COGAN, District Judge.
The Patient Protection and Affordable Care Act (the "ACA"), Pub. L. No. 111-148, 124 Stat. 119 (2010), requires that group health insurance plans cover certain preventative medical services without cost-sharing, such as a copayment or a deductible. Pursuant to regulations subsequently issued, the preventative services that must be covered include contraception, sterilization, and related counseling (the "Coverage Mandate" or "Mandate"). Certain religious employers, primarily churches, are exempt from this requirement. Further, the Government has recently promulgated regulations that seek to accommodate the religious objections of "eligible organizations," namely religious non-profits. Under this accommodation, "eligible organizations" do not have to pay for a health plan that covers contraceptive services; instead, an eligible organization must provide its issuer or third party administrator ("TPA") with a self-certification form stating its objection to the Mandate on religious grounds. The issuer or TPA is then required to provide contraceptive coverage without charging the eligible organization any fees or premiums, and without imposing any cost-sharing on the beneficiary.
Plaintiffs are six New York-area organizations affiliated with the Roman Catholic Church. Plaintiffs state that their Catholic beliefs prohibit them from providing, subsidizing, facilitating, or sponsoring the provision of contraception, sterilization, or abortion-inducing products and services. The Mandate, they argue, requires them to violate these core religious beliefs, regardless of the exemption for religious employers or the accommodation for eligible organizations. Plaintiffs bring claims under the Religious Freedom Restoration
Plaintiffs have moved for summary judgment as to all of their claims, seeking a preliminary and permanent injunction against enforcement of the Mandate against them. Defendants have cross-moved for summary judgment. For the reasons set forth below, plaintiffs' motion for summary judgment on their RFRA claims is granted in part and denied in part, and defendants' motion for summary judgment is granted in part and denied in part.
The six plaintiffs are all entities affiliated with the Roman Catholic Church. In their complaint, they allege that the Coverage Mandate forces them to choose between violating the tenets of their religious faith or paying substantial penalties. In particular, if plaintiffs want to avoid the penalties for non-compliance with the Mandate, they must authorize a third party to engage in activity, namely the provision of contraceptives, in which they themselves are religiously forbidden from engaging.
The Roman Catholic Archdiocese of New York (the "Archdiocese") is a non-profit organization that encompasses 370 parishes located in the New York area. It administers numerous charitable and educational programs, which, in line with Catholic teachings, are not aimed solely at Catholics, but are meant to benefit the broader community. The Archdiocese, its parishes, and its institutions employ nearly 10,000 people, almost 8,000 of whom are lay people. The Archdiocese does not know how many of its employees are Catholic.
The Archdiocese operates a self-insured health plan, underwriting its employees' medical costs. Its health plan and pharmaceutical coverage are administered by third parties. The plan year for the Archdiocese's plan begins on January 1. Consistent with Catholic teaching, the plan currently does not cover abortifacients, sterilization, or contraception.
Cardinal Spellman High School ("Cardinal Spellman") and Monsignor Farrell High School ("Monsignor Farrell") are two Catholic high schools located in the Bronx and Staten Island, respectively. Monsignor Farrell has 74 employees, and Cardinal Spellman has over 100. These schools both employ and educate individuals of all faiths. Employees at both high schools are currently covered under the Archdiocese's health plan, which, as stated, does not currently provide contraceptive coverage.
Catholic Health Care System and its affiliates, the Continuing Care Community of the Archdiocese of New York (collectively, "ArchCare"), are non-profit organizations
The Roman Catholic Diocese of Rockville Centre, New York (the "Diocese") is a nonprofit organization that encompasses 134 parishes in Nassau and Suffolk counties. The Diocese is responsible for numerous charitable and educational programs for the benefit of Catholics and non-Catholics alike. Together with its hospitals, schools, parishes and other associated institutions, the Diocese employs nearly 20,000 people.
Employees of both the Diocese and its affiliated charitable and educational organizations receive health care coverage through the Diocese's health plan, which covers over 4,500 people. The Diocese operates a self-insured health plan, administered by a TPA, underwriting its employees' medical costs. The plan does not cover abortifacients, sterilization, or contraception.
Catholic Health Services of Long Island ("CHSLI") is a non-profit organization that oversees Catholic health care organizations within the Diocese, including six hospitals, three nursing homes, and a hospice service. Neither CHSLI nor its member institutions condition employment or receipt of medical services on being Catholic.
CHSLI operates a self-insured health plan for its employees and employees of its member institutions, underwriting the plan while contracting with third parties for administration of the plan. The plan covers approximately 25,000 people. Like the other plaintiffs, consistent with Catholic teaching, CHSLI's plan does not cover abortifacients, sterilization, or contraception.
The Coverage Mandate is the result of a complex history of Congressional legislation and agency rulemaking involving the Department of Labor ("DoL"), the Department of the Treasury ("DoT"), and the Department of Health and Human Services ("HHS") (collectively, the "Departments").
In March 2010, Congress enacted the ACA as well as the Health Care and Education Reconciliation Act. These acts established a number of requirements relating to "group health plans," a term which encompasses employer plans that provide health care coverage to employees, regardless of whether the plans are insured or self-insured. See 42 U.S.C. § 300gg-91(a)(1); Interim Final Rules for Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventative Services Under the Patient Protection and Affordable Care Act, 75 Fed.Reg. 41,726, 41,727 (July 19, 2010) ("Interim Final Rules"). As is relevant here, the ACA requires that group health plans provide coverage for a number of preventative medical services at no charge to the patient. § 300gg-13. Specially, the ACA provides that a group health plan must "at a minimum provide coverage for and shall not impose any cost sharing requirements for[,]" among other things, women's "preventative care and screenings ... as
The ACA's preventative services coverage requirement does not apply, however, to group health plans that are "grandfathered." See 42 U.S.C. § 18011(a)(2). A group health plan is grandfathered when at least one person was enrolled in the plan on March 23, 2010 and the plan has continually covered at least one individual since that date. See 26 C.F.R. § 54.9815-1251T(a)(1)(i)(DoT); 29 C.F.R. § 2590.715-1251(a)(1)(i)(DoL); 45 C.F.R. § 147.140(a)(1)(i)(HHS). A plan may lose its grandfathered status if, when compared to the terms of the plan as of March 23, 2010, it eliminates benefits, increases a percentage cost-sharing requirement, significantly increases a fixed-amount cost-sharing requirement, significantly decreases an employer's contribution rate, or imposes or lowers an annual limit on the dollar value of benefits. See 26 C.F.R. § 54.9815-1251T(g)(1)(DoT); 29 C.F.R. § 2590.715-1251(g)(1)(DoL); 45 C.F.R. § 147.140(g)(1)(HHS). It is undisputed that none of plaintiffs' plans qualify as grandfathered due to changes made within the past two years.
