The trusted source for
healthcare information and
Robert B. Vogel, MD, JD
Retinal Ophthalmologist at Piedmont Eye Center, Lynchburg VA;
Attorney, Overbey Hawkins & Wright, PLLS, Lynchburg, VA;
Adjunct Professor, Humanities and Bioethics, Liberty University School of Medicine, Lynchburg, VA.
The U.S. District Court for the Northern District of Illinois (NDI) has issued a permanent injunction preventing the federal government from enforcing on Wheaton College, a Chicago-area Christian liberal arts school, the Affordable Care Act’s (ACA) contraceptive mandate. The injunction follows a four-year legal fight.
Wheaton argued that its being required to provide contraceptive coverage to employees violated its sincerely held religious beliefs. This claim was based on the U.S. Constitution and the federal Religious Freedom Restoration Act (RFRA).
The RFRA, enacted in 1993, mandates that the highest level of judicial scrutiny – “strict scrutiny” – be applied when evaluating whether a neutral law of general applicability violates the First Amendment’s free exercise of religion clause.
In other words, a law may not impose a “substantial burden” on religious freedom unless it furthers a “compelling government interest” and is the “least restrictive means” to achieve that interest. Although the Supreme Court eventually held the RFRA unconstitutional as applied to the states, it still applies to federal laws.
Wheaton’s injunction request initially was denied by the NDI and the Seventh Circuit. Both cited Notre Dame v. Sebelius (2014), where the circuit court found that Notre Dame failed to show the ACA mandate would impose a “substantial burden.”
But in 2014 Wheaton appealed to the Supreme Court, which granted a temporary injunction but did not decide the case on its RFRA merits. The case moved back to the DNI but was put on hold pending resolution of Zubik v. Burwell, decided in 2016.
In Zubik, the Supreme Court combined seven cases brought by plaintiffs similar to Wheaton. The Supreme Court remanded those cases to lower courts so that both sides in the disputes could “arrive at an approach” that “accommodates [religious employers’] religious exercise” and the ACA’s contraceptive coverage mandate.
Another development working in Wheaton’s favor came in October 2017, when the Trump Administration broadened Obama-era exemptions to the contraceptive mandate. More important for Wheaton, the administration agreed in this case “that enforcement [of the contraceptive mandate]…would violate RFRA.”
That is, the government told the court that it “did not oppose Wheaton’s renewed motion for injunctive and declaratory relief.” The court ruled in Wheaton’s favor.
But controversy regarding the contraceptive mandate is not going away soon.
Federal courts in California and Pennsylvania have issued preliminary injunctions against the Trump administration rules cited above. Both courts stated that given the change in the government’s position regarding these rules, opportunity for notice and comment was required under the Administrative Procedure Act.