ACA News & Publications

ACA Pathways: Supreme Court Upholds ACA Contraceptive Rule Exemptions

July 09, 2020

In a 7-2 decision, the U.S. Supreme Court has upheld two regulations expanding exemptions from the contraceptive coverage mandate under the Affordable Care Act (ACA). Under the regulations, plan sponsors that object to providing contraceptive coverage based on sincerely held religious beliefs or moral convictions will not be penalized for failing to include contraceptive coverage in the plan’s benefits.

Contraceptive Mandate

The ACA requires non-grandfathered health plans to cover certain women’s preventive health services without cost-sharing, including all FDA-approved contraceptives. Religious exemptions apply to certain churches, houses of worship, and other church-affiliated institutions, which allows them to choose not to contract, arrange, pay or refer for any contraceptive coverage.

In October 2017, the Trump administration issued two interim final regulations that expanded the availability of the exemption for employers that object to providing contraceptive coverage based on their religious beliefs, and provide an additional exemption for employers that object to providing contraceptive coverage based on their moral convictions (but not religious beliefs).

The Supreme Court has now ruled that the Trump administration had the authority under the ACA to provide these exemptions. This potentially expands the number of employers that are able to opt-out of providing the ACA mandated free contraceptive coverage, and thus, requiring their employees to find and pay for birth control on their own.

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