—A 2012 Missouri law that allows employers and insurers to deny contraceptive coverage is pre-empted by the healthcare reform law and accompanying regulations, a U.S. District Court judge ruled. Under the Missouri law, insurers and employers or other healthcare plan sponsors cannot be compelled to provide coverage for contraceptives, abortion or sterilization “if such items or procedures are contrary” to their religious beliefs or moral convictions. Two insurers—Health Alliance Life Insurance and HMO Missouri—challenged the law after they received charges from the Missouri Department of Insurance that they were violating state law by not offering healthcare plans excluding coverage for contraceptives. But Judge Audrey Fleissig of the U.S. District Court in St. Louis ruled that the statute ran afoul of the Supremacy Clause of the U.S. Constitution, which invalidates state laws that conflict with federal laws and rules. “Here the federal law and regulations, with limited exceptions, provide that insurers must provide contraceptive coverage without cost-sharing by an insured,” Fleissig wrote, referring to the Patient Protection and Affordable Care Act and federal regulations implementing that law. “The state law says that insurers cannot provide contraceptive coverage to any person or entity that objects to such coverage based on moral, ethical or religious objection. The court is hard-pressed to see how this does not create a direct conflict for Missouri health insurers,” Fleissig wrote.