Supreme Court Allows Employers To Continue to Opt Out Of ACA’s Mandate On Birth Control Coverage

In a 7-2 vote, the Supreme Court Justices issued a ruling on a case involving the “Little Sisters of the Poor” deciding that employers with “religious or moral objection” to contraceptives should not be forced to provide insurance coverage for the services for women. The Supreme Court’s ruling settled a decade’s worth of litigation over the women’s health provisions of the Affordable Care Act (ACA) ruling that employers with a “religious or moral objection” to providing contraceptive coverage to their employees may opt out without penalty. The ruling further clarified that the Trump administration was within its rights to exempt religious nonprofit agencies from having to participate in any way from facilitating contraceptive coverage for their employees.


The ACA itself did not require that contraceptives be covered. Rather, it called for preventive health services for women to be included in most insurance plans and left it to the Department of Health and Human Services (HHS) to figure out which ones. In the Obama administration, HHS asked the Institute of Medicine (now the National Academy of Medicine) to recommend which services had enough scientific evidence backing them to be added, and FDA-approved methods of contraception were added. That spurred a bitter controversy, with some religious groups and business owners who object to certain types of contraceptives arguing that they should not be forced to provide the services to workers.


The Supreme Court first ruled in 2014 that “closely held corporations” like the craft chain Hobby Lobby did not have to abide by the contraceptive coverage requirement. But that did not settle the issue completely. From the start, the Obama administration exempted churches and other religious entities from the coverage requirement. There was however still an outcry from religious non-profits like hospitals and some universities. With the election of President Trump, his administration crafted new rules to give organizations with not just religious, but also moral, objections to birth control the ability to opt out. It was then sued by those who believe women should have the right to no-cost contraception, including state governments, whose leaders fear that if employers opt out, the states will end up paying more for state contraceptive programs and costs associated with unwanted pregnancies.


The court’s recent decision now resolves the contraception issue albeit further challenges to the ACA are still set to be heard by the high court.

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