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Supreme Court Undercuts Access To Birth Control Under Obamacare

J. Scott Applewhite

Updated at 12:32 p.m. ET

The U.S. Supreme Court has made it more difficult for women to get access to birth control as part of their health plans if their employer has religious or moral objections to contraceptives.

The opinion upheld a Trump administration rule that significantly cut back on the Affordable Care Act requirement that insurers provide free birth control coverage as part of almost all health care plans.

"We hold that the [Trump administration] had the authority to provide exemptions from the regulatory contraceptive requirements for employers with religious and conscientious objections," Justice Clarence Thomas wrote for the majority.

He was joined by Chief Justice John Roberts, and Justices Samuel Alito, Neil Gorsuch and Brett M. Kavanaugh.

The case now goes back to a lower court, which the Supreme Court ordered to lift an injunction that had prevented the implementation of the exception.

Justices Elena Kagan and Stephen Breyer, two of the court's four liberals, did not join the majority opinion, but said they agreed with the conservatives to send the case back to the lower court.

Under the ACA, churches and synagogues were automatically exempted from the birth control insurance mandate. Not automatically exempt, however, were nonprofits like religiously affiliated universities, charities and hospitals, which employ millions of people who want their health insurance plans to cover birth control for themselves and their family members.

For these nonprofits, the Obama administration enacted an opt-out provision for employers with religious objections. They were required to notify the government or their insurance company, or their plan administrator so that the insurance company could provide free birth control options to individual employees but separate from the employer's plan.

That did not satisfy some religious objectors, however. They contended that signing an opt-out form or notifying their plan administrator was the same as authorizing the use of their plan for birth control.

The Supreme Court previously punted on the issue. And when President Trump came into office, his administration issued new rules that would give broad exemptions from the birth control mandate to nonprofits and some for-profit companies that object to birth control on religious or moral grounds.

Now the Supreme Court has upheld the Trump administration's rules, declaring that they are a reasonable accommodation between church and state.

Dissenting from the opinion were Justices Ruth Bader Ginsburg and Sonia Sotomayor.

"Today, for the first time, the Court casts totally aside countervailing rights and interests in its zeal to secure religious rights to the nth degree," Ginsburg wrote.

Copyright 2021 NPR. To see more, visit https://www.npr.org.

Nina Totenberg is NPR's award-winning legal affairs correspondent. Her reports air regularly on NPR's critically acclaimed newsmagazines All Things Considered, Morning Edition, and Weekend Edition.