REPRODUCTIVE HEALTH: The State of California, et al., v. Health & Human Services, et al. (U.S. District Court, Northern District of California, Oakland Division, 17-cv-05783); The State of California v. Azar (Little Sisters of the Poor) (U.S. Ninth Circuit Court of Appeal, 18-15144)

CMA joined the American College of Obstetricians and Gynecologists, Physicians for Reproductive Health, American Academy of Pediatrics as well as other health care provider organizations in support of the contraceptive-coverage provision under the Patient Protection and Affordable Care Act (ACA). In these cases, the State of California sought and obtained a preliminary injunction blocking the Interim Final Rules and the Final Religious Exemption Rule and Final Moral Exemption Rule issued by the U.S. Health and Human Services (HHS) that expanded the religious and moral exemption and accommodations to allow entities from opting out of the ACA’s contraceptive coverage mandate.

On December 13, 2018, the Ninth Circuit affirmed the preliminary injunction insofar as it barred enforcement of the interim rules in the plaintiff states, but not as it applied to other states. While the case regarding the interim final rules were pending, HHS issued the final rules. Once again, California, along with 12 other states and the District of Columbia filed a motion for preliminary injunction in federal district court. CMA's amicus brief, filed in both the Ninth Circuit in support of the preliminary injunction of the interim rules and in the district court in support of the preliminary injunction of the final rules, stressed the importance of widespread access to contraception as an essential component of health care for women of child-bearing age.

The brief also argued the Interim Final Rules and Final Rules negatively impact the patient-physician relationship by imposing the employer’s beliefs into the patient’s ability to access the care they need and would essentially force women to seek coverage for reproductive health services outside of their employer-based plans by divorcing reproductive health care from other preventative health care.

On January 13, 2019, one day before the Final Rules were to go into effect, the district court granted the motion to enjoin the Final Rules in the plaintiff states. On October 22, 2019, a three-judge panel of the Ninth Circuit Court of Appeals affirmed the district court's preliminary injunction.