The Departments began issuing regulations implementing the ACA in phases. On July 19, 2010, they announced that HHS was developing the HRSA guidelines and expected to issue them by August 1, 2011. See Interim Final Rules, 75 Fed.Reg. at 41,728. Because there were no existing HRSA guidelines concerning preventative care and screenings for women at the time of the Interim Final Rules, HHS commissioned the Institute of Medicine ("IOM"), a Congressionally-funded body, with "review[ing] what preventative services are necessary for women's health and well-being" and recommending comprehensive guidelines, as called for by the ACA. On July 19, 2011, IOM published a report recommending the inclusion of certain preventative medical services in HRSA's guidelines. Among other things, IOM recommended that group health plans be required to cover "the full range of Food and Drug Administration ["FDA"]-approved contraceptive methods, sterilization procedures, and patient education and counseling for women with reproductive capacity." FDA-approved contraceptive methods encompass oral conceptive pills, diaphragms, intrauterine devices, and emergency contraceptives such as Plan B, which, according to plaintiffs, can cause abortions.
HRSA adopted IOM's recommendations on August 1, 2011. Two days later, the Interim Final Rules were amended to "provide HRSA additional discretion to exempt certain religious employers from the [HRSA] Guidelines where contraceptive services are concerned." 76 Fed.Reg. 46,623 (Aug. 3, 2011). See also 45 C.F.R. § 147.130(a)(1)(iv)(A). In order to qualify for the religious employer exemption under the Interim Final Rules, an organization was required to meet certain criteria.
The Departments received over 200,000 responses to their request for comments on the amended Interim Final Rules. Many of the comments were submitted by religiously-affiliated institutions and asserted that the religious employer exemption was too narrow and that the limited scope of the exemption raised religious liberty concerns. Id. at 8,727. On February 15, 2012, the Departments finalized the amended Interim Final Rules without making any changes to the criteria used to determine whether an organization qualified for the religious employer exemption. Id.
At the same time that they finalized the Interim Final Rules, however, the Departments announced a "temporary enforcement safe harbor" period during which they planned "to develop and propose changes to these final regulations that would meet two goals — providing contraceptive coverage without cost-sharing to individuals who want it and accommodating non-exempted, non-profit organizations' religious objections to covering contraceptive services[.]" Id. Consistent with their announced plan "to develop and propose changes" to the Interim Final Rules, on March 21, 2012, the Departments filed an advance notice of proposed rulemaking ("ANPRM") in the Federal Register concerning possible means of accommodating religious organizations' objections to the Coverage Mandate. See Certain Preventative Services under the Affordable Care Act, 77 Fed.Reg. 16,501 (Mar. 21, 2012). The stated purpose of the ANPRM was to "amend the criteria for the religious employer exemption to ensure that an otherwise exempt employer plan is not disqualified because the employer's purposes extend beyond the inculcation of religious values or because the employer serves or hires people of different religious faiths," and to "establish accommodations for health coverage established or maintained by eligible organizations, or arranged by eligible organizations that are religious institutions of higher education, with religious objections to contraceptive coverage." 78 Fed.Reg. 8459 (Feb. 6, 2013). Defendants received over 400,000 comments (many of them standardized form letters) in response to the proposals set forth in the ANPRM and, in July 2013, issued rules finalizing the Mandate. See 78 Fed.Reg. 39,870, 39,871 (July 2, 2013) (the "Final Rules").
The Final Rules purport to accommodate religious objections to the Mandate in two ways. First, the Final Rules revised the definition of "religious employers," who are entirely exempt from the Mandate. The Final Rules define "religious employer" as a non-profit referred to in § 6033(a)(3)(A)(i) or (iii) of the Internal Revenue Code, which in turn refers to churches, their integrated auxiliaries, associations of churches, and the exclusively religious activities of religious orders. 78 Fed.Reg. at 39,874. The Archdiocese and Diocese (the "Diocesan plaintiffs" or "exempt plaintiffs") meet this definition and are thus exempt from the Mandate. The remaining plaintiffs (the "non-Diocesan plaintiffs" or "non-exempt plaintiffs") are not exempt. This includes the plaintiffs that participate in the Archdiocese's health plan, because non-exempt entities cannot avail themselves of the religious employer exemption unless they "independently meet the definition of religious employer." Id. at 39,886.
45 C.F.R. § 147.131(b).
There is no dispute that all of the non-Diocesean plaintiffs in this action qualify for this accommodation. The Final Rules state that an eligible organization is not required to "contract, arrange, pay, or refer for contraceptive coverage" as to which it has religious objections. 78 Fed.Reg. at 39,874. Instead, the eligible organization must complete a self-certification form stating that it is an eligible organization, and provide a copy of that form to its issuer or, where an eligible organization self-insures, as do all plaintiffs here, to their TPA. The TPA is then required to provide or arrange for payments for contraceptive services, a requirement imposed through the Department of Labor's ERISA enforcement authority. See id. at 39,879-39,880. The self-certification "will be treated as a designation of the third party administrator(s) as plan administrator and claims administrator for contraceptive benefits pursuant to section 3(16) of ERISA." Id. at 39,879. The TPA is required to provide these services "without cost sharing, premium, fee, or other charge to plan participants or beneficiaries, or to the eligible organization or its plan." Id. at 39,879-80. The TPA may seek reimbursement for such payments through adjustments to its Federally-Facilitated Exchange ("FFE") user fees. Id. at 39,882.
In December 2012, this Court denied in large part defendants' motion to dismiss for lack of standing. See Roman Catholic Archdiocese of New York v. Sebelius, 907 F.Supp.2d 310 (E.D.N.Y.2012).
