Sch. of the Ozarks, Inc. v. U.S. Dep't of Health & Human Servs.
| Decision Date | 13 January 2015 |
| Docket Number | Case No. 13–03157–CV–S–BP. |
| Citation | 86 F.Supp.3d 1066 |
| Parties | The SCHOOL OF THE OZARKS, INC., d/b/a College of the Ozarks, Plaintiff, v. UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES, et al., Defendants. |
| Court | U.S. District Court — Western District of Missouri |
Ashley Lowe Norgard, Ginger K. Gooch, Virginia L. Fry, Husch Blackwell LLP, Springfield, MO, Joann T. Sandifer, Husch Blackwell LLP, St. Louis, MO, for Plaintiff.
Jacek Pruski, U.S. Department of Justice, Washington, DC, for Defendants.
This matter comes before the Court on Plaintiff's Motion for Summary Judgment, (Doc. 31); Defendants' Motion to Dismiss, or Alternatively Motion for Summary Judgment, (Doc. 35); and American Civil Liberties Union's and American Civil Liberties Union of Missouri's (collectively “ACLU”) Motion for Leave to File Amici Curiae Brief, (Doc. 38). For the following reasons, Defendants' Motion is GRANTED, Plaintiff's Motion and the ACLU's Motion are DENIED.
Plaintiff is the School of the Ozarks, Inc. (“School”), a “four year liberal arts coeducational college located in Lookout, Missouri.” (Doc. 32, p. 8.) The School has a “five-fold emphasis” which focuses on academic, vocational, Christian, patriotic, and cultural education to develop students' character. (See id. ) Further, the School was originally established by a Missouri charter granted to the Missouri Synod of the Presbyterian Church. The School became a not-for-profit corporation pursuant to Missouri law in 2003. Currently, the School has more than 270 full-time employees and contracts to provide a group health insurance plan through an insurance company.
Defendants are the government agencies which administer the Patient Protection and Affordable Care Act (“ACA”), 42 U.S.C. § 300gg–13(a)(4), namely the Department of Health and Human Services (“HHS”), the Department of Treasury and the Department of Labor (“Labor”), as well as the secretary for each agency, (collectively “Departments”).
Under the ACA, an employer with more than 50 full-time employees must provide qualifying health insurance coverage to its employees. If such an employer does not provide health insurance coverage, it may be liable for assessable payments under 26 U.S.C. § 4980H(a) if one or more of its employees qualifies for a premium tax credit on the Health Insurance Marketplace.
One issue the ACA sought to address was the underutilization of preventative services due largely to the costs associated with such preventative services. As a part of the law's overall goal of encouraging preventative care, the ACA requires coverage of certain preventative services to women without cost-sharing, including copayments, coinsurance, or deductibles. With respect to contraception coverage, HHS requested the Institute of Medicine (“IOM”) conduct research to determine which preventative services should be required.
The research indicated that negative health consequences for the mother and child may occur in cases when a pregnancy is unintended. Further, unintended pregnancy can result in delayed prenatal care, continuation of behaviors which create risks for the fetus
, as well as depression and anxiety. Contraceptives also help space pregnancies, which avoids the risk associated with closely-spaced pregnancies. In addition, contraceptives may be used by women for whom pregnancy is contraindicated and to treat or prevent other conditions, such as menstrual disorders, acne, and certain cancers. Further, the research indicated women in reproductive years spend 68 percent more on out-of-pocket health care costs than men.
The Health Resources and Services Administration (“HRSA”) guidelines for preventative care and screening were created based upon the recommendations from the IOM. The guidelines require all FDA-approved contraceptives be covered, as well as patient education and counseling regarding those contraceptives, for women. This portion of the guidelines has been referred to as the Contraceptive Mandate (“Mandate”).
The Mandate applies to all non-grandfathered plans offered either by employers or on the Health Insurance Marketplace, except “religious employers.” The religious employer generally applies to houses of worship. Specifically a religious employer “is one that: (1)[h]as the inculcation of religious values as its purpose; (2) primarily employs persons who share its religious tenets; (3) primarily serves persons who share its religious tenets; and (4) is a nonprofit organization described in section 6033(a)(1) and (a)(3)(A)(i) or (iii) of the Code.” Coverage of Certain Preventive Services Under the Affordable Care Act, 78 Fed.Reg. 39,870, 39,873 –74; 45 C.F.R. § 147.131(a).
