Michigan Catholic Conference & Catholic Family Services v. Burwell, 807 F.3d 738

Background

The ACA requires health plans to cover contraceptives but exempts certain religious employers and allows an "accommodation" for objecting non-profits (and post-Hobby Lobby, closely held for‑profit entities) that shifts provision/payment to insurers or TPAs.
Plaintiffs are nine religious organizations: three eligible for the religious‑employer exemption and six eligible for the accommodation (five fully‑insured plans, one self‑insured).
The accommodation lets an objecting non‑profit either (a) send EBSA Form 700 to its insurer/TPA or (b) notify HHS; insurers/TPAs then must provide contraceptive coverage without cost‑sharing and may seek federal reimbursement.
Plaintiffs sued claiming RFRA, First Amendment, and APA violations and sought preliminary injunctions; district courts denied relief and the Sixth Circuit affirmed.
The Supreme Court vacated and remanded for consideration in light of Burwell v. Hobby Lobby Stores, Inc. (2014); the Sixth Circuit reconsidered and reaffirmed its prior ruling denying injunctive relief.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether the accommodation (opt‑out + insurer/TPA provision) substantially burdens plaintiffs’ religious exercise under RFRA	The accommodation forces plaintiffs to provide, pay for, or facilitate contraception (or be complicit), imposing a substantial burden	The accommodation insulates objectors: it shifts legal obligation to insurers/TPAs or the government; the notice/self‑certification is de minimis and not a substantial burden	Accommodation does not substantially burden religious exercise; RFRA claim fails
Effect of Hobby Lobby on accommodation analysis	Hobby Lobby shows payment equals compulsion; plaintiffs argue it requires the accommodation be treated as a violation	Government: Hobby Lobby addressed different actors (closely held for‑profit compelled to provide); Hobby Lobby did not condemn the accommodation and even discussed it favorably	Hobby Lobby does not change the outcome; it addressed a distinct legal question and does not invalidate the accommodation
Whether entities eligible for the religious‑employer exemption face any imposed obligations	Exemption plaintiffs claim some regulatory procedures still compel action or make them complicit	Gov: Exemption leaves religious employers free of any new requirement to provide/ pay/ facilitate contraceptives	Exempt entities have no likelihood of success; exemption leaves them untouched by the ACA requirement
Whether self‑insured plans (TPA) are compelled to provide/ plaintiffs compelled to trigger TPA coverage by opting out	Opting out ‘‘triggers’’ TPA provision making plaintiffs complicit and thus substantially burdened	Opt‑out simply shifts responsibility to a TPA already made legally responsible by the rule; plaintiffs do not provide, pay, or facilitate coverage after accommodation	For self‑insured plans, accommodation shifts obligation to TPA and does not impose a substantial RFRA burden on plaintiffs

Key Cases Cited

Burwell v. Hobby Lobby Stores, Inc., 134 S. Ct. 2751 (2014) (closely held for‑profit corporations cannot be compelled under RFRA to provide certain contraceptive coverage; Court did not decide legality of the accommodation)
Mich. Catholic Conference & Catholic Family Servs. v. Burwell, 755 F.3d 372 (6th Cir. 2014) (prior Sixth Circuit opinion; affirmed here and reissued)
Geneva Coll. v. Secretary of the U.S. Dep’t of Health & Human Servs., 778 F.3d 422 (3d Cir. 2015) (upheld accommodation; substantial‑burden inquiry is legal and focuses on how the regulation operates)
Priests for Life v. U.S. Dep’t of Health & Human Servs., 772 F.3d 229 (D.C. Cir. 2014) (upheld accommodation; completing opt‑out is not a substantial burden)
Univ. of Notre Dame v. Burwell, 786 F.3d 606 (7th Cir. 2015) (accommodation bypasses objector and places obligation on insurers/TPAs; no substantial burden)
Jolivette v. Husted, 694 F.3d 760 (6th Cir. 2012) (standard of review for denial of preliminary injunction)