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Has HHS Opened its Women’s Preventive Services Guidelines to Lawsuit?

The Religious Freedom Restoration Act (RFRA) may be used by religious organizations in their fight against recent Obamacare guidelines developed by the Department of Health and Human Services’s (HHS) Health Resources and Services Administration (HRSA). HRSA published its “Women's Preventive Services: Required Health Plan Coverage Guidelines” on August 1, 2011. The Guidelines would force employers to offer contraceptives in their employee health plans without any copays (or the like). This would include contraceptives that many religious organizations believe to induce abortions.

RFRA was a bipartisan response to the Supreme Court’s ruling in Employment Division v. Smith. In Smith, the court made it easier for the government to defend against lawsuits based on the First Amendment’s “Free Exercise of Religion” clause.

Before Smith, the burden was on the government to prove that 1)it had a “compelling interest” in establishing the law, 2) the law is narrowly tailored to address the interest, and 3) it used the “least restrictive means” in applying the law to the plaintiffs. This is called the “Compelling Government Interest” test.

Smith, however, changed this test to the less rigorous “Rational Basis” test which only requires that the government show that that the law is “rationally related” to a “legitimate” government interest.

By changing the level of court scrutiny, Smith made it near impossible for plaintiffs to succeed solely on the Free Exercise clause.

RFRA restored the standard of proof for free exercise cases to its pre-Smith status.

The Act was overturned in a case called City of Boerne v. Flores but only as it applied to the states. RFRA still applies to the federal government including, of course, HHS.

HHS has created a religious exemption, but is so narrow that it won’t apply to religious (non-church) organizations—including prolife organizations. And more importantly, its scope is much more narrow than RFRA.

Unless HHS expands its religious exemption or removes contraceptives from its Guidelines they are inviting lawsuits challenging their Guidelines as applied to those of religious conviction.