Late in the briefing of these motions — specifically, in their opposition to plaintiffs' motion for summary judgment filed November 1, 2013 — the Government "realized" for the first time that all of the plaintiffs' health plans are "church plans" as defined under Section 3(33) of the Employee Retirement Income Security Act (ERISA), 29 U.S.C. § 1002(33). As mentioned, the challenged regulations enforce the contraceptive coverage requirements against the TPAs of eligible organizations with self-insured group plans through the Department of Labor's ERISA enforcement authority. See 78 Fed.Reg. at 39,879-39,880. Church plans, however, are specifically excluded from the ambit of ERISA. See 29 U.S.C. § 1003(b)(2). The Government states that it thus has no authority to require the plaintiffs' TPAs to provide contraceptive coverage at this time. Therefore, the Government argues, all of the plaintiffs lack standing because the regulations will not actually force plaintiffs' TPAs to provide coverage for the objectionable services.
The Government's belated "realization" that the challenged regulations may not actually result in the provision of contraceptive coverage to plaintiffs' employees is difficult to fathom. Not only did the Archdiocese and Diocese state, in declarations filed in August with their initial moving papers, that they (and therefore the plaintiff high schools also covered by the Archdiocese's health plan) participate in church plans, but in both the Interim Final Rules and ANPRM, defendants noted proposals to define both "religious employer" and "eligible organization" as organizations that have health plans qualifying as church plans under ERISA. See 77 Fed.Reg. at 8,727 ("[C]ommenters referenced alternative standards, such as tying the [religious employer] exemption to the definition of `church plan'"); 77 Fed.Reg. at 16,504 ("[T]he intended regulations could base their definition [of an eligible organization] on another Federal law, such as section
Regardless, plaintiffs have alleged an injury-in-fact sufficient for Article III standing. It is well established that a plaintiff "may have a spiritual stake in First Amendment values sufficient to give standing to raise issues concerning the Establishment Clause and the Free Exercise Clause." Ass'n of Data Processing Serv. Orgs., Inc. v. Camp, 397 U.S. 150, 154, 90 S.Ct. 827, 830, 25 L.Ed.2d 184 (1970). The Government misunderstands the nature of plaintiffs' alleged injury. Plaintiffs do not object simply to the provision of contraceptive coverage to their employees. If that were plaintiffs' claim, then perhaps the uncertainty over whether their TPAs would actually provide such coverage would run afoul of the Article III requirement that "threatened injury must be certainly impending to constitute injury in fact, and that [a]llegations of possible future injury are not sufficient." Clapper v. Amnesty Int'l USA, ___ U.S. ___, 133 S.Ct. 1138, 1147, 185 L.Ed.2d 264 (2013) (quotation omitted; emphasis and alteration in original).
But plaintiffs' alleged injury is that the Mandate renders them complicit in a scheme aimed at providing coverage to which they have a religious objection. This alleged spiritual complicity is independent of whether the scheme actually succeeds at providing contraceptive coverage. It is undisputed that all of the non-exempt plaintiffs will still have to either comply with the Mandate and provide the objectionable coverage or self-certify that they qualify for the accommodation. See 78 Fed.Reg. at 39,893, 39,894-95. Plaintiffs allege that their religion forbids them from completing this self-certification, because to them, authorizing others to provide services that plaintiffs themselves cannot is tantamount to an endorsement or facilitation of such services. Therefore, regardless of the effect on plaintiffs' TPAs, the regulations still require plaintiffs to take actions they believe are contrary to their religion. As for the plaintiffs that qualify for the religious employer exemption, plaintiffs allege that the Diocese and Archdiocese will have to choose between complying with the Mandate by providing the objectionable coverage or ejecting their non-exempt affiliates from their health plans. Leaving aside for now the merits of these claims, as a court must, see Ross v. Bank of America, N.A., 524 F.3d 217, 222 (2d Cir.2008), plaintiffs have adequately alleged an injury-in-fact.
Summary judgment is warranted where there are no genuine disputes of material fact, such that the moving party is entitled to judgment as a matter of law. FED. R. CIV. P. 56(a). No genuine factual issue exists when the moving party demonstrates, on the basis of the pleadings and admissible evidence, and after drawing all inferences and resolving all ambiguities in favor of the non-movant, that no rational jury could find in the non-movant's favor. See Chertkova v. Conn. Gen. Life Ins. Co., 92 F.3d 81, 86 (2d Cir.1996). A party may not defeat a motion for summary judgment solely through "unsupported assertions" or conjecture. Goenaga v. March of Dimes Birth Defects Found., 51 F.3d 14, 18 (2d Cir.1995). "Conclusory allegations or denials are ordinarily not sufficient to defeat
Congress adopted the RFRA in response to the Supreme Court's decision in Employment Division, Department of Human Resources of Oregon v. Smith, 494 U.S. 872, 110 S.Ct. 1595, 108 L.Ed.2d 876 (1990). There, the Supreme Court upheld an Oregon statute that denied unemployment benefits to drug users over a challenge by Native Americans who used peyote in religious ceremonies. The Court held that the First Amendment's Free Exercise Clause does not prohibit burdens on religious practices if they are imposed by neutral laws of general applicability, and declined to apply the "compelling government interest" test to claims brought solely under the Free Exercise Clause. "In effect, Smith create[d] a `safe harbor' — if the law is `a valid and neutral law of general applicability,' then it must simply be rationally related to a legitimate government end." United States v. Hardman, 297 F.3d 1116, 1126 (10th Cir.2002).
Congress enacted the RFRA three years later. Finding that Smith "virtually eliminated the requirement that the government justify burdens on religious exercise imposed by laws neutral toward religion," and that "the compelling interest test as set forth in prior Federal court rulings is a workable test for striking sensible balances between religious liberty and competing prior governmental interests," 42 U.S.C. § 2000bb(a), Congress declared that the purpose of the RFRA was to "restore the compelling interest test as set forth in Sherbert v. Verner, 374 U.S. 398, 83 S.Ct. 1790, 10 L.Ed.2d 965 (1963) and Wisconsin v. Yoder, 406 U.S. 205, 92 S.Ct. 1526, 32 L.Ed.2d 15 (1972), and to guarantee its application in all cases where free exercise of religion is substantially burdened." 42 U.S.C. § 2000bb(b).