The School is considered a religious nonprofit under the ACA. Religious nonprofits may receive an accommodation as an eligible organization. In order to qualify, an eligible organization must: (1) have a religious objection to some or all contraceptive services required; (2) be a nonprofit entity; (3) hold itself out as a religious organization; and (4) self-certify the above either through EBSA Form 700 (“Form 700”) sent to the insurance provider or third-party administrator (“TPA”) or a written notice to HHS.2 After notification of the accommodation, either through Form 700 or notification from the Departments, the insurance provider segregates contraceptive coverage from the eligible organization's plan. The organization cannot be required “to contract, arrange, pay[, directly or indirectly], or refer for contraceptive coverage” to which it has objected. Coverage of Certain Preventive Services Under the Affordable Care Act, 78 Fed.Reg. 39,870, 39,874. Further, the insurance provider must send out separate notifications to the covered employees informing them of the accommodation and that “the eligible organization does not administer or fund contraceptive benefits [.]” 45 C.F.R. § 147.131(d).
The School believes human life begins at the fusion of the two haploid gametes which creates a zygote, or fertilized egg. Further, the school believes the destruction of a fertilized egg is morally wrong based upon its religious beliefs and convictions. The School objects to the emergency contraceptive drugs ulipristal acetate (“ella ”) and levonorgestrel (“Plan B”),3 as well as any counseling or education regarding those drugs, because they may interrupt implantation of the fertilized egg. For these reasons, the School has specifically excluded coverage for objectionable contraceptives in its group health insurance plans in the past. Moreover, the School initiated a lawsuit against its insurance company when it discovered its group health insurance plan provided such coverage. The Departments do not dispute the School's sincere religious belief. The School qualifies as an eligible organization and may utilize either accommodation method.
Pursuant to Federal Rule of Civil Procedure 56(a), summary judgment may be granted “if the movant shows that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law.” Substantive law identifies which facts are material. Id. When ruling on a motion for summary judgment, the Court should view the facts in the light most favorable to the adverse party and allow the adverse party the benefit of all reasonable inferences to be drawn from the evidence. Reed v. ULS Corp., 178 F.3d 988, 990 (8th Cir.1999). A moving party is “entitled to judgment as a matter of law” if the nonmoving party fails to demonstrate an essential element of a claim for which it has the burden of proof. Woodsmith Publ'g Co. v. Meredith Corp., 904 F.2d 1244, 1247 (8th Cir.1990).
The Religious Freedom Reformation Act (“RFRA”) provides that any law which substantially burdens a person's free exercise of religion must be (1) in furtherance of a compelling government interest and (2) use the least restrictive means of furthering that interest. 42 U.S.C. § 2000bb–1(b). To establish a claim, a plaintiff must first show the law in question substantially burdens the plaintiff's sincere religious exercise. Gonzales v. O Centro Espirita Beneficente Uniao do Vegetal, 546 U.S. 418, 428, 126 S.Ct. 1211, 163 L.Ed.2d 1017 (2006).5 If the plaintiff can make such a showing, the burden then shifts to the government to show the law uses the least restrictive means to further a compelling government interest. Id. The parties agree that the School sincerely believes participating in the accommodation process violates its religious beliefs. However, the parties do not agree about the burden created by the accommodation process. Therefore, the initial question is whether the School has shown the accommodation creates a substantial burden upon its sincere religious exercise.
In support of its argument that the Mandate constitutes a substantial burden on its sincere religious exercise, the School argues that the Mandate requires the school to actively participate in a scheme forbidden by its religious beliefs. The School explains that forcing it to participate in the accommodation process results in the School facilitating the provision of religiously offensive contraceptives to its employees. The Departments respond that the action taken by the School to opt out is the same action it took before the Mandate was enacted when notifying its insurer to not provide contraceptive coverage to its employee. Therefore the Mandate does not force the School to modify its behavior and, by extension, cannot be considered a substantial burden. In the event the accommodation process does constitute a modification of the School's previous action, the Departments argue that the action is too attenuated to the religious belief to constitute a substantial burden. The School replies that because it honestly believes the...
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