Implementing Health Reform. On December 10, 2015, Judge John Jones III of the federal district court of the Middle District of Pennsylvania decided yet another contraceptive coverage case. Unlike the dozens of challenges to the Affordable Care Act contraceptive coverage rule, including the challenge currently before the Supreme Court, this case was brought by a secular organization. Real Alternatives Inc. challenged the contraceptive requirement not under the Religious Freedom Restoration Act (RFRA), as have the other plaintiffs, but as a violation of the Constitution’s Equal Protection requirement, and also as arbitrary and capricious and thus impermissible under the Administrative Procedures Act.
Three employees of Real Alternatives also sued. They claimed that the requirement that their employee benefits plan cover contraceptives substantially burdened their religious rights and was not the least restrictive means of achieving a compelling federal interest, and thus violated the Religious Freedom Restoration Act.
Judge Jones entered summary judgment for the government on all substantive claims. He concluded that the government had only to show a rational basis for not extending to Real Alternatives’ secular moral claim the same accommodations that it extends to religious organizations. The court recognized that, in fact, religion has a special protected status under our law and Constitution that is not afforded mere moral beliefs.
Judge Jones also noted that serious deleterious effects would follow if individuals and organizations were allowed to exempt themselves from legal requirements based on their singular moral beliefs. Similarly the court held that a rule providing accommodations for religious organizations not offered to secular organizations was not “arbitrary and capricious” under the Administrative Procedures Act.
The court further ruled that the contraceptive requirement does not violate specific federal statues prohibiting federal programs from discriminating against entities for refusing to provide abortion coverage or forbidding the use of federal funds to pay for abortions. Judge Jones stated that there was no legal basis for the plaintiff’s claim that emergency contraceptives cause abortions.
Judge Jones also rejected the claims of the individual employees that the requirement that Real Alternatives, Inc. offer contraceptive coverage violated their rights under RFRA. He observed that their religious beliefs were not substantially burdened by a requirement that their employee benefits plan cover contraceptives, and that an insurance system in which every individual could demand an insurance policy that conformed to his or her religious beliefs would be unworkable. The court also noted that insurance policies often cover families, and family members may not all share the same beliefs.
Finally, the court concluded that even if the absence of an exemption burdened religious belief, the contraceptive rule is the least restrictive means of promoting compelling federal interests in gender equality and public health.
Judge Jones recognized that Judge Richard Leon of the District of Columbia federal district court reached opposite conclusions in a similar case, ruling that both a non-religious organization and individual plaintiffs had rights to regulatory accommodations of their beliefs. Judge Jones explained at length, however, his conclusion that Judge Leon was legally in error. These cases will no doubt be revisited again by higher courts.
New Consumer Tools On Healthcare.gov
On December 11, 2015, the Centers for Medicare and Medicaid Services (CMS) announced that out-of-pocket calculator, doctor and facility look-up, and prescription drug look-up features are now available on healthcare.gov for all consumers. Over 90 percent of participating insurers have provided validated data that is now accessible through the network and formulary look-up tools. Since the tools were launched in November, approximately 2 million consumers have used the tools to search for their doctors and drugs.
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