In City of Boerne v. Flores, 521 U.S. 507, 117 S.Ct. 2157, 138 L.Ed.2d 624 (1997), the Supreme Court held the RFRA unconstitutional as applied to state and local governments because it exceeded Congress's authority under § 5 of the Fourteenth Amendment. The Court did not, however, address the RFRA's constitutionality as applied to federal law. After Boerne, "[e]very appellate court that has squarely addressed the question has held that the RFRA governs the activities of federal officers and agencies." Hankins v. Lyght, 441 F.3d 96, 105-06 (2d Cir.2006) (collecting cases).
Under the RFRA, the federal Government may not "substantially burden a person's exercise of religion even if the burden results from a rule of general applicability, except as provided in subsection (b)." 42 U.S.C. § 2000bb-1(a). Subsection (b) of § 2000bb-1 qualifies the ban on substantially burdening the free exercise of religion, providing that the "[g]overnment may substantially burden a person's exercise of religion only if it demonstrates that application of the burden to the person — (1) is in furtherance of a compelling governmental interest; and (2) is the least restrictive means of furthering that compelling governmental interest." 42 U.S.C. § 2000bb-1(b). In 2000, Congress expanded the definition of "exercise of religion" to include "any exercise of religion, whether or not compelled by, or central to, a system of religious belief." 42 U.S.C. §§ 2000bb-2(4), 2000cc-5(7)(A). The RFRA applies retrospectively and prospectively to "all Federal
This case is not the first challenge to the Mandate on religious grounds. Secular, for-profit corporations have brought a number of suits alleging that the Mandate violated the RFRA and the Free Exercise clause. The Seventh, Tenth, and D.C. Circuit Courts of Appeal have granted preliminary injunctions to some of these plaintiffs, holding that they had demonstrated a strong likelihood of success on their claim that the Mandate violates the RFRA. See Korte v. Sebelius, 735 F.3d 654 (7th Cir. 2013); Gilardi v. U.S. Dep't of Health and Human Servs., 733 F.3d 1208 (D.C.Cir. 2013); Hobby Lobby Stores, Inc. v. Sebelius, 723 F.3d 1114 (10th Cir.2013) (en banc), cert. granted, ___ U.S. ___, 134 S.Ct. 678, 187 L.Ed.2d 544 (2013). The Third and Sixth Circuits have reached the opposite conclusion, reasoning that secular, for-profit corporations cannot engage in "religious exercise." See Autocam Corp. v. Sebelius, 730 F.3d 618 (6th Cir.2013); Conestoga Wood Specialties Corp. v. Sec'y of U.S. Dep't of Health and Human Servs., 724 F.3d 377 (3d Cir.2013), cert. granted, ___ U.S. ___, 134 S.Ct. 678, 187 L.Ed.2d 544 (2013). However, none of the plaintiffs in these cases were eligible for the accommodation, and thus none of these cases bear directly on the issue at hand. To this Court's knowledge, only one district court has ruled on whether the Mandate violates the RFRA as applied to religious non-profits; that court entered a preliminary injunction in two related actions, enjoining enforcement of the Mandate against non-profit Catholic entities similarly situated to the plaintiffs here. See Zubik v. Sebelius, 983 F.Supp.2d 576, Nos. 13-cv-1459, 13-cv-0303, 2013 WL 6118696 (W.D.Pa. Nov. 21, 2013).
In order to prevail on their RFRA claim, plaintiffs must first demonstrate that the Mandate has placed a substantial burden on their sincerely held religious beliefs. Plaintiffs state that their religious beliefs prohibit them from "facilitating access to abortion-inducing products, contraception, sterilization, and related counseling."
Rather, the core of the parties' dispute is how a court should determine whether a law imposes a "substantial burden" on religious exercise under the RFRA. It is undisputed — and indeed indisputable — that the substantial burden inquiry does not permit a court to determine the centrality of a particular religious practice to an adherent's faith. The RFRA states that explicitly, see 42 U.S.C. §§ 2000bb-2(4), 2000cc-5(7)(A), and the Supreme Court's Free Exercise cases are equally clear. See Thomas v. Review Bd. of Ind. Emp't Sec.
Drawing on this principle and the recent decisions of the Seventh and Tenth Circuits, plaintiffs contend that the Court's "only task is to determine whether the claimant's belief is sincere, and if so, whether the government has applied substantial pressure on the claimant to violate that belief." Hobby Lobby, 723 F.3d at 1137; see also Korte, 735 F.3d at 683. The Government contends that, in addition to analyzing the magnitude of the pressure exerted on a plaintiff, a court must independently analyze the character and nature of the acts required by the challenged law, an "objective" inquiry for which "the Constitution, rather than an individual's religion, must supply the frame of reference." Bowen v. Roy, 476 U.S. 693, 701 n. 6, 106 S.Ct. 2147, 90 L.Ed.2d 735 (1986). According to the Government, under plaintiffs' formulation, "the standard expressed by Congress under the RFRA would convert to an `any burden' standard." Conestoga Wood Specialities Corp. v. Sebelius, 917 F.Supp.2d 394, 413-14 (E.D.Pa.2013).
The RFRA does not define the term "substantial burden." The legislative history surrounding the 2000 passage of the Religious Land Use and Institutionalized Persons Act ("RLUIPA") and amendment of the RFRA indicates that this was an intentional omission, reflecting Congress's intent to incorporate the Supreme Court's jurisprudence in defining a "substantial burden."
Courts have identified three broad ways in which religious exercise may be substantially burdened. Government action may: (1) compel the plaintiff to do something that is inconsistent with his religious beliefs; (2) forbid the plaintiff from doing something that his religion motivates him to do; or (3) not directly compel the plaintiff to do something forbidden by his religious beliefs or to refrain from doing something motivated by those beliefs, but instead put substantial pressure on the plaintiff to do so. See Hobby Lobby, 723 F.3d at 1138 (citing Abdulhaseeb v. Calbone, 600 F.3d 1301, 1315 (10th Cir.2010)). This case could be placed into the third category, as the Tenth Circuit did, if viewed as applying indirect pressure to force plaintiffs into a "Hobson's choice" between violating their religious beliefs and paying substantial fines. See Hobby Lobby, 723 F.3d at 1141. However, it seems that the first category is a better fit — the Mandate directly compels plaintiffs, through threat of onerous penalties, to undertake actions that their religion forbids. See id. at 1151-52 (Hartz, C.J., concurring); Korte, 735 F.3d at 707 (Rovner, C.J., dissenting).
