Wieland v. U.S. Dep't of Health & Human Servs.

• Decision Date: 08 January 2016
• Docket Number: Case No. 4:13-cv-01577-JCH
• Parties: PAUL JOSEPH WIELAND, et al., Plaintiffs, v. UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES, et al., Defendants.
• Court: U.S. District Court — Eastern District of Missouri

PAUL JOSEPH WIELAND, et al., Plaintiffs, v. UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES, et al., Defendants.

Case No. 4:13-cv-01577-JCH

UNITED STATES DISTRICT COURT EASTERN DISTRICT OF MISSOURI EASTERN DIVISION

January 8, 2016

MEMORANDUM AND ORDER

This matter is before the Court on Defendants' renewed Motion to Dismiss pursuant to Federal Rule of Civil Procedure 12(b)(6). (ECF No. 53.) The Motion has been fully briefed and is ready for disposition.

BACKGROUND

In 2010, Congress passed the Patient Protection and Affordable Care Act ("ACA"), Pub.L. No. 111-148, 124 Stat. 119 (2010). The ACA and its implementing regulations require group health plans and health-insurance issuers offering health insurance coverage to provide essential minimum coverage, without cost-sharing requirements. See 26 U.S.C. § 4980H(a); 42 U.S.C. § 300gg-13. For women specifically, such minimum coverage includes coverage for all Food and Drug Administration approved contraceptive methods and sterilization procedures—the so-called "contraceptive mandate" (hereinafter, the "Mandate"). See 42 U.S.C. § 300gg-13(a)(4); 77 Fed. Reg. 8725, 8726 (Feb. 15, 2012). In general, an employer that offers employees a group health plan must comply with the Mandate. The ACA provides several exemptions, however, for employers with fewer than 50 employees, employers maintaining "grandfathered" plans, and certain religious employers. See 26 U.S.C. § 4980H(c)(2); 42 U.S.C. § 18011; 45 C.F.R. §§ 147.131, 147.140. In addition, accommodations are available for certain non-exempt, nonprofit religious organizations. See 78 Fed. Reg. 39,870, 39,871 (July 2, 2013).

As life-long Roman Catholics, Plaintiffs Paul and Teresa Wieland, along with their three daughters, oppose the use, funding, provision, and support of contraceptives, sterilization, and abortifacients (collectively and hereinafter, "contraceptives"). Plaintiffs believe that paying for or participating in a healthcare plan that includes coverage for contraceptives violates their sincerely-held religious beliefs, as does providing such coverage to their daughters. Mr. Wieland serves as a State Representative in the Missouri General Assembly. As an employment benefit, he receives health insurance coverage through Missouri Consolidated Health Care Plan ("MCHCP"), an entity of the State. Plaintiffs pay a portion of the insurance premiums in order to maintain coverage for themselves and their daughters, and the State of Missouri contributes the remaining portion. Prior to August 1, 2013, and pursuant to state law, MCHCP offered Mr. Wieland an opportunity to opt out of coverage for contraceptives. Following the decision in Missouri Insurance Coalition v. Huff, 947 F. Supp. 2d 1014, 1020 (E.D. Mo. 2013) (finding certain portions of Mo Rev. Stat. § 376.1119, which required health insurers to offer plans that excluded coverage for contraceptives if such coverage was contrary to enrollee's religious beliefs, was preempted by ACA), MCHCP discontinued the opt-out offer, and the Wielands were placed in a healthcare plan that included coverage for contraceptives.

In August 2013, Plaintiffs filed suit against Defendants United States Department of Health and Human Services ("HHS"); Kathleen Sebelius, in her official capacity as the Secretary of HHS; United States Department of Treasury ("Treasury"); Jacob Lew, in his official capacityas the Secretary of Treasury; United States Department of Labor ("Labor"); and Seth Harris, in his official capacity as Acting Secretary of Labor (collectively, "Defendants").¹ (Compl., ECF No. 1.) Plaintiffs allege that the Mandate forces them to either (1) violate their religious opposition to contraceptives by paying to make such services available to their daughters, (2) forfeit the benefit of employer-sponsored health insurance for themselves and their daughters and purchase more expensive coverage, or (3) forgo health insurance for themselves and their daughters altogether. Plaintiffs further allege that they cannot obtain insurance coverage other than through Mr. Wieland's employee plan without incurring significantly greater expense, that upon information and belief they cannot obtain any insurance plan that does not provide coverage for contraceptives, and that forgoing health insurance altogether violates their religious duty to provide for the health and well-being of their children. Id.

