Why Obamacare's contraception coverage requirement is still up for debate

The Affordable Care Act’s mandate that employers have to provide health insurance that covers contraception to their employees violates the employers religious freedom, even if they don't have to pay for it, a federal appeals court said on Thursday.

The decision, by the 8th Circuit Court of Appeals in St. Louis, marks a break with other appeals courts that have considered the issue of balancing religious freedom with providing contraceptive and other preventative care to workers.

It puts the the court more in line with the US Supreme Court’s controversial Hobby Lobby ruling from June 2014, where the court held 5 to 4 that the Affordable Care Act violated laws protecting religious freedom by requiring profit-making corporations to provide contraceptives to their employees.

The Obama administration had created a workaround for employees interested in seeking contraception by crafting a rule that allows companies to opt out of paying for such services by petitioning the Department of Health and Human Services. Under the rule, the government can then connect the employee to a private insurer at no additional cost to the company.

Employers have previously filed suits alleging that the opt-out process violates their rights by making them indirectly complicit in providing contraception to workers, but previous appeals court have rejected that argument.

This time, however, was different. The court must defer to employers “sincere religious belief that their participation in the accommodation process makes them morally and spiritually complicit in providing abortifacient coverage,” wrote Judge Roger Wollman, using a term that usually refers to drugs which induce abortions.

Unlike the decision regarding Hobby Lobby, which is a for-profit corporation, Thursday’s ruling came on behalf of several non-profit religious-affiliated colleges and service providers. One ruling was for Heartland Christian College in Newark, Mo., and the addiction services provider CNS International Ministries Inc, also based in Missouri; the other came on behalf of Dordt College and Cornerstone University, both based in Iowa.

The employers said the Affordable Care Act’s opt-out provision violates the 1993 Religious Freedom Restoration Act, which states that “governments should not substantially burden religious exercise without compelling justification.”

This report contains material from Reuters.