Third Circuit upholds ACA contraception accommodations

PHILADELPHIA - The use of third party insurance providers to fulfill the contraceptive

needs of female employees does not place additional burdens on religious organizations that morally object to the Affordable Care Act's requirements, according to a ruling published Wednesday by a three-judge panel of the U.S. Court of Appeals for the Third Circuit.

The opinion, authored by Judge Marjorie O. Rendell, reverses injunctions granted by federal judges to Geneva College and religious employers affiliated with the Roman Catholic Dioceses in Erie and Pittsburgh, which sued the U.S. Department of Health and Human Services.

“Such a ruling should cause deep concern for anyone who cares about any First Amendment rights, especially the right to teach and practice a religious faith. This decision says that the church is no longer free to practice what we preach,” Bishop David Zubik of the Pittsburgh Diocese said in a press statement.

The passage of the Affordable Care Act in 2010 included a provision that required group health plans and health insurance issuers to cover preventive care and screenings for women, without cost sharing, such as a copayment, coinsurance, or a deductible. Religious groups and organizations objected to the rule, saying they faced a choice between going against their beliefs to provide abortifacient contraceptives or paying hefty fines.

In response to the objections, the legislation was revised to allow employers to provide paperwork that certified their status as a religious organization and its opposition to the birth control mandate. Submission of the forms allows a third party provider or administrator to fulfill the preventative care needs to the female employees without involving the organization, according to the amended law.

The lawsuits filed in 2013 by Geneva College, affiliated with the Reformed Presbyterian Church, and the diocesan organizations claimed that signing the federal document triggered the contraceptive services and constituted a casual link that still violated their religious freedoms. The complaints also claimed that completely exempting churches but not the employers affiliated with the parishes drove a wedge between the congregations.

The Third Circuit rejected the arguments, saying that the certifications were not the catalyst to provide contraceptive coverage, but the federal law.

"The obligation to cover contraception is not triggered by the act of self-certification," Rendell said. "Rather, it is triggered by the force of law—the ACA and its implementing regulations."

Rendell writes that submitting the self-certification form means only that the eligible organization is not providing contraceptive coverage and will not be subjected to penalties. By participating in the accommodation, the organization has no role
whatsoever in the provision of the objected-to contraceptive services. The form removes the religious objectors from the process, leaving the federal government to assign a plan administrator who oversees the coverage.

"Because we find that the self-certification procedure does not cause or trigger the provision of contraceptive coverage, appellees are unable to show that their religious exercise is burdened," Rendell said. "Even if we were to conclude that there is a burden imposed on the appellees' religious exercise, we would be hard-pressed to find that it is substantial."

Attorneys representing Geneva College have indicated intentions to appeal the decision, either before the full nine-member bench of the Third Circuit or the U.S. Supreme Court.

“All Americans should oppose unjust laws that force people — under threat of punishment — to give up their fundamental freedoms and act contrary to their beliefs,” attorney Gregory S. Baylor said in a statement for the college. “The administration has no business punishing people of faith for making decisions consistent with that faith.”