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Analysis

Nationwide Injunction: Judge Blocks Broader Exceptions to ACA Birth Control Mandate

By Steven Porter  
   January 14, 2019

The new rules give even nonreligious employers the ability to claim a moral objection to offering coverage for contraceptives.

A federal judge in Pennsylvania issued a nationwide injunction Monday blocking two new rules by the Trump administration that widen exceptions to the Affordable Care Act's birth control mandate.

The rules, which took effect Monday, gave employers greater latitude to decline to cover contraception on moral or religious grounds. But the rules were already blocked in 13 states and the District of Columbia after a federal judge in California issued a limited injunction Sunday.

While the Obama administration had narrow accommodations for religious objections to the ACA's birth control mandate, the Trump administration widened those circumstances in which employers could claim an exemption, giving even nonreligious employers the option to claim a moral objection.

The administration said the change is expected to affect no more than about 200 employers and coverage for about 6,400 women (with a maximum of 127,000 women impacted), according to a fact sheet accompanying the rules.

Judge Wendy Beetlestone in the Eastern District of Pennsylvania acknowledged in her ruling that there has been a lot of talk lately about the propriety of District Court judges issuing nationwide injunctions.

"While a nation-wide injunction may prove overbroad, there is no more geographically limited injunction that protects the States from potential harm," Beetlestone wrote.

The states in this case, Pennsylvania and New Jersey, argue that promulgation of the two new rules violated the Administrative Procedure Act, Title VII of the Civil Rights Act, the Fifth Amendment's Equal Protection Clause, and the First Amendment's Establishment Clause.

Steven Porter is an associate content manager and Strategy editor for HealthLeaders, a Simplify Compliance brand.


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