Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania
140 S. Ct. 2367
| SCOTUS | 2020Background
- The ACA’s Women’s Health Amendment (42 U.S.C. §300gg‑13(a)(4)) requires group health plans to cover “preventive care and screenings…as provided for in comprehensive guidelines supported by HRSA.” HRSA’s 2011 Guidelines included coverage for all FDA‑approved contraceptive methods.
- The Departments (HHS, Labor, Treasury) created a narrow church exemption and a self‑certification accommodation (2013) allowing certain religious employers to opt out while insurers provided contraceptive coverage separately to employees.
- Religious objectors (e.g., Little Sisters) challenged the accommodation under RFRA, arguing certification or participation made them complicit in objectionable conduct; Hobby Lobby (2014) held the mandate could substantially burden some employers and pointed to the accommodation as a less‑restrictive alternative.
- Following Zubik (2016) and extensive litigation/comments, the Departments issued 2017 interim final rules and 2018 final rules expanding exemptions: a broad religious exemption and a moral exemption that allow many employers (including some for‑profits) to avoid the contraceptive‑coverage requirement without preserving insurer‑provided seamless coverage for employees.
- Pennsylvania and New Jersey sued under the APA claiming the Departments lacked statutory authority and acted procedurally improperly (bypassing notice‑and‑comment and failing to consider alternatives). District court enjoined the rules; Third Circuit affirmed; the Supreme Court granted certiorari.
Issues
| Issue | Plaintiff's Argument (Pennsylvania/New Jersey) | Defendant's Argument (Government / Departments) | Held |
|---|---|---|---|
| Whether the ACA (42 U.S.C. §300gg‑13(a)(4)) authorizes the Departments to create religious and moral exemptions from HRSA’s preventive‑care guidelines | §300gg‑13(a) requires group plans and issuers to “shall…provide” services; paragraph (4) only lets HRSA define what services are covered, not who must provide them or permit exemptions | The phrase “as provided for in comprehensive guidelines” grants HRSA broad discretion to define preventive care and to identify/create exemptions or accommodations from its Guidelines | The Court held the ACA’s text authorizes HRSA/the Departments to create the religious and moral exemptions. |
| Whether RFRA barred the Departments from considering or adopting exemptions only after judicial determination of a RFRA violation | RFRA does not permit agencies to preemptively rewrite regulatory obligations to accommodate religious objections absent a court finding or explicit statutory mandate | RFRA applies to federal law and its implementation; agencies may and should consider RFRA when rulemaking to avoid arbitrary and capricious action and to cure potential RFRA conflicts | The Court held it was appropriate for the Departments to consider RFRA in formulating the exemptions (but did not rest the decision solely on RFRA). |
| Whether the Departments complied with the APA’s notice‑and‑comment requirements when they issued IFRs titled as “Interim Final Rules with Request for Comments” | The IFR label and procedure bypassed the APA’s required “notice of proposed rulemaking” and lacked good cause; the final rules were essentially unchanged, showing lack of real notice/input | The IFRs provided the substantive information required by §553(b)–(c); the request for comments satisfied APA notice; any labeling issue was harmless error | The Court held the IFRs satisfied APA notice requirements and, even if not, respondents failed to show prejudicial error; procedural challenge failed. |
| Whether the final rules were procedurally invalid because the agency lacked an “open mind” (final rules near identical to IFRs) | Minor changes from IFRs to final rules show the Departments did not genuinely consider comments and thus acted arbitrarily, violating APA | The APA prescribes the maximum procedural requirements; there is no judicially created “open‑mindedness” test. Departments satisfied §553(b)–(d) (notice, comment opportunity, statement of basis and purpose, 30‑day delay) | The Court rejected the open‑mindedness test, found the Departments complied with APA procedural requirements, and upheld the rules’ procedures. |
Key Cases Cited
- Burwell v. Hobby Lobby Stores, Inc., 573 U.S. 682 (2014) (RFRA analysis: mandate could substantially burden some employers and the availability of accommodations is relevant to least‑restrictive‑means inquiry)
- Perez v. Mortgage Bankers Ass'n, 575 U.S. 92 (2015) (agencies normally must use notice‑and‑comment unless APA exception applies)
- Motor Vehicle Mfrs. Ass'n v. State Farm Mut. Auto. Ins. Co., 463 U.S. 29 (1983) (agency must provide reasoned explanation and show rational connection between facts and choice)
- Vermont Yankee Nuclear Power Corp. v. NRDC, 435 U.S. 519 (1978) (courts cannot impose additional procedural requirements beyond the APA)
- Sherbert v. Verner, 374 U.S. 398 (1963) (compelling‑interest/least‑restrictive‑means approach foundational to RFRA analysis)
- Cutter v. Wilkinson, 544 U.S. 709 (2005) (accommodations must account for burdens on nonbeneficiaries)
- Gonzales v. O Centro Espírita Beneficente União do Vegetal, 546 U.S. 418 (2006) (RFRA analysis and application)
- Hosanna‑Tabor Evangelical Lutheran Church and School v. EEOC, 565 U.S. 171 (2012) (ministerial‑exception doctrine recognizing church autonomy in certain employment contexts)
- Griswold v. Connecticut, 381 U.S. 479 (1965) (recognition of privacy/right to use contraception)