Supreme Court Sends Birth Control Case Back to Lower Courts

The U.S. Supreme Court on Monday sent back to lower courts a case that pits religious groups against the Obama administration over a requirement that some employers provide birth control benefits to female employees.

Avoiding a major ruling on a challenge to the federal Affordable Care Act's contraceptive mandate, the justices unanimously remanded the case — which includes challenges from East Texas Baptist University and Houston Baptist University — saying the two sides should "resolve" their differences at the lower court level.

In taking up the case, known as Zubik v. Burwell, the Supreme Court was expected to consider if the right to religious freedom is broad enough to completely exempt nonprofits with religious objections to birth control from providing women access to it through their insurance plans.

The Texas case is among seven related lawsuits the high court agreed to hear together in which religious nonprofits argue the mandate infringes on their religious freedom. The Obama administration says the groups are offered a way around the requirement through a mechanism that still gives women access to free contraception.

Under the federal health care act, employers with 50 or more full-time employees are required to offer health plans with “minimum essential coverage,” including access to federally approved contraception for women, without co-payments or deductibles.

Religious nonprofits can seek “accommodations” to be exempted from the contraceptive mandate by submitting a form or notification certifying the organization’s objection on religious grounds. Doing so transfers the administrative duties of providing contraception coverage from the employer to the insurance company or a third party, which takes over handling the claims.

But the nonprofits argue they should be exempted from the requirement altogether because they are still “being forced to facilitate access” to contraceptives they oppose. In this case, the religious groups object to emergency contraceptives, including the so-called morning-after-pill, and intrauterine devices, which they liken to so-called “abortifacients” — or drugs that induce an abortion. (Health experts and scientists have disputed that claim.)

Citing the federal Religious Freedom Restoration Act, the groups say the requirement substantially burdens their sincerely held beliefs and that the government and “courts can’t second-guess the reasonableness” of those beliefs.

The federal government contends the religious nonprofits’ beliefs should not get in the way of their female employees’ ability to obtain contraception of their choice. The law gives religious nonprofits a way to opt out, federal attorneys say, but that reprieve does not extend to third parties left to administer insurance plans.

They also point out that the religious accommodation was crafted in consultation with other religious organizations, insurers and women’s groups.

The high court appeared divided during oral arguments in March. With a vacancy on the Supreme Court, a ruling in the case could have left access to certain contraceptives under the ACA mandate up to geography. A tie among the eight remaining justices — four each appointed by Democrats and Republicans — would have upheld lower court rulings, which have varied across the country.

In the Texas case, a federal district court previously sided with the universities, blocking the mandate from going into effect. But the New Orleans-based U.S. 5th Circuit Court of Appeals — considered the most conservative appellate court in the country — later reversed that decision.

In its unsigned opinion, the high court vacated those rulings and indicated it "expresses no view on the merits of the cases."