owned businesses, which argued that several types of contraceptives violate their owners’ religious beliefs. According to them, they should be exempted from the requirement because of the 1993 Religious Freedom Restoration Act that says the government may not pose a “substantial burden” on the free exercise of religion unless that burden is the narrowest possible way to further a compelling government interest. The federal government and other advocates argued that only individuals — not corporations — can exercise religious rights.

While some analysts believe the ruling could open the door for employers to use religious objections to opt out of other areas of healthcare coverage, Justice Samuel Alito’s decision went to lengths to limit the scope of the decision by writing: “This decision concerns only the contraceptive mandate and should not be understood to hold that all insurance-coverage mandates, e.g., for vaccinations or blood transfusions, must necessarily fall if they conflict with an employer’s religious beliefs.”