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Federal court halts expanded religious exemption from ACA contraceptive mandate

January 18, 2019
Area(s) of Interest: Amicus Briefs Health Care Reform Access to Care 


On January 7, 2019, the California Medical Association (CMA), along with other health care provider organizations, filed an amicus brief in support of the State of California in its challenge to federal rules that would expand a group health plan or health insurer's ability to claim a religious or moral objection to opt out of the Affordable Care Act’s (ACA) contraceptive coverage mandate. On January 13, 2019, one day before the effective date, the federal court granted the state’s motion for a preliminary injunction, blocking the rules from going into effect the plaintiff states.

The U.S. Department of Health and Human Services, at the direction of the President “to address conscience-based objections to the preventative care mandate,” issued rules to broaden the scope of the religious and moral exemptions to encompass all entities and individuals with “sincerely held religious beliefs objecting to contraceptive or sterilization coverage” and made the accommodation process optional for eligible organizations, thus allowing for a full exemption from the mandate for those entities.

California, along with Connecticut, Delaware, Hawaii, Illinois, Maryland, Minnesota, New York, North Carolina, Rhode Island, Vermont, Washington, the Commonwealth of Virginia, and the District of Columbia, sought a preliminary injunction in federal court to stop the rules from going into effect.

The ACA requirement to provide FDA-approved contraception has been challenged by groups who allege that providing contraceptive coverage violates their religious beliefs. The contraceptive coverage mandate has been wrapped up in litigation for more than six years. CMA had previously filed a similar brief to enjoin the interim rules issued in October 2017, and this recent filing continues our advocacy in the line of cases involving the ACA’s contraceptive coverage mandate, including our amicus involvement in the Burwell v. Hobby Lobby and Zubik v. Burwell cases.

CMA’s briefs have all stressed the importance of widespread access to contraception as an essential component of health care for women of child-bearing age. CMA strongly believes that medical decisions should be made by patients in consultation with their health care providers. CMA policy supports access, without copays, to all FDA approved contraception as a basic preventative health service. The overwhelming weight of the evidence establishes that access to the full range of FDA-approved prescription contraceptives is an essential component of effective health care for women and their families.

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