PHILIP A. BRIMMER, United States District Judge.
This matter is before the Court on two motions for a preliminary injunction: one filed by plaintiffs Association of Christian Schools International ("ACSI"), Samaritan Ministries International ("SMI"), Taylor University, and Indiana Wesleyan University ("IWU") [Docket No. 11] (the "original motion"), and a second motion filed by plaintiffs Asbury Theological Seminary ("ATS") and Alliance Defending Freedom ("ADF") [Docket No. 24].
Plaintiffs are Christian non-profit organizations challenging a particular aspect
The mandate requires group health plans, including both insured and self-insured employer-based plans, to include minimum coverage for a variety of preventative health measures at no cost to covered beneficiaries. 42 U.S.C. § 300gg-13(a); see also id. § 300gg-91(a) (defining "group health plan"). With respect to women's health, the Act required the Health Resources and Services Administration ("HRSA") to develop "comprehensive guidelines" that would define the required preventative services that must be covered free of charge. Id. § 300gg-13(a)(4). HRSA, in reliance on work performed by the independent Institute of Medicine, established guidelines for women's preventative services that include screening for gestational diabetes, human papillomavirus testing, counseling for sexually transmitted infections, and, as relevant to this motion, "[a]ll Food and Drug Administration approved contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity." See Health Resources and Servs. Admin., Women's Preventive Services Guidelines, http://www.hrsa.gov/womensguidelines.
In August 2011, HHS issued an interim final regulation that adopted HRSA's guidelines as applied to contraceptive coverage. See 76 Fed.Reg. 46621 (Aug. 3, 2011). In light of concerns over "the effect on the religious beliefs of certain religious employers if coverage of contraceptive services were required in the group health plans in which employees in certain religious positions participate[,]" the interim final regulation provided HRSA with discretion to exempt certain religious employers from the mandate. Id. at 46623. This exemption would apply to any employer that
Id.; see also 45 C.F.R. § 147.131(a). The stated purpose of the exemption was to "respect[] the unique relationship between a house of worship and its employees in ministerial positions." 76 Fed.Reg. at 46623. The exemption did not apply to organizations, like plaintiffs, that share the beliefs of exempt entities but do not qualify as houses of worship or their auxiliaries. The interim final regulations required employers not subject to the exemption to begin covering preventive services, including contraception, as of August 2012. Id. at 46624.
In January 2012, HHS Secretary Kathleen Sebelius announced that non-profit employers who, based on religious objections, did not provide contraceptive coverage in their insurance plans (referred to as "eligible organizations" in the regulations), would be given a one-year extension, until August 2013, to comply with the law. See Statement by U.S. Department of Health and Human Services Secretary Kathleen Sebelius (Jan. 20, 2012), available at http://www.hhs.gov/news/press/2012pres/01/20120120a.html. This "temporary enforcement safe harbor" was officially announced in February 2012, and the Departments indicated that they would work "to develop alternative ways of providing contraceptive coverage without cost sharing with respect to non-exempted, non-profit religious organizations with religious objections to such coverage." 77 Fed.Reg. 8725, 8728 (Feb. 15, 2012).
In July 2013, after the conclusion of a notice and comment period, the Departments issued final rules providing for an accommodation for eligible organizations (the "original accommodation"). 78 Fed. Reg. 39870 (July 2, 2013); see also 45 C.F.R. §§ 147.131(HHS); 26 C.F.R. § 54.9815-2713A (Treasury); 29 C.F.R. § 2590.715-2713A (DOL). The original accommodation was intended to "protect[]... nonprofit religious organizations with religious objections to contraceptive coverage from having to contract, arrange, pay,
For institutions with insured health plans, once the insurance issuer received the self-certification form, the issuer was required to "[p]rovide separate payments for any contraceptive services required to be covered ... for plan participants and beneficiaries for so long as they remain enrolled in the plan." 29 C.F.R. § 2590.715-2713A(c)(2)(i)(B). The issuer was prohibited from "impos[ing] any cost-sharing requirements ... or impos[ing] any premium, fee, or other charge, or any portion thereof, directly or indirectly, on the eligible organization, the group health plan, or plan participants or beneficiaries." Id. § 2713(A)(c)(2)(ii). In the case of self-insured health plans, when a third-party administrator received the self-certification form, it was required to "provide or arrange payments for contraceptive services" either by providing the payments itself or by arranging for an issuer or another entity to provide the payments. 29 C.F.R. § 2590.715-2713A(b)(2)(i), (ii). The third-party administrator was also prohibited from imposing any fee on the eligible organization, either directly or indirectly. Id. § 2590.715-2713A(b)(2)(ii).
