by Leslie C. Griffin, Boyd Professor of Law, UNLV Boyd School of Law
Should judges tell the Little Sisters of the Poor, a group of Roman Catholic nuns who devote their lives to caring for the elderly poor, how to analyze moral complicity?
That’s a question the Supreme Court will consider on Friday, October 30, when the Justices decide whether to grant certiorari on cases brought by religious nonprofits challenging the contraceptive mandate of the Affordable Care Act (ACA). This particular question about nuns and moral complicity comes from the pen of Paul Clement, the seasoned Supreme Court litigator who represents the sisters. Clement and the Sisters are competing with the Archbishop of Washington for the attention of the Court.
Background: Challenges to the Accommodation, not the Contraceptive Mandate
The ACA requires employers to provide insurance coverage for preventive health services, which for women include reproductive care. The insurance regulations specifically require employer health care plans to cover twenty FDA-approved contraceptives as well as sterilization procedures and reproductive counseling.
The Little Sisters are among 140 plaintiffs in 56 cases brought by religious nonprofits challenging, not the contraceptive mandate itself, but the accommodation that allows religious employers to opt out of the mandate. Under the opt-out mechanism, the employer merely has to inform the Department of Health and Human Services (HHS) of its objection to contraception, identify what kind of insurance plan it offers, and provide the name and contact information of the insurance plans’ third party administrators (TPAs) and health insurance issuers. Once HHS or the insurers receive the notification, the burden of coverage shifts completely to the TPAs and health insurance companies, who provide the contraceptive coverage in separate plans, with no financial input from the religious employers.
The religious nonprofits argue that this accommodation violates the Religious Freedom Restoration Act (RFRA), which holds that [g]overnment may substantially burden a person’s exercise of religion . . . [only if it is] in furtherance of a compelling government interest; and it is the least restrictive means of furthering that government interest.”
How Many Angels Can Dance on the Head of a Pin?
A central debate in the cases is whether the “substantial burden” of RFRA is a theological term or a legal one. As Paul Clement’s question suggests, the moral casuistry of these cases would make a medieval monk proud. Unlike many of the non-Catholic plaintiffs, who oppose only four of the contraceptives that they believe to be abortifacient, all the Catholic plaintiffs believe that the use of artificial contraception is always immoral. The Sisters therefore believe that even signing the compliance form would “make them morally complicit in grave sin.” Their lawyer argues that the courts may not question that this moral belief is automatically a substantial burden under RFRA because it appears substantial to the sisters.
The plaintiffs differ about just where the immorality occurs – in providing insurance, in signing the form, in authorizing the TPAs, in knowing that contraceptive access will occur, all of the above, or none of the above. Although the moral description varies from case to case, however, the plaintiffs uniformly want no judicial scrutiny of their moral analyses.