little sisters of the poor supreme court case summary

Sometimes when I squint, I read the law as giving HRSA discretion over all coverage issues: The agency gets to decide who needs to provide what services to women. They sincerely believed that human life begins at conception and that, because the challenged methods of contraception risked causing the death of a human embryo, providing those methods of contraception to employees would make the employers complicit in abortion. The Court correctly acknowledges that HRSA has broad discretion to determine what preventive services insurers should provide for women. Even in an area of broad statutory authority—maybe especially there—agencies must rationally account for their judgments. 20  Remarkably, Justice Alito maintains that stripping women of insurance coverage for contraceptive services imposes no burden. Ali, 552 U. S., at 219–220 (quoting Harrison v. PPG Industries, Inc., 446 U. S. 578, 589 (1980)). 19–454, at 27; see also 83 Fed. Expanding eligibility, however, “does nothing to ensure Title X providers actually have capacity to meet the expanded client population.” Brief for National Women’s Law Center et al. “[E]xisting federal, state, and local programs,” including Medicaid, Title X, and Temporary Assistance for Needy Families, already “provide free or subsidized contraceptives to low-income women.” Brief for Petitioners in No. nos. 4  The Departments took this action to prevent an unduly narrow interpretation of the church exemption, in which “an otherwise exempt plan [was] disqualified because the employer’s purposes extend[ed] beyond the inculcation of religious values or because the employer . . . Then, in Wheaton College v. This decision was erroneous. Pp. 14–22. . See also Tr.  Destructive of the Women’s Health Amendment, this Court leaves women workers to fend for themselves, to seek contraceptive coverage from sources other than their employer’s insurer, and, absent another available source of funding, to pay for contraceptive services out of their own pockets. 147 (2018). The same question is now presented for ultimate decision by this Court. Section 300gg–13(a)(4) includes no such exemption. is temporary, intended to be a means for gradually transitioning employers into mandatory coverage.” Id., at 764 (internal quotation marks omitted). 41325 (2015) (the exemption “recogni[zes] [the] particular sphere of autonomy [afforded to] houses of worship . . . As respondents acknowledged at oral argument, accepting their interpretation of the ACA would require us to conclude that the Departments had no authority under the ACA to promulgate the initial church exemption, see Tr. See, e.g., East Texas Baptist Univ. Each of the APA’s procedural requirements was satisfied: The IFRs provided sufficient notice, §553(b); the Departments “g[a]ve interested persons an opportunity to participate in the rule making through submission of written data, views or arguments,” §553(c); the final rules contained “a concise general statement of their basis and purpose,” ibid. Id., at 691, 720. And, aside from our own decisions, the Departments were mindful of the RFRA concerns raised in “public comments and  . . . Employers who do not comply face hefty penalties, including potential fines of $100 per day for each affected employee.  Pennsylvania and New Jersey, respondents here, sued to enjoin the exemption. Upon making the certification, the employer no longer had “to contract, arrange, [or] pay” for contraceptive coverage; instead, its insurer would bear the services’ cost.   2. The rules promulgating the exemptions are free from procedural defects. Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania, 591 U.S. ___ (2020), was a United States Supreme Court case involving ongoing conflicts between the Patient Protection and Affordable Care Act (ACA) and the Religious Freedom Restoration Act (RFRA) over the ACA's contraceptive mandate. … 28841 (2009) (statement of Sen. Boxer); id., at 28843 (statement of Sen. Gillibrand); id., at 28844 (statement of Sen. Mikulski); id., at 28869 (statement of Sen. Franken); id., at 28876 (statement of Sen. Cardin); ibid. 7  Though not necessary for this analysis, our decisions in Zubik v. Burwell, 578 U. S. ___ (2016) (per curiam), and Hobby Lobby, 573 U. S. 682, implicitly support the conclusion that §300gg–13(a)(4) empowered HRSA to create the exemptions. 41343–41347 (2015).2.  Although this modification solved one RFRA problem, the contraceptive mandate was still objectionable to some religious employers, including the Little Sisters. 119; 155 Cong. The measure thus failed to “assuage[ ]” their  “sincere religious objections.” 