Top court to weigh limits on birth control coverage

WASHINGTON — The Supreme Court agreed Friday to decide whether the Trump administration may allow employers to limit women’s access to free birth control under the Affordable Care Act.

During the Obama administration, the court heard two cases on whether religious groups could refuse to comply with regulations requiring contraceptive coverage. The new case asks whether the Trump administration can allow all sorts of employers with religious or moral objections to contraception to opt out of the coverage requirement.

President Barack Obama signed the Affordable Care Act in March 2010. One section of the law requires coverage of preventive health services and screenings for women. In August 2011, the Obama administration required employers and insurers to provide women with coverage at no cost for all methods of contraception approved by the Food and Drug Administration.

But the Trump administration has said requiring contraception coverage can impose a “substantial burden” on the exercise of religion by some employers. The regulations it has promulgated made good on a campaign pledge by President Donald Trump, who has said that employers should not be “bullied by the federal government because of their religious beliefs.” And they added an exception for employers who said they had moral objections to certain forms of birth control.

Pennsylvania and New Jersey challenged the rules, saying they would have to shoulder much of the cost of providing contraceptives to women who lost coverage under the Trump administration’s rules.

In May, a three-judge panel of the 3rd U.S. Circuit Court of Appeals, in Philadelphia, unanimously blocked the regulations, issuing a nationwide preliminary injunction.

The requirement that employers and insurers provide women with coverage for contraception at no cost has had a large practical effect, Judge Patty Shwartz wrote for the 3rd Circuit. “Cost is a significant barrier to contraceptive use and access,” she wrote. “The most effective forms of contraceptives are the most expensive. After the ACA removed cost barriers, women switched to the more effective and expensive methods of contraception.”

Shwartz added that expanding the Trump administration’s exceptions would have predictable consequences.

“Because the rules allow employers to opt out of providing coverage for contraceptive services,” she wrote, “some women may no longer have insurance to help offset the cost for these and other contraceptives.”

The coverage requirement, sometimes called the contraceptive mandate, has been the subject of much litigation, reaching the Supreme Court twice.

In urging the Supreme Court to hear its appeal, the administration said the new exceptions were authorized by the health care law and required by the federal Religious Freedom Restoration Act.

Lawyers for Pennsylvania and New Jersey responded that the administration lacked statutory authority to issue the regulations and had not followed proper administrative procedures.