Rather than whether the pressure is indirect or direct, it seems that the more important distinction for the case at bar is between government action that pressures an individual to act inconsistently with his beliefs, and government action that discourages a plaintiff from acting consistently with those beliefs. See Sherbert, 374 U.S. at 402-03, 83 S.Ct. 1790 (noting that although the government may not "compel affirmation of a repugnant belief," the Court "has rejected challenges under the Free Exercise Clause to governmental regulation of certain overt acts prompted by religious beliefs"); Braunfeld v. Brown, 366 U.S. 599, 603, 81 S.Ct. 1144, 1146, 6 L.Ed.2d 563 (1961) ("The freedom to hold religious beliefs and opinions is absolute.... However, the freedom to act, even when the action is in accord with one's religious convictions, is not totally free from legislative restrictions."). Cases where the Supreme Court has declined to apply strict scrutiny have generally involved laws that make a religious activity more difficult, without pressuring the individual to actively violate their religious beliefs. See Lyng v. Nw. Indian Cemetery Protective Ass'n, 485 U.S. 439, 449-50, 108 S.Ct. 1319, 1325-26, 99 L.Ed.2d 534 (1988) (noting that although "the challenged Government action would interfere significantly with private persons' ability to pursue spiritual fulfillment according to their own religious beliefs," the plaintiffs would not "be coerced by the Government's action into violating their religious beliefs; nor would ... governmental action penalize religious activity by denying any person an equal share of the rights, benefits, and privileges enjoyed by other citizens"); Tony and Susan Alamo Found. v. Sec'y of Labor, 471 U.S. 290, 303-04, 105 S.Ct. 1953, 1962-63, 85 L.Ed.2d 278 (1985) (rejecting Free Exercise challenge to Fair Labor Standards Act, where law did not require payment of cash wages in violation of plaintiffs' religious beliefs). Where the government does not compel a plaintiff to act contrary to his stated beliefs, a court might be able to determine that a burden on religious practice is insubstantial — for example, if the challenged law only makes engaging in that religious practice somewhat more expensive. See Hernandez v. C.I.R., 490 U.S. 680, 699, 109 S.Ct. 2136,
Take, for example, religious objections to the payment of taxes. Where Amish plaintiffs asserted that the act of paying social security taxes was forbidden by their religion, the Supreme Court's burden analysis was succinct: "Because the payment of the taxes or receipt of benefits violates Amish religious beliefs, compulsory participation in the social security system interferes with their free exercise rights." See United States v. Lee, 455 U.S. 252, 257, 102 S.Ct. 1051, 1055, 71 L.Ed.2d 127 (1982). However, where a plaintiff does not "allege[ ] that the mere act of paying the tax, by itself, violates its sincere religious beliefs," but that "imposition of a generally applicable tax merely decreases the amount of money [plaintiff] has to spend on its religious activities, any such burden is not constitutionally significant." Jimmy Swaggart Ministries v. Bd. of Equalization of California, 493 U.S. 378, 391-92, 110 S.Ct. 688, 696-97, 107 L.Ed.2d 796 (1990); see also Hernandez, 490 U.S. at 694-700, 109 S.Ct. 2136.
This distinction between laws pressuring action and those pressuring forbearance is far from precise, and may in some circumstances verge on the metaphysical.
Plaintiffs argue that the Mandate requires them to act in two specific ways.
In response, the Government argues that any burden placed on plaintiffs' beliefs by the Mandate is too "de minimis" or "attenuated" to be substantial under the RFRA. The Government stresses that the Mandate does not require plaintiffs to "contract, arrange, pay, or refer for [contraceptive] coverage." Completing the self-certification form is a purely administrative task that would take a matter of minutes, according to the Government, and is tantamount to stating a religious objection to contraceptive coverage, a statement that plaintiffs already make to their TPAs in order to ensure their plans do not cover contraception. As for identifying and contracting with a TPA, the Government argues that this activity is not attributable to the challenged regulations. Plaintiffs are self-insured, and thus already have TPAs; they will not be forced to find new ones, nor modify their existing contracts with their current TPAs. According to the Government, the regulations therefore do not require plaintiffs to do anything at all with regard to their TPAs.
Plaintiffs' suggestion that they will be forced to identify and contract with TPAs who will provide contraceptive coverage is indeed somewhat speculative.
As for the self-certification requirement, the Court rejects the Government's position that plaintiffs may be compelled to perform affirmative acts precluded by their religion if a court deems those acts merely "de minimis." This argument — which essentially reduces to the claim that completing the self-certification places no burden on plaintiffs' religion because "it's just a form" — finds no support in the case law. As discussed, where a law places substantial pressure on a plaintiff to perform
Again, the Government does not contest that completing the self-certification violates plaintiffs' religious beliefs. But beyond its repeated insistence that this is an "objective" inquiry, the Government provides no framework for how a court could determine whether an act that concededly violates a plaintiff's religious beliefs is actually only "de minimis." Inquiring into the relative importance of a particular act to a particular plaintiff would necessarily place the court in the unacceptable "business of evaluating the relative merits of differing religious claims." Lee, 455 U.S. at 263 n. 2, 102 S.Ct. 1051 (Stevens, J. concurring). There is no way that a court can, or should, determine that a coerced violation of conscience is of insufficient quantum to merit constitutional protection.
