Healthcare Business News

N.Y. Catholic health system wins ruling against contraception mandate

By Joe Carlson
Posted: December 16, 2013 - 7:30 pm ET

A federal judge in New York ruled that several Catholic organizations, including a six-hospital health system and a healthcare network for the poor run by the church, do not have to obey rules on providing insurance coverage for employees' contraception.

Dozens of federal lawsuits across the country are challenging the provision of the Patient Protection and Affordable Care Act that requires employer-sponsored health plans to include coverage of contraception and the morning-after pill. But this week's ruling is one of the first to directly address the legality of an exemption intended to accommodate the concerns of not-for-profit religious organizations like Catholic hospitals.

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In response to hundreds of thousands of public comments, HHS announced earlier this year that religious not-for-profits could self-certify their moral opposition to contraception. Organizations that object must have an outside company administer the benefits without passing on the costs to the rest of the health plan.

That accommodation didn't satisfy the concerns of the Archdiocese of New York. Nor did it satisfy ArchCare, the archdiocese's health network for the poor, or its six-hospital health system Catholic Health Services of Long Island, or several other Catholic organizations. Those organizations said they would still be forced to take steps to support services to which they object.

In a 41-page ruling Monday (PDF), U.S. District Judge Brian Cogan agreed.

Cogan issued a preliminary injunction barring enforcement of the law against the plaintiffs in the case, concluding that the contraception mandate likely violates the Religious Freedom Restoration Act even with the accommodation for religious employers. That decision could be appealed to higher courts, or the government could try to prove its case during a trial.

The U.S. Supreme Court has held that the First Amendment does not automatically bar laws that restrict religious freedom. For example, laws that outlaw the use of marijuana even though use of the drug is central of Rastafarian religious beliefs can be constitutional.

So Congress passed the Religious Freedom and Restoration Act in 1993, which requires that federal laws that burden the free exercise of religion must serve a compelling government goal and do so in the most restrictive way.

In the reform law case, Cogan wrote, other options were available to accomplish the goal of extending access to preventive healthcare services like contraception, including having the government give away contraception directly or by offering tax incentives. He also questioned whether forcing religious non-profits to certify their objections would accomplish a compelling government interest.

The Catholic Health Association, which has been an important ally to the White House in passing and implementing the Affordable Care Act, indicated in a July memo to members that the association was satisfied with the accommodation.

Last month, the Supreme Court said it would hear two challenges to the contraception rule brought by for-profit employers.

Follow Joe Carlson on Twitter: @MHJCarlson

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