Overview of the Lawsuits Challenging the Affordable Care Act’s No Cost-Sharing Contraceptive Coverage Benefit

Full Document with Chart

61 lawsuits have been filed in federal court challenging the Affordable Care Act’s no cost-sharing contraceptive coverage benefit.  For-profit companies are among those who are pushing for the courts to allow bosses to make women’s reproductive health decisions.

Cases brought by non-profits:

• 32 cases have been brought by non-profit organizations.  Three cases were withdrawn by the plaintiffs, so 29 cases are pending.
• One non-profit, College of the Ozarks, recently filed a second lawsuit (the first was voluntarily dismissed in 2012).  In its second lawsuit, College of the Ozarks also brings a claim against its insurance provider for not granting the school’s request to exclude coverage of emergency contraception and other drugs or devices the school deems “abortifacients.”
• Where decisions have been reached, courts are largely dismissing the cases as not being ripe or because plaintiffs lack standing.  This is because non-profits with religious objections to providing contraception currently have a safe harbor – a one year delay in implementing the benefit –and the Administration is undertaking rulemaking that could address their concerns.

Cases brought by for-profits:

• 29 of the cases have been filed by for-profit companies, ranging from a mining company to a crafts store chain to an HVAC company.  One case was even brought by a business owner who currently has no employees. One of these cases – Geneva College – also includes non-profit plaintiffs.

• The cases brought by for-profits are moving quickly because these companies are not eligible for the safe harbor, and, for the most part, are already required to provide the contraceptive coverage benefit.  The courts are addressing these, and reaching different outcomes.
• One court has reached the merits – a district court granted the government’s motion to dismiss in one case, O’Brien, which is now on appeal to the 8th Circuit.  The district court recognized that the Religious Freedom Restoration Act (the federal law the companies are relying upon to challenge the benefit) “is not a means to force one’s religious practices upon others.”  The 8th Circuit has issued a stay pending appeal.
• In six cases, courts have denied for-profit companies’ request for temporary relief, meaning those companies must provide the benefit.  At least one company – Hobby Lobby – has pushed back its plan year start date in order to avoid complying.
• Nineteen companies so far have some form of temporary relief, which means the companies do not have to provide the benefit while they pursue their claims in court.  (In some of those cases, the district court denied preliminary injunctions, but the circuit court issued temporary relief as an appeal moves forward).
• No court of appeals has reached the merits yet.
• Three courts of appeals – the 3rd, 6th, and 10th Circuit Courts of Appeals – have refused to delay the enforcement of contraceptive coverage benefit.  The U.S. Supreme Court denied a request for an emergency injunction in the 10th Circuit case.
• Three courts of appeals – the D.C. Circuit and the 7th and 8th Circuit Courts of Appeals  – have given temporary relief.