"Government may neither compel affirmation of a repugnant belief, nor penalize or discriminate against individuals because they hold religious views abhorrent to the authorities." Sherbert, 374 U.S. at 402, 83 S.Ct. 1790 (citation omitted). Requiring, for example, a Jehovah's Witness to salute the flag may seem like a de minimis act to an "objective observer," but to a believer that action may be very significant indeed. Cf. West Virginia State Bd. of Educ. v. Barnette, 319 U.S. 624, 63 S.Ct. 1178, 87 L.Ed. 1628 (1943) (striking down such a law on free speech grounds). The same could be said of requiring adherents to swear to, rather than affirm the veracity of their testimony, but those with religious objections have been largely exempt from doing so since before the Bill of Rights. See Michael W. McConnell, The Origins and Historical Understanding of Free Exercise of Religion, 103 HARV. L.REV. 1409, 1466-73 (1990) ("By 1789, virtually all of the states had enacted oath exemptions.").
The Government's "it's just a form" argument suffers from the same infirmity. The non-exempt plaintiffs are required to complete and submit the self-certification, which authorizes a third-party to provide the contraceptive coverage to which they object. They consider this to be an endorsement of such coverage; to them, the self-certification "compel[s] affirmation of a repugnant belief." Sherbert, 374 U.S. at 402, 83 S.Ct. 1790. It is not for this Court to say otherwise.
The Government's argument that any burden placed on plaintiffs is too "attenuated" to be substantial is similarly flawed. Defendants argue that plaintiffs' self-certification would only result in the use of contraception after a series of independent decisions by plaintiffs' employees. Although factually accurate, this argument rests on a misunderstanding (or mischaracterization) of plaintiffs' religious objection. Plaintiffs' religious objection is not only to the use of contraceptives, but also to being required to actively participate in a scheme to provide such services. The Government feels that the accommodation sufficiently insulates plaintiffs from the objectionable services, but plaintiffs disagree. Again, it is not the Court's role to say that
The Government's contention that the self-certification simply requires plaintiffs to inform their TPAs of their religious objection to contraceptive coverage, just as they would without the Mandate, is unpersuasive for similar reasons. Even if this were true, the self-certification would still transform a voluntary act that plaintiffs believe to be consistent with their religious beliefs into a compelled act that they believe forbidden. Clearly, plaintiffs view the latter as having vastly different religious significance than the former.
Of course, as plaintiffs correctly concede, the Mandate could not place a substantial burden on their religious beliefs if it involved "no action or forbearance" on their part. Kaemmerling v. Lappin, 553 F.3d 669, 679 (D.C.Cir.2008) ("[R]eligious exercise necessarily involves an action or practice."). But that is not the case here, and the Government's reliance on Kaemmerling is therefore misplaced. In Kaemmerling, the plaintiff objected only to the Government's collection, storage and analysis of his DNA; he did not object to the collection of any particular DNA carrier from his body, such as blood, saliva, skin or hair. Id. at 678. Noting that "[t]he extraction and storage of DNA information are entirely activities of the FBI, in which Kaemmerling plays no role and which occur after the BOP has taken his fluid or tissue sample (to which he does not object)", the court held that the plaintiff had failed to allege a substantial burden because he identified "no religious observance that the DNA Act impedes, or acts in violation of his religious beliefs that it pressures him to perform." Id. at 678-79. Just as Kaemmerling's objection to the activities of third parties in which he played "no role" failed to allege a substantial burden under the RFRA, plaintiffs could not object if the Government simply provided contraceptive coverage to plaintiffs' employees, or worked with a third party to do so without requiring plaintiffs to do anything. What the Government cannot do — absent a compelling interest and narrow tailoring — is compel plaintiffs to act in violation of their religious beliefs.
The Diocesan plaintiffs, however, are entirely exempt from the Mandate as religious employers. The parties have made little effort to distinguish the claims of the Diocesan plaintiffs from those of the
Second, even if the law did pressure the Diocesan plaintiffs to "expel" their affiliates, plaintiffs do not state that the Diocesan plaintiffs' religious beliefs require them to have all their affiliate organizations on a single health plan, such that "expelling" the non-exempt affiliates would be an act forbidden by their religion. Rather, their claim is that expelling the non-exempt organizations could force those affiliates to provide coverage or self-certify, which in turn could mean that the Diocesan plaintiffs' prior act of expulsion facilitated the provision of contraception. This religious objection — which is not to the act itself, but instead is entirely dependent on the conduct of third parties occurring after that act — is quite similar to the claim rejected in Kaemmerling. 553 F.3d at 678. The Diocesan plaintiffs have therefore failed to demonstrate that the Mandate imposes a substantial burden on their religious exercise, and defendants are entitled to summary judgment on the Diocesan plaintiffs' RFRA claims.
The non-Diocesan plaintiffs have demonstrated that the Mandate, despite the accommodation, compels them to perform acts that are contrary to their religion. And there can be no doubt that the coercive pressure here is substantial. If plaintiffs do not comply with the Mandate, they are subject to fines of $100 per day per affected beneficiary. See 26 U.S.C. § 4980D(b)(1). If they seek to cease providing health insurance altogether, they face an annual fine of $2,000 per full-time employee. See 26 U.S.C. § 4980H(a), (c)(1). The only other option available to plaintiffs is to violate their religious beliefs, by either providing the objectionable coverage or completing the objectionable self-authorization. Although the Government disagrees with some of plaintiffs' calculations as to the amount of fines to which they would potentially be exposed, the Government does not actually argue that the coercive effect of the Mandate is insubstantial. The non-Diocesan plaintiffs have demonstrated a substantial burden under the RFRA, requiring the Government to demonstrate that the Mandate is narrowly tailored to serve a compelling governmental interest.
Because plaintiffs have demonstrated a substantial burden on their religious beliefs, the Government bears the onus of demonstrating that the Mandate "is the least restrictive means of furthering
The Government identifies two interests served by the Mandate: "the promotion of public health, and ensuring that women have equal access to health-care services." These interests are certainly important.
The Government argues that granting plaintiffs the exemption they seek would "undermine defendants' ability to enforce the regulations in a rational manner." If "any organization with a religious objection were able to claim an exemption," defendants could not "administer the regulations in a manner that would achieve Congress's goals of improving the health of women and newborn children and equalizing the coverage of preventive services for women," because women who work for employers like plaintiffs would face negative health outcomes simply by virtue of their employment. In simpler terms, the Government argues that many fewer women will be covered.