In July 2014, the Supreme Court preliminarily enjoined the requirement that any party seeking to opt out of the mandate fill out Form 700 as specified in the regulations governing the original accommodation. Wheaton Coll. v. Burwell, ___ U.S. ___, 134 S.Ct. 2806, 189 L.Ed.2d 856 (2014). Specifically, the Court enjoined HHS from enforcing the original accommodation against a non-profit organization that had notified the Secretary of Health and Human Services in writing of its eligibility for the accommodation, even though the organization had not completed Form 700. Id. at 2807.
In August 2014, the Departments issued a new interim final rule in response to the Court's order in Wheaton. See 79 Fed. Reg. 51092 (Aug. 27, 2014). The new interim final rule modified the notice requirements for organizations that wished to invoke the accommodation (the "new accommodation"). See id. Consistent with the Supreme Court's order in Wheaton, the new accommodation
Id. at 51094-95. The interim final rule noted that the required information "represents the minimum information necessary for the Departments to determine which entities are covered by the accommodation, to administer the accommodation, and to implement the policies in the July 2013 final regulations." Id. at 51095. While eligible organizations are still permitted to use Form 700, they are no longer required to do so under the new accommodation.
After notice is provided to HHS, a separate notification is sent (by DOL in the case of self-insured plans or by HHS in the case of insured health plans) to the plan's third-party administrator or health insurance issuer. 79 Fed.Reg. at 51095. That notification informs the administrator or health insurance issuer of the organization's religious objection to the mandate, and provides for continuing contraceptive coverage for the organization's employees at no cost to the organization. See id.
Congress enacted RFRA in direct response to the Supreme Court's holding in Employment Division, Dep't of Human Res. of Oregon v. Smith, 494 U.S. 872, 110 S.Ct. 1595, 108 L.Ed.2d 876 (1990). In Smith, the Court held that laws of general applicability do not violate the Free Exercise Clause even if complying with those laws burdens individuals' religious beliefs. Id. at 884-85, 110 S.Ct. 1595. In so holding, the Court abandoned the "compelling interest" test that it had previously applied to claims under the Free Exercise Clause. See, e.g., Sherbert v. Verner, 374 U.S. 398, 83 S.Ct. 1790, 10 L.Ed.2d 965 (1963); Wisconsin v. Yoder, 406 U.S. 205, 92 S.Ct. 1526, 32 L.Ed.2d 15 (1972). The stated purposes of RFRA are: "(1) to restore the compelling interest test as set forth in Sherbert v. Verner ... and Wisconsin v. Yoder ... and to guarantee its application in all cases where free exercise of religion is substantially burdened; and (2) to provide a claim or defense to persons whose religious exercise is substantially burdened by government." 42 U.S.C. § 2000bb(b).
RFRA provides that "[g]overnment shall not substantially burden a person's exercise of religion even if the burden results from a rule of general applicability." 42 U.S.C. § 2000bb-1(a). RFRA recognizes only one exception, where the substantial burden (1) furthers a compelling governmental interest; and (2) is the least restrictive means of furthering that compelling governmental interest. Id. §§ (b)(1)-(2). "Congress directly referenced and incorporated the legal standards the Supreme Court used in its pre-Smith line of cases in RFRA. Constitutional free exercise clause cases that predate Smith accordingly remain instructive when determining RFRA's requirements." Priests For Life v. U.S. Dep't of Health & Human Servs., 772 F.3d 229, 2014 WL 5904732, at *9 (D.C.Cir. Nov. 14, 2014) (citing Kaemmerling v. Lappin, 553 F.3d 669, 678-80 (D.C.Cir.2008)).
Plaintiffs are non-profit organizations that object to certain methods of contraception that they believe are abortifacients, including Plan B, ella, and intrauterine devices.
To justify the issuance of a preliminary injunction, the moving party must show (1) a likelihood of success on the merits; (2) a likelihood that the movant will suffer irreparable harm in the absence of preliminary relief; (3) that the balance of equities tips in the movant's favor; and (4) that the injunction is in the public interest. RoDa Drilling Co. v. Siegal, 552 F.3d 1203, 1208 (10th Cir.2009) (citing Winter v. Natural Resources Defense Council, Inc., 555 U.S. 7, 20, 129 S.Ct. 365, 172 L.Ed.2d 249 (2008)). Because RFRA claims are analogous to First Amendment claims, plaintiffs' likelihood of success on the merits will often be the determinative factor. See Hobby Lobby Stores, Inc. v. Sebelius, 723 F.3d 1114, 1145-46 (10th Cir. 2013) (citing ACLU of Illinois v. Alvarez, 679 F.3d 583, 589 (7th Cir.2012)), aff'd by Burwell v. Hobby Lobby Stores, Inc., ___ U.S. ___, 134 S.Ct. 2751, 189 L.Ed.2d 675 (2014).