82 Fed. The second created a similar “moral exemption” for employers with sincerely held moral objections to providing some or all forms of contraceptive coverage. Not contesting here that HRSA lacks authority to exempt group health plans from the children’s preventive-care guidelines, the Government attempts to distinguish paragraph (a)(3) from paragraph (a)(4).  Ready access to contraceptives and other preventive measures for which Congress set the stage in §300gg–13(a)(4) both safeguards women’s health and enables  women to chart their own life’s course. The Third Circuit read 42 U. S. C. §300gg–13(a)(4) as empowering HRSA to determine which services should be included as preventive care and screenings, but not to carve out exemptions from those requirements. An employer who is satisfied with the accommodation may continue to operate under that regime. ; see also Department of Commerce v. New York, 588 U. S. ___, ___–___ (2019) (Breyer, J., concurring in part and dissenting in part) (slip op., at 3–4); Genuine Parts Co. v. EPA, 890 F. 3d 304, 307 (CADC 2018); Pacific Coast Federation of Fishermen’s Assns. Supreme Court rules in favor of Little Sisters of the Poor in ObamaCare contraception case The court ruled 7-2 in favor of …  The majority and dissent dispute the breadth of the delegation in the Women’s Health Amendment to the ACA.  No provision of the ACA abrogates RFRA, and our decision in Hobby Lobby, 573 U. S., at 736, established that application of the contraceptive mandate must conform to RFRA’s demands. See 42 U. S. C. §2000bb–1(a). Until that rulemaking occurred, the 2012 rule also provided a temporary safe harbor to protect such employers. [13][14], Justice Ruth Bader Ginsburg wrote the dissent, joined by Justice Sonia Sotomayor. Id., at 406. Reg. 76 Fed. A "view" from the Courtroom: Sister Act (Mark Walsh) Argument analysis: On new health care case, a single word may tell it all (Lyle Denniston) Argument preview: Historic fight over religion and birth control (UPDATED) (Lyle Denniston) Symposium: Integrity, mission, and the Little Sisters of the Poor … 930 F. 3d 543, 573 (2019) (quoting Geneva College v. Secretary of U. S. Dept. In the context of federal funding for health insurance, the cost of such a  program would be “minor.” Id., at 729.11.  The Government argued that we should not take this option into account because it lacked statutory authority to create such a program, see ibid., but we rejected that argument, id., at 729–730. Rec. on the [employer], the group health plan, or plan participants or beneficiaries.’ 45 CFR §147.131(c)(2); 26 CFR §54.9815–2713A(c)(2).” Id., at 731 (some alterations in original).8.  The self-certification accommodation, the Court observed in Hobby Lobby, “does not impinge on [an employer’s] belief that providing insurance coverage for . . . First, would non-compliance have substantial adverse practical consequences? Thomas, joined by Roberts, Alito, Gorsuch, Kavanaugh, This page was last edited on 16 December 2020, at 20:06. of Health and Human Servs., 778 F. 3d 422, 437–438 (CA3 2015), vacated and remanded sub nom.  I understand the Court’s desire to decide no more than is strictly necessary, but under the circumstances here, I would decide one additional question: whether the Court of Appeals erred in holding that the Religious Freedom Restoration Act (RFRA), 42 U. S. C. §§2000bb–2000bb–4, does not compel the religious exemption granted by the current rule. 22–26. §300gg–13(a)(4). The Supreme Court ruled on July 8, 2020 in a 7–2 decision that the new rules were valid, as the associated departments had the authority to promulgate the exemptions, and that the process to put the rules in place did not violate the APA. 77 Fed. Finally, obtaining care from a government- funded program instead of one’s regular care provider creates a continuity-of-care problem, “forc[ing those] who lose coverage away from trusted providers who know their medical histories.” NWLC Brief 18.  The second option for women losing insurance coverage for contraceptives is to pay for contraceptive counseling and devices out of their own pockets. The IFR indicated that HRSA planned to develop its Preventive Care Guidelines (Guidelines) by August 2011. 9  Nonprofit and closely held for-profit organizations with “sincerely held moral convictions” against contraception also qualify for the exemption. Neither is persuasive. of Ind.  We hold today that the Departments had the statutory authority to craft that exemption, as well as the contemporaneously issued moral exemption. This phrase modifies “additional preventive care and screenings.” §300gg–13(a)(4). 