Catholic Health Care System v. Burwell
796 F.3d 207
2d Cir.2015Background
- Plaintiffs are several Catholic-affiliated nonprofit employers with self‑insured church plans who object on religious grounds to providing or facilitating contraceptive coverage required by ACA regulations.
- The ACA requires group health plans to cover preventive services for women (including FDA‑approved contraceptives) without cost‑sharing; Congress delegated scope to HRSA and agencies implemented the mandate.
- The regulations exempt "religious employers" and provide an "accommodation" for other religious non‑profit organizations: a one‑page self‑certification or letter to HHS/TPA that relieves the employer from contracting, arranging, paying, or referring for contraceptive coverage while directing insurers/TPAs to provide separate contraceptive payments without charging the employer.
- Plaintiffs sued under RFRA, arguing the accommodation itself substantially burdens their religious exercise because opting out (by notification) makes them complicit in third‑party provision of objectionable services; district court granted summary judgment for plaintiffs.
- The Second Circuit reverses, holding the accommodation imposes only a de minimis administrative burden (notification) and does not substantially burden plaintiffs’ religious exercise under RFRA; downstream government or third‑party actions are not cognizable RFRA burdens on the objector.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the accommodation substantially burdens plaintiffs' religious exercise under RFRA | Notification forces plaintiffs to facilitate provision of contraceptives, making them complicit and thus substantially burdening religion | The accommodation relieves plaintiffs of providing or paying for contraceptives; notification is a minimal, non‑substantial administrative act | Held: No substantial burden — notification is de minimis and does not violate RFRA |
| Whether plaintiffs’ sincere religious belief alone establishes substantial burden | Plaintiffs: sincerity suffices to treat their assessment of burden as dispositive | Government: substantiality is an objective legal question for courts to decide | Held: Court rejects treating subjective belief as dispositive; substantiality is an objective inquiry |
| Whether penalties for non‑compliance convert the notification into a substantial burden | Plaintiffs: threat of significant fines or providing coverage makes the appellate choice coercive and burdensome | Government: because notification itself is not burdensome, alternative penalties are irrelevant | Held: Penalties irrelevant where required act is not itself a substantial burden |
| Whether downstream government/TPA actions triggered by notification make notification a substantial burden | Plaintiffs: causation/complicity — their opt‑out triggers objectionable conduct by others | Government: third‑party and government actions are independent; burden falls on them, not plaintiffs | Held: Actions by third parties or government do not transform plaintiffs’ notification into a cognizable RFRA burden |
Key Cases Cited
- Burwell v. Hobby Lobby Stores, Inc., 134 S. Ct. 2751 (2014) (RFRA analysis finding substantial burden where mandate required for‑profit employers to pay for contraceptives without accommodation)
- Bowen v. Roy, 476 U.S. 693 (1986) (government internal procedures that offend religious beliefs do not themselves violate Free Exercise)
- Sherbert v. Verner, 374 U.S. 398 (1963) (establishes strict‑scrutiny framework for substantial burdens on religious exercise)
- Wisconsin v. Yoder, 406 U.S. 205 (1972) (religious exemption precedent under strict scrutiny)
- Priests for Life v. HHS, 772 F.3d 229 (D.C. Cir. 2014) (held accommodation imposes only de minimis burden; courts evaluate substantiality)
- Holt v. Hobbs, 135 S. Ct. 853 (2015) (RFRA/LRUPA decision reaffirming that plaintiffs must prove substantial burden beyond sincerity)
- Thomas v. Review Bd., 450 U.S. 707 (1981) (substantial burdens where government action denies benefits central to practice)
- Kaemmerling v. Lappin, 553 F.3d 669 (D.C. Cir. 2008) (declined RFRA relief where burden fell on government activity, not the adherent)
- Jolly v. Coughlin, 76 F.3d 468 (2d Cir. 1996) (example of substantial burden where state compelled invasive medical screening of prisoner)