Supreme Court Hears Case Challenging Trump-Pence Denial of Birth Control Coverage


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On May 6 the Supreme Court heard arguments in a case of national significance that could have a huge impact on the ability of women across the country to access birth control. 

The case, Trump v. Pennsylvania, challenges the Trump-Pence Administration’s efforts to allow virtually any employer or university to deny its employees and students the birth control coverage required by the Affordable Care Act (ACA).  

The Center for Reproductive Rights joined 20 other organizations, led by Americans United for Separation of Church and State, in filing a “friend of the court” brief in the case, telling the Supreme Court, “Through the rulemaking challenged here, the government has sought to...[establish] religious and moral exemptions that effectively nullify the contraceptive-coverage requirement’s protections for hundreds of thousands of women...” 

In a separate case, the Center and its partners in 2018 sued the Trump-Pence Administration and the University of Notre Dame, after the University opted to deny students, employees, and their dependents the birth control coverage required by the ACA. Notre Dame claims that its actions have been independently sanctioned by the Trump Administration through a contract that the University executed with the federal government, and also based on the challenged rulemaking being considered by the Supreme Court in Trump v. Pennsylvania. 

Trump’s Expanded Religious Exemptions Put Birth Control Coverage at Risk for Many 

The Affordable Care Act guarantees that health plans provide preventive care for women at no cost. Federal guidelines specify that this includes access to FDA-approved birth control. 

This coverage is essential to the health and well-being of women and families across the country. For those with lower incomes especially, effective birth control was a burdensome expense before the ACA’s contraceptive coverage guarantee, which explicitly requires insurance plans to cover preventative services at no cost to the covered individual.  

Houses of worship and religious nonprofits are exempt from the birth control coverage guarantee, and the Supreme Court ruled in Burwell v. Hobby Lobby (2014) that small corporations with religious objections can also opt out. 

The no-cost birth control guarantee remained intact for most Americans until 2017, when the Trump Administration introduced new rules that would expand the exemption so broadly that it could render the birth control guarantee meaningless for millions of Americans. Under the rules, any entity, whether non-profit or for-profit, could deny birth control coverage for its workers or students as long as it claimed to have religious or even moral objections. 

“Moral” in this context is a term so broad and so vague that it allows companies to offer almost any excuse they want to get out of providing cost-free access to birth control coverage for their employees. 

The question the Court will address in Trump v. Pennsylvania is whether the Trump-Pence Administration has the authority to create such broad exemptions from the ACA’s birth control coverage guarantee. 

Defending ACA’s No-Cost Birth Control Coverage 

Several states challenged the Trump-Pence Administration’s vast expansion of these so-called "conscience" exemptions. In this case, Pennsylvania argues that the government does not have legal authority to broadly exempt private employers from the ACA’s birth control coverage guarantee.  

Lower courts repeatedly agreed with the states and blocked the Trump-Pence Administration’s rules from taking effect. The administration then asked the Supreme Court to hear the case. 

The amicus brief filed by religious and civil-rights organizations, including the Center, notes, “The rights to believe and practice one’s faith, or not, are sacrosanct. But they do not extend to imposing on others by operation of law the costs and burdens of one’s beliefs. Government should not, and under the Establishment Clause cannot, favor the religious beliefs of some at the expense of the rights, beliefs, and health of others.” 

The Trump-Pence Administration’s rules eviscerate the ACA’s birth control coverage guarantee, as Center staff attorneys Scott Ruskay-Kidd and Joel Dodge wrote for the American Constitution Society in 2019: “These extreme rules purport to interpret the Affordable Care Act’s landmark contraceptive coverage guarantee, but perversely hollow it out...Any company that chooses to – think Nasdaq or Fortune 500 – can claim an exemption, as can any private university.” 

The Supreme Court heard arguments in Trump v. Pennsylvania via teleconference, because of the COVID-19 pandemic, with the proceedings streamed live. Click here for a replay of the May 6 oral arguments. 

The Supreme Court may issue a ruling in the case before the end of its term in June.