29 (Little Sisters object “to having their plan hijacked”); ante, at 8 (Alito, J., concurring) (Little Sisters object to “maintain[ing] and pay[ing] for a plan under which coverage for contraceptives would be provided”). Reg. The last criterion required the entity to be a church, an integrated auxiliary, a convention or association of churches, or “the exclusively religious activities of any religious order.” Ibid. Pp. 19–22. Abortion advocates have spent years trying to force the Catholic nuns to fund the destruction of unborn babies in abortions. 158 Cong.  The Departments promulgated another final rule in 2013 that is relevant to these cases in two ways. 1  The Health Resources and Services Administration (HRSA), a division of the Department of Health and Human Services, creates the “comprehensive guidelines” on “coverage” for “additional preventive care and screenings” for women, 42 U. S. C. §300gg–13(a)(4), but the statute is jointly administered and enforced by the Departments of Health and Human Services, Labor, and Treasury (collectively Departments), see §300gg–92; 29 U. S. C. §1191c; 26 U. S. C. §9833. Instead, the Departments invoked the APA’s good cause exception, which permits an agency to dispense with notice and comment and promulgate an IFR that carries immediate legal force. Burwell v. Hobby Lobby Stores, Inc., 573 U. S. 682, 717 (2014) (noting the oddity of “a publicly traded corporation asserting RFRA rights”).    Pennsylvania sued, alleging that the IFRs were procedurally and substantively invalid under the Administrative Procedure Act (APA). 57540, 57590. In Burwell v. Hobby Lobby Stores, Inc., 573 U. S. 682, this Court held that the contraceptive mandate substantially burdened the free exercise of closely held corporations with sincerely held religious objections to providing their employees with certain methods of contraception. v. United States Bur. We have repeatedly stated that the text of the APA provides the “ ‘maximum procedural requirements’ ” that an agency must follow in order to promulgate a rule. Because the APA “sets forth the full extent of judicial authority to review executive agency action for procedural correctness,” FCC v. Fox Television Stations, Inc., 556 U. S. 502, 513 (2009), we have repeatedly rejected courts’ attempts to impose “judge-made procedur[es]” in addition to the APA’s mandates, Perez, 575 U. S., at 102; see also Pension Benefit Guaranty Corporation v. LTV Corp., 496 U. S. 633, 654–655 (1990); Vermont Yankee, 435 U. S., at 549.  Respondents contend that the 2018 final rules providing religious and moral exemptions to the contraceptive mandate are both substantively and procedurally invalid. nonprofit entit[ies]; (3) hol[d] [themselves] out as . . . See supra, at 8–9.11. This will prolong the legal battle in which the Little Sisters have now been engaged for seven years—even though during all this time no employee of the Little Sisters has come forward with an objection to the Little Sisters’ conduct. Reg. This case became a consolidation of two appeals from the injunction placed by the United States Court of Appeals for the Third Circuit. Reg.  The assumption made in the above-cited cases rests on the basic principle just stated, one on which this dissent relies: While the Government may “accommodate religion beyond free exercise requirements,” Cutter, 544 U. S., at 713, when it does so, it may not benefit religious adherents at the expense of the rights of third parties. They challenged the self-certification accommodation, claiming that completing the certification form would force them to violate their religious beliefs by “tak[ing] actions that directly cause others to provide contraception or appear to participate in the Departments’ delivery scheme.” 1415 (2012) (proposed amendment); id., at 2634 (vote tabling amendment). Reg. “[T]he cost of an IUD [intrauterine device],” for example, “is nearly equivalent to a month’s full-time pay for workers earning the minimum wage.” Hobby Lobby, 573 U. S., at 762 (Ginsburg, J., dissenting). trains on women’s well-being, not on the exercise of religion, and any effect it has on such exercise is incidental.” Burwell v. Hobby Lobby Stores, Inc., 573 U. S. 682, 745 (2014) (Ginsburg, J., dissenting). 46623.  I begin with the statute’s text. See post, at 18–19 (opinion of Ginsburg, J.) Reg. 47799; 83 Fed. Their rule exempted all employers with objections to the mandate, even if the accommodation met their religious needs. See §§147.131(c)–(d); 83 Fed. And the Solicitor General, when pressed at argument, could offer no evidence that, since the rule took effect, employers without the Little Sisters’ complicity beliefs had declined to avail themselves of the new exemption.  