The Supreme Court has made clear that a general interest in uniformity is not enough to show a compelling interest; rather, the Government "can demonstrate
The Government has not made a similar showing of a compelling interest in uniform enforcement of the Mandate, for the simple reason that enforcement of the Mandate is currently anything but uniform. Tens of millions of people are exempt from the Mandate, under exemptions for grandfathered health plans, small businesses, and "religious employers" like the Diocesan plaintiffs here. Millions of women thus will not receive contraceptive coverage without cost-sharing through the Mandate. Having granted so many exemptions already, the Government cannot show a compelling interest in denying one to these plaintiffs. See Church of Lukumi Babalu Aye, Inc. v. Hialeah, 508 U.S. 520, 547, 113 S.Ct. 2217, 2234, 124 L.Ed.2d 472 (1993) ("It is established in our strict scrutiny jurisprudence that a law cannot be regarded as protecting an interest `of the highest order' ... when it leaves appreciable damage to that supposedly vital interest unprohibited."); see also Korte, 735 F.3d at 686 (holding that ACA's myriad exemptions meant that the Government could not pass the compelling interest test of the RFRA); Gilardi, 733 F.3d at 1222-23 (same); Hobby Lobby, 723 F.3d at 1144 (same).
The Government does not contest the existence or breadth of the ACA's exemptions, but instead justifies each one individually — the grandfathering provisions are intended only to be temporary; small employers are not exempt from the Mandate, but from the mechanisms that impose penalties if they do not provide health coverage, which they are encouraged to do through tax and other incentives; fully exempting religious employers but not religious non-profit organizations is rational because employees of the former are less likely to use contraception than employees of the latter. Assuming all this to be true, it misses the point — the RFRA requires the Government to identify a compelling interest in applying the law to "the particular claimant whose sincere exercise of religion is being substantially burdened." O Centro, 546 U.S. at 431-32, 126 S.Ct. 1211. The fact that these exemptions work the same harm to the Government's interests as would any exemption granted to plaintiffs greatly undermines the Government's assertion that it has a compelling interest in enforcing the Mandate against plaintiffs. See id. at 434, 126 S.Ct. 1211.
The cases upon which the Government relies do not support its position. In rejecting a Rastafarian's claim that the RFRA required a religious exemption for probationers to smoke marijuana, the court in United States v. Israel, 317 F.3d 768, 772 (7th Cir.2003), noted that "[a]ny judicial attempt to carve out a religious exemption in this situation would lead to significant administrative problems for the probation office and open the door to a weed-like proliferation of claims for religious exemptions." No exemptions existed that allowed federal probationers to
Finally, but very significantly, the Government's belated revelation that the regulations do not even require plaintiffs' TPAs to provide contraceptive coverage
Nor is the Mandate the least restrictive means by which the Government can improve public health and equalize women's access to healthcare. "A statute or regulation is the least restrictive means if `no alternative forms of regulation would [accomplish the compelling interest] without infringing [religious exercise] rights.'" Kaemmerling, 553 F.3d at 684 (quoting Sherbert, 374 U.S. at 407, 83 S.Ct. 1790). At this point, it is important to recall the nature of the burden on plaintiffs' religion. The Mandate does not burden plaintiffs' religion because it allows their employees to receive and use contraception at no cost; indeed, "it goes without saying that [plaintiffs] may neither inquire about nor interfere with the private choices of their employees on these subjects." Korte, 735 F.3d at 684. Rather, the Mandate burdens plaintiffs' religion by coercing them into authorizing third parties to provide this coverage through the self-certification requirement, an act forbidden by plaintiffs' religion.
In view of this burden, numerous less restrictive alternatives are readily apparent. The Government could provide the contraceptive services or insurance coverage directly to plaintiffs' employees, or work with third parties — be it insurers, health care providers, drug manufacturers, or non-profits — to do so without requiring plaintiffs' active participation. It could also provide tax incentives to consumers or
It is true that a proposed alternative scheme must be workable in order to qualify as a viable less restrictive means. See Fisher v. Univ. of Texas at Austin, ___ U.S. ___, 133 S.Ct. 2411, 2420, 186 L.Ed.2d 474 (2013). The Government first argues that the alternatives above are infeasible because the defendants lack statutory authority to enact some of them. This argument makes no sense; in any challenge to the constitutionality of a federal law, the question is whether the federal government could adopt a less restrictive means, not any particular branch within it. It would set a dangerous precedent to hold that if the Executive Branch cannot act unilaterally, then there is no alternative solution. If defendants lack the required statutory authority, Congress may pass appropriate legislation.
The Government also argues that these alternatives would impose new administrative costs or not be as effective in advancing the Government's goals. As for the first argument, the Government has not identified these costs with any specificity, and in any event a less restrictive alternative is not infeasible simply because it is somewhat more expensive for the Government. See Riley v. Nat'l Fed'n of the Blind, 487 U.S. 781, 799-800, 108 S.Ct. 2667, 2680, 101 L.Ed.2d 669 (1988) (noting that a state "may vigorously enforce its antifraud laws" as a less restrictive alternative to compelled disclosures). As for the second, the Government argues that the proposed alternatives would be less effective because they require women to take extra, burdensome steps including "find[ing] out about the availability of and sign[ing] up for a new benefit," rather than the "minimal logistical and administrative obstacles" they would enjoy under the Mandate. The Government does not, however, further explain these steps and why they would be burdensome on plaintiffs' employees. If these steps only entail filling out a form, it seems that the burden of filling out that form should fall on those who have no religious objection to doing so. If finding out about these benefits is burdensome, the Government could make a stronger effort to inform the public about them.
Relatedly, the Government and the ACLU as amicus argue that exempting plaintiffs from the Mandate would deny to plaintiffs' employees the benefits that Congress sought to provide them, effectively allowing plaintiffs to impose their religious beliefs on employees who might not share them. The potential burden that granting an exemption would impose upon third parties is certainly a relevant consideration in Free Exercise cases. See e.g., Sherbert, 374 U.S. at 409, 83 S.Ct. 1790 (noting that granting exemption did not "serve to abridge any other person's religious liberties"); see also Korte, 735 F.3d at 719-20 (Rovner, C.J., dissenting) (collecting cases). But this is not a case where, for example, plaintiffs claim a religious right to engage in invidious discrimination that Congress has sought to remedy. Cf. Dole v. Shenandoah Baptist Church, 899 F.2d 1389, 1398 (4th Cir.1990) (religiously-motivated disparate pay for female employees). The Court is cognizant of the fact that, if plaintiffs were exempt, their employees would not be able to receive a benefit that Congress intended to grant them, at least temporarily. But the availability of less restrictive means by which Congress can provide this benefit means that the burden on plaintiffs' employees does not change the result here.
