On July 8, 2020, the U.S. Supreme Court upheld two regulations expanding exemptions from the contraceptive coverage mandate under the Affordable Care Act (ACA).
Under the regulations, plan sponsors that object to providing contraceptive coverage based on sincerely held religious beliefs or moral convictions will not be penalized for failing to include this coverage for employees.
In a 7:2 decision, the Court ruled that the government did have the authority under the ACA to adopt broad religious and moral exemptions to the contraceptive mandate and that the rules did not violate the American Psychological Association (APA). The Court remanded the case to the lower courts to dissolve a nationwide preliminary injunction, temporarily preventing the regulations from taking effect.
In the meantime, attorney generals in Pennsylvania and New Jersey announced that they would continue to challenge whether the rules are arbitrary and capricious under the APA.
In October 2017, the Trump administration issued two interim final rules that expand the availability of the exemption for employers that object to providing contraceptive coverage based on their religious beliefs, and provide an additional exemption for employers that object to providing contraceptive coverage based on their moral convictions (but not religious beliefs).
The ACA requires covered employers to provide women with “preventative care and screenings” without cost-sharing, including all FDA-approved contraceptives.
Religious exemptions only apply to certain churches, houses of worship, and other church-affiliated institutions, which allows them to choose not to contract, arrange, pay, or refer for any contraceptive coverage.
Therefore, women will have to look elsewhere for contraceptive coverage and potentially pay out-of-pocket for this form of healthcare. Some women may even have to go without access to contraceptives at all.
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