Plaintiffs' motion makes little mention of the new accommodation and why plaintiffs believe it fails to alleviate the substantial burden the mandate places on their religious exercise. See Docket No. 11 at 5-9. Plaintiffs' primary argument is that the Court should adopt the reasoning of Judge William Pryor's concurrence in Eternal Word Television Network, Inc. v. Sebelius, 756 F.3d 1339 (11th Cir.2014). In that case, the plaintiff sought a preliminary injunction based on four objections to the
In his concurrence, Judge Pryor stated that the requirement that the plaintiff deliver Form 700 to the third-party administrator of its health care plan substantially burdened the plaintiff's religious exercise because it required an action that the plaintiff believed "makes it complicit in a grave moral wrong[.]" Eternal Word, 756 F.3d at 1348. Judge Pryor further stated that "[s]o long as the [plaintiff's] belief is sincerely held and undisputed ... we have no choice but to decide that compelling the participation of the [plaintiff] is a substantial burden on its religious exercise." Id. According to Judge Pryor, as long as plaintiffs sincerely believe that an action compelled by the government substantially burdens its religious exercise, courts are powerless to conclude otherwise.
In contrast to Judge Pryor's concurrence, the Sixth, Seventh, and D.C. Circuits have rejected the argument that mandatory self-certification under Form 700 imposed a substantial burden on religious exercise by requiring religious organizations to "trigger" provision of contraceptive coverage. See Univ. of Notre Dame v. Sebelius, 743 F.3d 547 (7th Cir. 2014), Mich. Catholic Conference & Catholic Family Servs. v. Burwell, 755 F.3d 372 (6th Cir.2014), Priests For Life, 772 F.3d 229, 2014 WL 5904732. In each of these cases, the courts concluded that whether a required action substantially burdens religious exercise is a matter of law for the court to decide, regardless of the parties' sincere beliefs that submitting Form 700 made them complicit in providing contraceptive coverage. See Notre Dame, 743 F.3d at 558 ("Notre Dame may consider the [self-certification] process a substantial burden, but substantiality — like compelling governmental interest — is for the court to decide"); see also Mich. Catholic Conference, 755 F.3d at 385 ("although we acknowledge that the [plaintiffs] believe that the regulatory framework makes them complicit in the provision of contraception, we will independently determine what the regulatory provisions require and whether they impose a substantial burden on [plaintiffs'] exercise of religion"); Priests for Life, 772 F.3d 229, 2014 WL 5904732 at *12 ("[a]ccepting the sincerity of [p]laintiffs' beliefs, however, does not relieve this Court of its responsibility to evaluate the substantiality of any burden on [p]laintiffs' religious exercise, and to distinguish [p]laintiffs' duties from obligations imposed, not on them, but on insurers and [third-party administrators].").
The Court finds that plaintiffs' argument that the mere invocation of a sincerely held belief divests the court of discretion to decide whether a governmental
Plaintiffs' interpretation is also inconsistent with the Tenth Circuit's application of the "substantial burden" requirement. For example, in Abdulhaseeb v. Calbone, 600 F.3d 1301, 1321 (10th Cir.2010), the Tenth Circuit considered a Muslim inmate's claim that prison officials who had forced him to accept certain foods on his meal tray substantially burdened his religious exercise under the Religious Land Use and Institutionalized Persons Act ("RLUIPA"), 42 U.S.C. § 2000cc et seq.
Although the facts of Abdulhaseeb are different from this case, the Abdulhaseeb court recognized that under RLUIPA, and by extension under RFRA, courts may properly find that certain burdens on religious exercise are de minimis and not substantial. Accordingly, notwithstanding the sincerity of plaintiffs' beliefs as to the effect of complying with the mandate, the Court has an independent obligation to analyze the actions required of plaintiffs and to determine whether the compelled action rises to the level of a substantial burden.
Plaintiffs state that their religious convictions do not allow them to "pay for, facilitate, enable, or otherwise support access to abortion[.]" Docket No. 23 at 2, ¶ 2. The new accommodation does not require them to do so. All that plaintiffs are required to do under the new accommodation is provide a single sheet of paper that attests to their sincere religious objection
Plaintiffs argue that under the mandate, plaintiffs' decision to offer their employees health benefits is a but-for cause of those employees' access to free abortifacients. Docket No. 19 at 8. The concept of but-for causation, however, goes too far in this context. See Notre Dame, 743 F.3d at 554-55. Plaintiffs have no right to "require the Government to conduct its own internal affairs in ways that comport with the religious beliefs of particular citizens." Bowen v. Roy, 476 U.S. 693, 699, 106 S.Ct. 2147, 90 L.Ed.2d 735 (1986) (holding, in a pre-Smith Free Exercise Clause case, that plaintiff's religious exercise was not burdened by the government's use of his daughter's social security number). Accordingly, plaintiffs "do not suffer substantial burdens under RFRA where the only harm to them is that they sincerely feel aggrieved by their inability to prevent what other people would do to fulfill regulatory objectives after they opt out." Priests for Life, 772 F.3d 229, 2014 WL 5904732 at *11.
For the foregoing reasons, it is