Cutler v. United States Department of Health & Human Services, 797 F.3d 1173

Plaintiff Jeffrey Cutler (pro se) is a nonobservant Pennsylvania resident who objects on secular grounds to being required to obtain ACA-compliant health insurance or pay the individual mandate penalty; he does not qualify for the ACA religious exemption.
Cutler’s prior health plan was cancelled; he sued HHS and other federal defendants challenging (1) the ACA’s religious exemption as an Establishment Clause violation and (2) the Administration’s transitional policy (allowing states/insurers to renew noncompliant plans temporarily) as an equal protection violation.
The district court dismissed both claims for lack of standing; it alternatively rejected the Establishment Clause claim on the merits.
On appeal the D.C. Circuit rejected the district court’s standing ruling for the Establishment Clause claim (holding Cutler plausibly alleged a concrete, traceable, and redressable injury) but agreed he lacked standing as to the equal protection challenge.
On the merits the court held settled precedent permits the ACA’s religious accommodation (modeled on the Social Security exemption): it is narrow, based on sincere belief plus an established sectarian safety net, and thus constitutionally permissible as an accommodation rather than an establishment of religion.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Standing to bring Establishment Clause challenge	Cutler says he is injured because religious objectors avoid the penalty while secular objectors like him do not	Govt. argued Cutler lacks standing; invalidating the exemption wouldn’t change his obligations	Court: Cutler has Article III standing to challenge the exemption (injury, traceability, redressability)
Establishment Clause validity of ACA religious exemption	Exemption discriminates in favor of religion by excusing believers from mandate/penalty	Exemption is a permissible religious accommodation, narrow and tied to sects that provide private care	Court: Exemption is constitutional under controlling Supreme Court precedent; accommodation allowed
Standing for equal protection challenge to transitional policy	Transitional policy causes geographic unequal treatment; in some states insurers continued old plans, in PA Cutler’s insurer cancelled his plan	Govt. argued Cutler lacks injury traceable to the policy because insurers, not the policy, cancelled his plan	Court: No Article III standing for equal protection claim—injury was caused by private insurer decisions, not the transitional policy

National Fed. of Indep. Bus. v. Sebelius, 567 U.S. 519 (describing ACA goals and individual mandate)
Lujan v. Defenders of Wildlife, 504 U.S. 555 (standing test: injury, traceability, redressability)
Arkansas Writers’ Project, Inc. v. Ragland, 481 U.S. 221 (standing for challenges to underinclusive exemptions)
United States v. Lee, 455 U.S. 252 (upholding Social Security religious exemption as accommodation)
Cutter v. Wilkinson, 544 U.S. 709 (government may accommodate religion without Establishment Clause violation)
McCreary County v. ACLU of Ky., 545 U.S. 844 (governmental neutrality between religion and nonreligion)
Heckler v. Matthews, 465 U.S. 728 (remedies for successful discrimination challenges: invalidate benefit or extend it)