Association of Christian Schools International v. Burwell

75 F. Supp. 3d 1284, 2014 U.S. Dist. LEXIS 165462, 2014 WL 6704310
District Court, D. Colorado·Decided November 26, 2014·No. Civil Action No. 14-cv-02966-PAB·Published·Cited by 1 cases

Opinion

ORDER

PHILIP A. BRIMMER, United States District Judge

This matter is before the Court on two motions for a preliminary injunction: one filed by plaintiffs Association of Christian Schools International (“ACSI”), Samaritan Ministries International (“SMI”), Taylor University, and Indiana Wesleyan University (“IWU”) [Docket No. 11] (the “original motion”), and a second motion filed by plaintiffs Asbury Theological Seminary (“ATS”) and Alliance Defending Freedom (“ADF”) [Docket No. 24].1 The Court has jurisdiction pursuant to 28 U.S.C. § 1331.

I. BACKGROUND

Plaintiffs are Christian non-profit organizations challenging a particular aspect2 of the contraceptive coverage requirement of the Patient Protection and Affordable Care Act (the “Act”), 42 U.S.C. § 300gg-13(a)(4) (the “mandate”). Plaintiffs’ principal claim — and the sole basis for their preliminary injunction motion — is that the mandate imposes a substantial burden on their religious exercise in violation of the Religious Freedom Restoration Act (“RFRA”). 42 U.S.C. § 2000bb et sec/.3

A. The Mandate

The mandate requires group health plans, including both insured and self-insured employer-based plans, to include minimum coverage for a variety of preventative health measures at no cost to covered beneficiaries. 42 U.S.C. § 300gg-13(a); see also id. § 300gg-91(a) (defining “group health plan”). With respect to women’s health, the Act required the Health Resources and Services Administration (“HRSA”) to develop “comprehensive guidelines” that would define the required preventative services that must be covered free of charge. Id. § 300gg-13(a)(4). HRSA, in reliance on work performed by the independent Institute of Medicine, established guidelines for women’s preventative services that include screening for gestational diabetes, human papillomavirus testing, counseling for sexually transmitted infections, and, as relevant to this motion, “[a]ll Food and Drug Administration approved contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity.” See Health Resources and Servs. Admin., Women’s Preventive Services Guidelines, http://www.hrsa.gov/womensguidelines.

[1287] In February 2012, the three agencies responsible for the Act’s implementation— the Department of Health and Human Services (“HHS”), the Department of Labor (“DOL”), and the Department of the Treasury (“Treasury”) (collectively, the “Departments”) — each issued regulations that adopted the HRSA’s guidelines, thus requiring group health plans to cover contraceptive services. See 45 C.F.R. § 147.130(a)(1)(iv)(HHS); 29 C.F.R. § 2590.715-2713(a)(1)(iv)(DOL); 26 C.F.R. § 54.9815-2713(a)(1)(iv) (Treasury).

1. The Religious Employer Exemption

In August 2011, HHS issued an interim final regulation that adopted HRSA’s guidelines as applied to contraceptive coverage. See 76 Fed.Reg. 46621 (Aug. 3, 2011). In light of concerns over “the effect on the religious beliefs of certain religious employers if coverage of contraceptive services were required in the group health plans in which employees in certain religious positions participate^]” the interim final regulation provided HRSA with discretion to exempt certain religious employers from the mandate. Id. at 46623. This exemption would apply to any employer that

(1) Has the inculcation of religious values as its purpose; (2) primarily employs persons who share its religious tenets; (3) primarily serves persons who share its religious tenets; and (4) is a non-profit organization under section 6033(a)(1) and section 6033(a)(3)(A)(I) or (iii) of the [Internal Revenue] Code. Section 6033(a)(3)(A)(I) and (iii) refer to churches, their integrated auxiliaries, and conventions or associations of churches, as well as to the exclusively religious activities of any religious order.

Id.-, see also 45 C.F.R. § 147.131(a). The stated purpose of the exemption was to “respect[ ] the unique relationship between a house of worship and its employees in ministerial positions.” 76 Fed.Reg. at 46623. The exemption did not apply to organizations, like plaintiffs, that share the beliefs of exempt entities but do not qualify as houses of worship or their auxiliaries. The interim final regulations required employers not subject to the exemption to begin covering preventive services, including contraception, as of August 2012. Id. at 46624.

2. The Eligible Organization Accommodation

In January 2012, HHS Secretary Kathleen Sebelius announced that non-profit employers who, based on religious objections, did not provide contraceptive coverage in their insurance plans (referred to as “eligible organizations” in the regulations), would be given a one-year extension, until August 2013, to comply with the law. See Statement by U.S. Department of Health and Human Services Secretary Kathleen Sebelius (Jan. 20, 2012), available at http:// www.hhs.gov/news/press/2012pres/01/ 20120120a.html. This “temporary enforcement safe harbor” was officially announced in February 2012, and the Departments indicated that they would work “to develop alternative ways of providing contraceptive coverage without cost sharing with respect to non-exempted, non-profit religious organizations with religious objections to such coverage.” 77 Fed.Reg. 8725, 8728 (Feb. 15, 2012).

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Association of Christian Schools International v. Burwell, 75 F. Supp. 3d 1284, 2014 U.S. Dist. LEXIS 165462, 2014 WL 6704310 (D. Colo. 2014).

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