Power

No Solution in Sight for Supreme Court Birth Control Fight

With all the legal briefs filed to the Supreme Court and no solutions proposed, it's going to be up to the justices to put an end to the lawsuits swarming the Affordable Care Act.

By late Wednesday evening when the final supplemental briefs were filed in Zubik v. Burwell, the challenge to the Affordable Care Act's birth control benefit, it was clear this case will not have a clean ending. In fact, it could very well result in a deadlocked U.S. Supreme Court and patchwork contraception insurance coverage across the country. American Life League / Flickr

By late Wednesday evening when the final supplemental briefs were filed in Zubik v. Burwell, the challenge to the Affordable Care Act’s birth control benefit, it was clear this case will not have a clean ending. In fact, it could very well result in a deadlocked U.S. Supreme Court and patchwork contraception insurance coverage across the country.

Almost exactly a week after oral arguments in Zubik, the Court justices ordered attorneys from both sides to file briefs setting out possible paths to resolving the case, in a move signaling they were looking to prevent a tied 4-4 ruling. Specifically, the Court asked the lawyers to address whether religiously affiliated nonprofit hospitals, nursing homes, and colleges could be separated out from a government-administered health insurance plan that would be the source of contraceptives for the nonprofits’ employees and students. In its initial responses, the Obama administration grudgingly admitted the idea proposed by the Court was theoretically possible, but insisted it was both impractical and not currently allowed under the ACA.

The religious objectors, on the other hand, insisted that if the contraception benefit contained an exemption for churches, it should have the same exemption for hospitals and universities. And while the religious objectors didn’t come right out and say so in this latest round of briefs, if they get an exemption then so too, eventually, would secular for-profit companies like Hobby Lobby.

The religious objectors have insisted that the Religious Freedom Restoration Act (RFRA) is broad enough to allow the objectors to interfere with, based on religious principle, third-party insurance companies from offering contraception insurance for their employees and students. But that argument evolved during oral arguments in March—or rather, the religious objectors clarified to the Roberts Court that if the Court was nervous about making such a ruling based on the precedent it would set for future RFRA challenges, then the Court should just grant businesses full exemptions from the law. The effect of such a ruling would be to block, writ large, contraception access for private employees and students altogether unless the government were to step in and provide that coverage directly.

In its final supplemental briefing to the Roberts Court, the religious objectors finally came clean and made that argument directly. “[I]f the government really believes the only way to accomplish its objectives [of providing seamless contraception coverage] is to force every religious nonprofit to contract for an insured plan so the government will have something suitable to piggyback on, then petitioners’ concerns that the government wants to hijack their plans have been confirmed,” wrote the objectors. They continued, “Petitioners’ alternative—where the separate policies offered by commercial insurers are offered to employees of self-insured objectors as well—would reinforce the true separateness of those policies, rather than just reinforcing the RFRA violation.”

The Obama administration opened its supplemental brief taking this clarified argument by the religious objectors to the woodshed: “In a sharp departure, petitioners now acknowledge that they cannot invoke RFRA to prevent the government from requiring that the insurers with which they contract also provide separate contraceptive coverage to their employees.”

“But petitioners assert that it is not enough that insurers provide that coverage entirely outside petitioners’ health plans and without their involvement, as the accommodation already requires,” it continued. “Petitioners also insist that the coverage must consist of contraceptive-only insurance policies, not direct payments [to anyone] for contraceptives. And they add that women must take affirmative steps to enroll, and cannot be covered automatically.”

In other words, the religious objectors’ legal argument is that they are entitled under RFRA to make accessing contraception coverage in the private marketplace as onerous as possible, the result of which would mean many people would just not get the contraception they need.

This sounds a lot like conservatives’ approaches to abortion restrictions. And it should. The same sense of moral entitlement to regulate ad infinitum women’s bodies, expressed as the state’s interest in promoting fetal “personhood,” is the theoretical precursor to the religious objectors’ arguments in Zubik. In litigating the availability of contraception coverage under the ACA, religious objectors have effectively borrowed the moral justifications anti-choice lawmakers use to restrict abortion access—that women’s health care must always take a back seat to purported claims of religious freedom—and pasted them into their legal arguments as to why the private sector has the right to dictate who can access contraception in this country, and when and how.

With a Supreme Court evenly split ideologically on the contraception benefit and the limits of RFRA, it’s unlikely these latest briefs will do anything to avoid a split decision here. If these challenges are going to get resolved this term, and with them the argument that private employers can block their employees from accessing contraception coverage, then one of the justices is going to have to change their mind. Right now, that seems like a stretch.