Status of the Lawsuits Challenging the Affordable Care Act's Birth Control Coverage Benefit
Over 100 lawsuits have been filed in federal court challenging the Affordable Care Act’s birth control coverage benefit. The benefit requires new health plans to include coverage for the full range of FDA-approved methods of birth control, sterilization, and related education and counseling at no cost-sharing.
Both for-profit companies and non-profit organizations have challenged the birth control coverage requirement
Status of Non-Profit Cases:
Non-profit organizations filing lawsuits are objecting to the “accommodation” given to them by the Administration. The accommodation allows a non-profit that holds itself out as religious and has religious objections to birth control to refuse to provide health insurance coverage of birth control, while ensuring that the non-profit’s employees receive the coverage without cost-sharing directly from the insurance company. The non-profit must notify either its insurance company or the federal government of its objection.
- 43 non-profit cases are pending (including 4 cases that include both for- and non-profit plaintiffs), of a total of 68 cases that have been filed by non-profit organizations.
- All of the circuit courts to consider these cases have disagreed with the non-profits’ arguments that the accommodation violates the law:
- DC Circuit in Priests for Life/Archbishop of Washington (Nov. 14, 2014);
- 3d Circuit in Geneva College/Persico/Zubik (Feb. 11, 2015);
- 5th Circuit in East Texas Baptist Univ./Univ. of Dallas/Diocese of Beaumont/Diocese of Fort Worth (June 22, 2015);
- 7th Circuit in Wheaton College (July 1, 2015) and University of Notre Dame (May 19, 2015);
- 10th Circuit in Little Sisters of the Poor/Southern Nazarene Univ./Reaching Souls International (July 14, 2015).
- The Supreme Court has intervened in three non-profit cases, allowing the non-profit to notify HHS instead of the insurance company of its objections. The Court has made clear that these orders should not be construed as the Court’s views on the merits of the non-profits’ claims.
Status of For-Profit Cases:
- Since that decision, the lower courts have applied the Hobby Lobby decision to 41 of the 50 for-profit cases that have been filed.
- On July 10, 2015, responding to the Hobby Lobby decision, the Administration finalized a rule expanding the “accommodation” to certain closely-held for-profit companies. Closely-held for-profit companies that qualify for the accommodation will not be required to provide insurance coverage of birth control in the employer health plan. Instead, employees will get birth control coverage services directly from the insurance company. The companies that have challenged the birth control coverage requirement will have to comply with the accommodation, including the 41 that have received court orders based on the Hobby Lobby decision.
On June 30, 2014, the Supreme Court issued its decision in the Hobby Lobby case. The 5-4 decision held that the Religious Freedom Restoration Act (RFRA) allows some closely-held for-profit companies to get out of including birth control in the employer-based health insurance plan if the company’s owner has a religious objection to such coverage.
Status of Other Cases:
There have been several other challenges filed involving the contraceptive coverage provision. One case, which is still pending, was brought by an individual who objects to having health insurance that includes coverage for birth control.
The attached charts detail these cases. The first chart contains the for-profit cases; the second contains challenges that include both for- and non-profits; the third contains the non-profit cases; and the fourth contains other related cases.
Each chart is organized by the region of the country in which the case was filed, according to the boundaries of the courts of appeals. The cases that have been heard by the Supreme Court are highlighted in yellow. Closed cases are highlighted in grey. The chart can also be found online at
For more information about the health care law’s birth control coverage benefit and the legal claims at issue in the cases, please visit: http://www.nwlc.org/preventive-services-including-contraceptive-coverage-under-health-care-law.