On July 8, 2020, by a vote of 7-2, the Supreme Court of the United States (SCOTUS) in their Little Sisters of the Poor decision upheld Trump administration rules permitting employers to decline contraceptive coverage (including preventative health services, birth control pills, IUDs, etc.) on the basis of sincerely held religious or moral grounds.
The Trump administration, for some time now, has been working to allow certain organizations to opt-out of offering birth control to employees without also providing an alternate coverage arrangement and this ruling is certainly a tentative fulfillment of those efforts. Short of additional litigation on the matter to come, the Court’s decision here would effectively make it more difficult for women to obtain access to birth control and will increase their yearly out-of-pocket costs as well if their employer decides to drop coverage. The Department of Health and Human Services (HHS) estimates that the average annual cost of contraception per woman per year is $584. In her dissent, Justice Ginsburg noted governmental statistics which estimated that “between 70,500 and 126,400 women would immediately lose access to no-cost contraceptive services”, asserting that the SCOTUS was placing a precedence on religious rights in this instance.
Some background here, as the Affordable Care Act (ACA) already guaranteed an exemption from the birth control mandate for religious organizations such as churches and synagogues. However, it did not likewise extend the same automatic exemption to religiously affiliated colleges and universities, charities, and hospitals, for example. These religiously affiliated organizations previously would have needed to offer no-cost birth control options to employees on an individual basis outside of the employer-sponsored health plan should they claim religious or moral objection. That will no longer be required if this decision is upheld upon further review from the lower courts to which this case has been remanded, with Justice Thomas writing on behalf of the majority that the Trump administration "…had the authority to provide exemptions from the regulatory contraceptive requirements for employers with religious and conscientious objections." Under the Trump administration’s new proposals, essentially all employers will now have the opportunity to drop contraceptive coverage should they decide to do so.
We will provide updates on this as the situation develops, as it will likely have a potentially large impact on the world of health and welfare benefits.