Real Alternatives, Inc. v. Secretary Department of Health & Human Services
2017 U.S. App. LEXIS 14361
| 3rd Cir. | 2017Background
- Real Alternatives is a secular nonprofit anti‑abortion employer that historically offered employee health plans excluding contraceptive coverage; after the ACA rules took effect its insurer began offering plans including FDA‑approved contraceptives.
- Three Real Alternatives employees (Bagatta, Lang, McKeown) objected on religious grounds to participating in or financially supporting insurance that covers contraceptives.
- The ACA/HRSA contraceptive‑coverage requirement (the Contraceptive Mandate) contains an exemption for houses of worship and an accommodation for other religious nonprofits; Real Alternatives challenged the exemption’s limited scope.
- Procedurally: District Court granted summary judgment to the government and denied plaintiffs’ motions; the Third Circuit reviewed de novo and affirmed in full.
- Plaintiffs raised (1) an Equal Protection challenge to the exemption’s religious‑only scope; (2) APA challenges (arbitrary and capricious; violations of ACA/Weldon); (3) Church Amendment claim; and (4) RFRA claims by the employees.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Equal Protection: whether secular employers with identical opposition to contraception must be exempt like houses of worship | Real Alternatives: the religious exemption discriminates against secular, single‑issue groups with identical objections | Government: exemption is rationally related to legitimate interest in protecting religious autonomy and longstanding special status of houses of worship | Court: Not similarly situated; rational‑basis review satisfied; equal protection claim fails (affirmed) |
| APA / Arbitrary & Capricious: whether the exemption / mandate are arbitrary or violate ACA/Weldon | Real Alternatives: rule irrational as applied; mandate requires coverage of abortifacients contrary to ACA; Weldon violated | Government: agency action rationally based; FDA/agency definitions treat covered methods as contraception; Weldon inapplicable | Court: APA claim fails for same reasons as equal protection; ACA and Weldon claims rejected (affirmed) |
| Church Amendment (42 U.S.C. §300a‑7): whether employees can invoke it | Employees: Mandate forces participation in HHS‑funded program that conflicts with beliefs | Government: Employees obtain coverage via private market/insurer, not HHS‑funded program; Church Amendment does not apply | Court: No standing / not implicated because insurance is purchased in private market; claim fails (affirmed) |
| RFRA (individual employees): whether being covered by an employer plan that includes contraceptive coverage substantially burdens religious exercise | Employees: enrolling in and financially supporting a plan that covers contraceptives puts them to a Hobson’s choice—violate beliefs or forgo coverage/pay penalty | Government: employee enrollment is passive/attenuated; any effect is indirect/incidental and not a substantial burden; agency has compelling interests | Court: No substantial burden under RFRA—coverage is incidental/attenuated and employee participation is not coercive; therefore court did not reach least‑restrictive‑means and rejected RFRA claim (affirmed) |
Key Cases Cited
- Burwell v. Hobby Lobby Stores, Inc., 134 S. Ct. 2751 (2014) (RFRA analysis: employer‑provision of contraceptive coverage can be a substantial burden; strict scrutiny applies)
- Zubik v. Burwell, 136 S. Ct. 1557 (2016) (vacatur/remand of several ACA‑RFRA panels to allow parties to attempt accommodations; did not decide merits)
- City of Cleburne v. Cleburne Living Ctr., 473 U.S. 432 (1985) (rational‑basis equal protection standard articulated)
- Gonzales v. O Centro Espirita Beneficente Uniao do Vegetal, 546 U.S. 418 (2006) (RFRA requires strict scrutiny and courts must consider individualized burdens and accommodations)
- Lyng v. Northwest Indian Cemetery Protective Ass'n, 485 U.S. 439 (1988) (incidental effects of government programs are not necessarily substantial burdens absent coercion)
- Bowen v. Roy, 476 U.S. 693 (1986) (government can condition benefits on procedures even if that conflicts with religious belief when not coercing religious practice)
- United States v. Lee, 455 U.S. 252 (1982) (limits on religious exemptions where government shows compelling interest and necessity; analysis of exemptions narrowness)
- Corp. of the Presiding Bishop v. Amos, 483 U.S. 327 (1987) (recognition of special solicitude for religious organizations in certain statutory accommodations)
- Hosanna‑Tabor Evangelical Lutheran Church & Sch. v. EEOC, 565 U.S. 171 (2012) (First Amendment special solicitude for internal religious governance and autonomy)
- Barnhart v. Walton, 535 U.S. 212 (2002) (deference to longstanding agency interpretations)