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U.S. Supreme Court Considers ACA Contraception Coverage Changes -- Update

Updated: Oct 7

By Leah Gonzalez


July 10, 2020


On July 8, 2020, the United States Supreme Court ruled to allow employers and insurers to cite religious or moral objections and opt out of the Affordable Care Act (ACA) provision that ensures contraceptive services, and all FDA-approved contraceptive methods, are available through employer-sponsored health plans at no cost to the client.

This means that more employers now have the option to decide whether their employees have access to contraception and puts the contraceptive coverage that millions of women rely on at risk.


Since the ACA was implemented, there’s been a consistent campaign to degrade the contraception provision.

  • Initially, ACA regulations allowed exemptions for places of worship and provided religiously affiliated non-profit organizations the opportunity to apply for an accommodation in which the employer did not have to pay for contraception coverage.

  • As a result of the 2014 Hobby Lobby case, the accommodation application process was extended to certain for-profit corporations. 

  • The 2020 Supreme Court decision upholds the new regulations finalized in 2018 that allow any employer with a religious or moral objection to bypass any exemption or accommodation application process and simply choose not to include contraceptive services in their employee coverage plans.

Though the rule was upheld, the fight is not necessarily over. The case was sent back down to lower courts and litigation will likely continue. Additionally, if a different federal administration is voted into office in November, new rules reversing these changes could be issued.

May 28, 2020


Earlier this month, the U.S. Supreme Court heard oral arguments regarding the Affordable Care Act (ACA) provision that ensures contraceptive services, and all FDA-approved contraceptive methods, are available through employer-sponsored health plans at no cost to the client.

In October 2017, the administration issued two rules that allow broad exemptions for insurers and employers to claim a moral or religious objection to providing contraceptive coverage. A process already existed for employers who chose not to participate due to religious objection, but these new rules could vastly increase the number of employers able to opt out of covering contraceptive services.

During the comment period on the proposed changes, the Texas Women’s Healthcare Coalition (TWHC) submitted comments to the administration. At the same time, Pennsylvania and New Jersey sued the federal government, which led to a nationwide injunction that halted the implementation of the changes. During the interim, multiple intervention attempts were made, and in December 2019, the administration, along with the Little Sisters of the Poor – a Catholic religious institute for women – filed petitions to have the issue heard by the Supreme Court. By January 2020, the request was approved to move forward.

Oral arguments were taken by phone earlier this month, and a decision is expected by late June, but may be delayed. Though supporting and clarifying documents were submitted to the Court from national partners, and strong arguments were made, experts anticipate a ruling in favor of the administration. This would allow the October 2017 rules to go into effect, which puts contraceptive coverage that millions of women rely on – including over four million women in Texas who depend on the contraceptive coverage guarantee for no-cost birth control and contraceptive services – at risk.

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The Texas Women's Healthcare Coalition is a project of Healthy Futures of Texas, a 501(c)(3) non-profit based in San Antonio.

©2020 by Texas Women's Healthcare Coalition.