Plaintiffs assert that the Mandate and Defendants' enforcement of the Mandate against them violate their rights under the Religious Freedom Restoration Act ("RFRA"), 42 U.S.C. § 2000bb et seq. (Count 1); the Free Exercise and Free Speech Clauses of the First Amendment, and the Due Process Clause of the Fifth Amendment (Counts 2-4); and the Administrative Procedure Act, 5 U.S.C. § 706 ("APA") (Count 5). Id. ¶¶ 88-130. Plaintiffs seek declaratory and injunctive relief; specifically, they seek a Court "order prohibiting Defendants from enforcing the Mandate against [them] insofar as it forces them to provide, fund or participate in the provision of [contraceptives]." Id. ¶ 131.

In October 2013, this Court dismissed Plaintiffs' Complaint for lack of standing. (ECF Nos. 37, 38.) Upon remand from the Eighth Circuit, Defendants renew their request for dismissal pursuant to Rule 12(b)(6). (ECF No. 53.)

DISCUSSION

In ruling on a motion to dismiss, the Court must construe the complaint liberally and in the light most favorable to the plaintiff. See Eckert v. Titan Tire Corp., 514 F.3d 801, 806 (8th Cir. 2008). The Court "must accept the allegations contained in the complaint as true and draw all reasonable inferences in favor of the nonmoving party." Coons v. Mineta, 410 F.3d 1036, 1039 (8th Cir. 2005) (citation omitted). A complaint's factual allegations must be sufficient "to raise a right to relief above the speculative level," however, and a motion to dismiss must be granted if the complaint does not contain "enough facts to state a claim to relief that is plausible on its face." Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555, 570 (2007). In addition, "the tenet that a court must accept as true all of the allegations contained in a complaint is inapplicable to legal conclusions," and "[t]hreadbare recitals of the elements of a cause of action, supported by mere conclusory statements, do not suffice." Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (citing Twombly, 550 U.S. at 555).

A. RFRA Claim

Congress enacted RFRA "in order to provide very broad protection for religious liberty." Burwell v. Hobby Lobby Stores, Inc., 134 S. Ct. 2751, 2760-61 (2014) (RFRA was enacted in response to Emp't Div., Dep't of Human Res. of Or. v. Smith, 494 U.S. 872 (1990), in which Supreme Court held that neutral, generally applicable laws may be applied to religious practices even when not supported by compelling governmental interest). "[T]o ensure broad protection for religious liberty, RFRA provides that the 'Government shall not substantially burden a person's exercise of religion even if the burden results from a rule of general applicability.'" Id. at 2761 (quoting 42 U.S.C. § 2000bb-1(a)). "If the Government substantially burdens a person's exercise of religion, under the Act that person is entitled to an exemption from the rule unless theGovernment 'demonstrates that application of the burden to the person—(1) is in furtherance of a compelling governmental interest; and (2) is the least restrictive means of furthering that compelling governmental interest.'" Id. (quoting 42 U.S.C. § 2000bb-1(b).) The "exercise of religion" protected under RFRA "involves not only belief and profession but the performance of (or abstention from) physical acts that are engaged in for religious reasons." Id. at 2770 (citation omitted). In addition, RFRA protects "any exercise of religion, whether or not compelled by, or central to, a system of religious belief," and "mandate[s] that this concept be construed in favor of a broad protection of religious exercise." Id. at 2762 (citations omitted).

Here, the parties do not dispute the sincerity of Plaintiffs' beliefs, and thus the threshold question is whether plaintiffs have alleged sufficient facts to demonstrate that the Mandate substantially burdens their exercise of religion. Defendants argue that the Mandate does not substantially burden Plaintiffs' exercise of religion because it does not apply to Plaintiffs at all, in that it does not require them to provide coverage, unlike group health plans and health-insurance issuers. Defendants cite various cases from other Circuits in which organizations that were eligible for accommodations under the ACA brought suit challenging the requirement that they complete certain documentation in order to receive such accommodations. The eligible-organization plaintiffs argued that the accommodation process substantially burdened their sincerely-held religious beliefs because their required completion of the documentation indirectly facilitated the delivery of the objectionable coverage, and in effect their only option was to not comply with the ACA and to incur significant financial penalties. The courts rejected the plaintiffs' challenges to the accommodation process, reasoning that the resulting obligation to provide contraceptive coverage fell on the health-insurance issuers and third-party administrators, not on the eligible organizations opting out. Relying on these cases(many of which have since been appealed and are now pending review before the Supreme Court), Defendants assert that "courts have made clear in cases challenging the accommodations for eligible organizations that '[a]n asserted burden is ... not an actionable substantial burden when it falls on a third party, not on the religious adherent.'" (ECF No. 53.1 at 15-17 (quoting Priests for Life v. U.S. Dep't of Health & Human Servs., 772 F.3d 229, 246 (D.C. Cir. 2014), cert. granted, 84 U.S.L.W. 3257 (U.S. Nov. 6, 2015) (No. 14-1453)).) Defendants urge this Court to adopt...