Supreme Court Requests Compromise Options in ACA Contraception Case
Setnor Byer Insurance & Risk
Supreme Court, Group Health Insurance, Health Care Plans
In Zubik v. Burwell, the U.S. Supreme Court is considering whether the rights of religiously affiliated nonprofit organizations are violated by the Affordable Care Act’s contraceptive-coverage mandate. Given the sensitive, often contentious issues raised in this case, the public is anxiously awaiting the Court’s decision. However, many were surprised when less than a week after hearing oral arguments, the Court ordered the parties to provide potential compromise solutions.
The ACA generally requires group health insurance plans to cover preventive care and screenings for women without cost sharing elements (copayment, coinsurance, deductible), including all contraceptive methods approved by the Food and Drug Administration. Though generally mandatory for nonprofit employers with no religious affiliation and for-profit employers that are not closely-held (the Hobby Lobby case), religious and religiously affiliated employers can avoid the contraceptive-coverage mandate, either by exemption or accommodation.
Exemption. Federal regulations authorize an exemption for nonprofit religious employers, including churches and their integrated auxiliaries. These employers are not bound by the contraceptive-coverage mandate. Their employees and dependents do not have guaranteed contraceptive coverage.
Accommodation. Religiously affiliated nonprofit corporations may obtain an accommodation that relieves them from complying with the mandate. These employers must notify their insurance company, third-party administrator or the Department of Health and Human Services of their religious objections to providing insurance coverage for contraceptives.
Under the ACA, religious employers are exempt from the mandate, but religiously affiliated employers must take steps to obtain an accommodation. Nevertheless, these employers are not required to contract, arrange or pay for contraceptive coverage. According to the Secretary of Health and Human Services (Burwell), the regulatory process to obtain an accommodation does not substantially burden religiously affiliated employers seeking to avoid the mandate.
Though some of the employers in Zubik are entitled to an accommodation, they argue that the process itself violates their sincerely held religious beliefs. According to these employers, complying with the regulatory mechanism to obtain an accommodation would make them “complicit in providing contraceptive coverage” in violation of their religion.
The passing of Justice Scalia leaves only eight justices to decide this case. Many believe they are evenly divided. In the event of a 4-4- tie, the lower court rulings would remain intact, which could lead to inconsistent application of the law nationally because the Zubik case is actually a consolidation of several different cases from across the country. Perhaps this explains why the Court issued an order directing the parties to discuss ways to reach an acceptable compromise.
We may never know for sure why the Court did this, but it will be interesting to see if this exercise produces any results. Fortunately, we shouldn’t have to wait long because the Court didn’t give the parties much time. All briefs must be filed by April 20, 2016.
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