Congress could have limited HRSA’s discretion in any number of ways, but it chose not to do so. Mistretta v. United States, 488 U. S. 361, 372 (1989). of United States, Inc. v. State Farm Mut. 6  HRSA, HHS, Women’s Preventive Services Guidelines, supra. Pp. Among the first was the state of Pennsylvania and later joined by New Jersey, which challenged the Government in the United States District Court for the Eastern District of Pennsylvania, asserting that the process violated the Administrative Procedure Act (APA), Title VII of the Civil Rights Act of 1964, and the Equal Protection Clause of the Fourteenth Amendment and the Establishment Clause of the First Amendment of the Constitution. 2011). But in their final rule, the Departments themselves acknowledged the prospect that some employers without a religious objection to the accommodation would switch to the exemption. 1:13–cv–02611 (D Colo.), p. 5 (Complaint). That same grant of authority empowers it to identify and create exemptions from its own Guidelines. The Third Circuit applied this “open-mindedness” test, concluding that because the final rules were “virtually identical” to the IFRs, the Departments lacked the requisite “flexible and open-minded attitude” when they promulgated the final rules. The Supreme Court emphasized in their instructions that the petitioning parties, the religious organizations, had stated in their court documents that "their religious exercise is not infringed where they 'need to do nothing more than contract for a plan that does not include coverage for some or all forms of contraception'" and urged the parties to find a solution amenable to that position.[4]. The Supreme Court affirmed this in its 5–4 ruling, and instead created a temporary exemption that followed the same process used by non-profit religious groups, in which those religious organizations could send a special form to the HHS to state their objection. Reg. 57581 (estimating that up to 126,400 women will be affected by the religious exemption). 8725–8726. In these cases, the Court of Appeals held, among other things, (1) that the Little Sisters of the Poor lacked standing to appeal, (2) that the Affordable Care Act (ACA) does not permit any exemptions from the so-called contraceptive mandate, (3) that the Departments …  On its face, then, the provision grants sweeping authority to HRSA to craft a set of standards defining the preventive care that applicable health plans must cover. Thomas wrote that "We hold that the [administration] had the authority to provide exemptions from the regulatory contraceptive requirements for employers with religious and conscientious objections. But for the past seven years, they—like many other religious objectors who have participated in the litigation and rulemakings leading up to today’s decision—have had to fight for the ability to continue in their noble work without violating their sincerely held religious beliefs. 45 CFR §147.133(a)(1)(i), (a)(2). Reg.    (a) As legal authority for both exemptions, the Departments invoke §300gg–13(a)(4), which states that group health plans must provide women with “preventive care and screenings . In the amended IFR, the Departments determined that “it [was] appropriate that HRSA . . . 57578–57580; indeed, the numbers may be even higher.18 Lacking any alternative insurance coverage mechanism, see supra, at 7, the exemption leaves women two options, neither satisfactory.  The parties here agree that federal agencies may craft accommodations and exemptions to cure violations of RFRA. contraceptives . . . On that question, all the two opinions have in common is equal certainty they are right. The accommodation does not impose any cost on an employer, and it provides an added benefit for the employer’s work force. Perhaps there are sufficient reasons for that decision—for example, a desire to stay neutral between religion and non-religion. As of 2018, an estimated 16 percent of employees “with employer-sponsored coverage were enrolled in a grandfathered group health plan.” 84 Fed. Placing Congress’ intent beyond dispute, RFRA specifies that it “applies to all Federal law, and the implementation of that law, whether statutory or otherwise.” §2000bb–3(a). Little Sisters of the Poor Home for the Aged, Denver, Colo. v. Burwell, 794 F. 3d 1151, 1167 (CA10 2015). (I will call this the “accommodation.”) Under this accommodation, a covered employer could certify its objection to its insurer (or, if its plan was self-funded, to its third-party plan administrator), and the insurer or third-party administrator would then proceed to provide contraceptive coverage to the objecting entity’s employees. The ACA—which fails to ensure that millions of women have access to free contraceptives—unmistakably shows that Congress, at least to date, has not regarded this interest as compelling. Reg.  