In sum, the non-Diocesan plaintiffs have demonstrated that there is no genuine issue
As discussed, the parties made little effort to distinguish between the RFRA claims brought by the exempt and non-exempt plaintiffs; they have made almost none with regard to plaintiffs' other claims. The Court's ruling that the Diocesan plaintiffs have not suffered a substantial burden on their religion under the RFRA because they are exempt from the Mandate largely compels the conclusion that these plaintiffs cannot succeed on their remaining claims. Defendants are entitled to summary judgment as to these claims.
Having failed to meet the more lenient standard of the RFRA, the Diocesan plaintiffs cannot succeed on their Free Exercise constitutional claim, Count II of the Amended Complaint. Count VI of the Amended Complaint alleges that the Mandate unconstitutionally interferes with the Catholic Church's internal governance by "artificially splitting the Catholic Church in two," dividing its religious arm from its charitable and educational arms. This is little more than a restatement of the Diocesan plaintiffs' RFRA claim, and fails for much the same reasons. The Mandate does not "split" the Catholic Church in two — it does not require any change to the religious structure, hierarchy or organization of the Church and its affiliated organizations. At most, it could "split" the Church's health plan in two.
The Diocesan plaintiffs' Free Speech claims must fail because the none of the claimed infringements — that paying for contraceptive and other counseling is compelled speech; that self-certification requirement is also compelled speech; or
The standard for granting a permanent injunction is essentially the same as that for a preliminary injunction, except that the moving party must demonstrate actual, rather than likely, success on the merits of its claim. See Richards v. Napolitano, 642 F.Supp.2d 118 (E.D.N.Y. 2009). In determining whether to grant a permanent injunction, therefore, a court must consider: (1) success on the merits; (2) whether the movant will suffer irreparable injury absent an injunction; (3) the balance of hardships between the parties; and (4) whether the public interest supports granting the requested injunction. See Winter v. Natural Res. Def. Council, Inc., 555 U.S. 7, 129 S.Ct. 365, 172 L.Ed.2d 249 (2008).
As set forth above, the non-Diocesan plaintiffs have demonstrated success on the merits of their RFRA claims. For the same reasons, they have also demonstrated that they will suffer irreparable injury absent an injunction. "The loss of First Amendment freedoms, even for minimal periods of time, unquestionably constitutes irreparable injury." New York Progress and Protection PAC v. Walsh, 733 F.3d 483, 486 (2d Cir.2013) (quoting Elrod v. Burns, 427 U.S. 347, 373, 96 S.Ct. 2673, 49 L.Ed.2d 547 (1976)). Indeed, the Government concedes that resolution of these first two prongs depends on the merits of plaintiffs' RFRA claims.
Plaintiffs have also satisfied the remaining two prongs. The balance of equities weighs in favor of plaintiffs. Although it is true that "there is inherent harm to an agency in preventing it from enforcing regulations that Congress found it in the public interest to direct that agency to develop and enforce," Cornish v. Dudas, 540 F.Supp.2d 61, 65 (D.D.C.2008), entering an injunction in this case would simply maintain the status quo, and therefore would not place any significant additional burden on the Government. See Tyndale House Publishers, Inc. v. Sebelius, 904 F.Supp.2d 106, 129-30 (D.D.C.2012). And though the Government argues that granting injunctive relief to plaintiffs would "would undermine the Government's ability to achieve Congress's goals of improving the health of women and newborn children and equalizing the coverage of preventive services for women
The public interest similarly weighs in favor of granting an injunction. "[S]ecuring First Amendment rights is in the public interest." Walsh, 733 F.3d at 488. The countervailing public interests cited by the Government — in uniform enforcement of the Mandate and in allowing plaintiffs' employees to enjoy its benefits — do not outweigh the public interest in protecting plaintiffs' religious liberty. First, as described earlier, the Government has not shown a compelling interest in uniform enforcement of the Mandate; enjoining its enforcement simply adds plaintiffs to the large number of employers not subject to the Mandate.
Second, the Government is correct that, as the Ninth Circuit has held, "[t]here is a general public interest in ensuring that all citizens have timely access to lawfully prescribed medications." Stormans Inc. v. Selecky, 586 F.3d 1109, 1139 (9th Cir. 2009). But Stormans, which involved a Free Exercise challenge brought by religious pharmacists against enforcement of a state regulation requiring pharmacies to fill prescriptions of Plan B, actually demonstrates why this public interest does not change the result here. The Ninth Circuit in Stormans vacated the district court's preliminary injunction in part because it was vastly overbroad; the district court had enjoined enforcement of the regulation against all pharmacies and pharmacists who refused to fill Plan B prescriptions, without limitation to the parties before the court or even those with religious objections to doing so. The Ninth Circuit noted that enjoining enforcement only against the plaintiffs themselves, as the plaintiffs in this case request, would not present great hardship to the public. In addition, the public interest identified in Stormans was access to prescribed medications, which would indeed be curtailed if pharmacies refused to fill prescriptions. Here, the public interest identified by the Government is in access to free contraception. An injunction will not prevent or unreasonably delay plaintiffs' employees from accessing prescribed medications; rather, an injunction would simply require them to pay for it, as they would have to without the Mandate. The non-Diocesan plaintiffs have demonstrated that they are entitled to an injunction against enforcement of the Mandate against them.
The non-Diocesan plaintiffs' motion for summary judgment on their RFRA claims is granted, and their remaining claims are dismissed as moot. The Government's motion for summary judgment is granted as to the Diocesan plaintiffs' claims. Pursuant to Federal Rule of Civil Procedure 58, a Final Judgment and Injunction shall issue separately.
45 C.F.R. § 147.130(a)(1)(iv)(B).
146 Cong. Rec. S7774, 7776 (July 27, 2000).