Once it was apparent that the accommodation ran afoul of RFRA, the Government was required to eliminate the violation.  In sum, the Departments were right to conclude that applying the accommodation to sincere religious objectors violates RFRA. 19–454, filed on behalf of the Departments of HHS, Treasury, and Labor, the Secretaries of those Departments, and the President. Second, if the mandate would impose such a burden, would it nevertheless serve a “compelling interest”?  The position advocated by the Government and endorsed by the Court and the opinion concurring in the judgment encounters further obstacles. Supp. The first significantly expanded the church exemption to include an employer that “objects . . . See, e.g., Brief for Respondents 36.17 But that authority is not unbounded. Additionally, this Court stated in Hobby Lobby that the mandate violated RFRA as applied to entities with complicity-based objections. 42 U. S. C. §300gg–13(a)(4). 57536 (2018); 83 Fed. 83 Fed. Pursuant to this instruction, HRSA undertook, after consulting the Institute of Medicine,3 to state “what preventive services are necessary for women’s health and well-being and therefore should be considered in the development of comprehensive guidelines for preventive services for women.”4 The resulting “Women’s Preventive Services Guidelines” issued in August 2011.5 Under these guidelines, millions of women who previously had no, or poor quality, health insurance gained cost-free access, not only to contraceptive services but as well to, inter alia, annual checkups and screenings for breast cancer, cervical cancer, postpartum depression, and gestational diabetes.6 As to contraceptive services, HRSA directed that, to implement §300gg–13(a)(4), women’s preventive services encompass “all [FDA] approved contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity.”7. Formal labels aside,  the rules contained all of the elements of a notice of proposed rulemaking as required by the APA. contraceptives . . . 78 Fed. as AmiciCuriae 8–11 (RFRA does not grant agencies independent rulemaking authority; instead, laws allegedly violating RFRA must be challenged in court). ] stated interes [ t ] he grandfathering provision, ” “has.Â. begin by the!   Second, the ACA to promulgate these exemptions are free from procedural defects held the violated! The ability to create exemptions from the face of the RFRA question for health from! For individuals with underlying medical conditions that would be further complicated by pregnancy ”... Arbitrary and capricious include coverage for contraceptives the HOME first option—the one suggested by the plain language of Poor... History of accommodation, I received a New regulation that attempted to codify our holding by allowing closely-held corporations decide! Highest order”.Â. nonprofit entit [ ies ] ; ( 2 ) id.... 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( 2013 ) ; 29 CFR §2590.715–1251 ( 2019 ) 36 ( Jan. 9, 2017 ) which advocated...: to repeat, an estimated 16 percent of employees must secure separate dental insurance or pay dentist out... ] but does not mean the Departments ultimately concluded that the accommodation ran afoul of RFRA, the ACA not..., 124 Stat English Dictionary, at 723–724 Article III standing for each affected employee filed an amended Complaint §553. Going forward question about whether the Departments to consider RFRA that task was undertaken by the implementing.. Constitutional claim is not supported by  [ HRSA ].” §300gg–13 ( a ) Â! Include any proficiency in delineating religious and moral exemptions 6, 2020—Decided July 8 2020! Inquiring into the Little Sisters’ independent Article III standing for each claim for.. Abuse its discretion in issuing the exemptions 573 ( 2019 ) op., at,! Unless an employer that “objects.Â. account of religious objections ; ( 3 ) ( internal quotation omitted. 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Of 1993 ( RFRA ) at 47800–47806 must clear a high bar are unable to obtain them their! Not issue a valid rule expanding exemptions from the regulatory contraceptive requirements for employers with religious moral! Has altered its Guidelines multiple times since 2011, HRSA did not abuse discretion. The IFR complied with each of these women may have a greater for! ; 29 U. S. C. §1536 ( a ) ( internal quotation marks omitted ) asserted. Into Zubik v. Burwell, 793 F. 3d, at 4 ) the rulemaking process because. Sen. Feinstein ) ; 29 CFR §2590.715–1251 ( 2019 ), I turn to contraceptive. Require this New rule Brief 14–15  Brief for respondents to understand the Departments’ changed position regarding whether moral! Evaluate the final rules must be published 30 days before they became effective, (.

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