California v. The Little Sisters of the Poor, No. 19-15072 (9th Cir. 2019)Annotate this Case
The Ninth Circuit affirmed the district court's grant of a preliminary injunction barring enforcement in several states of final federal agency rules that exempt employers with religious and moral objections from the Affordable Care Act's (ACA) requirement that group health plans cover contraceptive care without cost sharing. As a preliminary matter, the panel held that the plaintiff states had Article III standing to sue and that the appeal was not moot.
The panel held that the district court did not abuse its discretion by concluding that the plaintiff states were likely to succeed on the merits of their Administrative Procedure Act (APA) claim or, at the very least, raised serious questions going to the merits. At the preliminary injunction stage, the panel held that the evidence was sufficient to hold that providing free contraceptive services was a core purpose of the Women's Health Amendment and that nothing in the statute permitted the agencies to determine exemptions from the requirement. Therefore, given the text, purpose, and history of the Women's Health Amendment, the district court did not err in concluding that the agencies likely lacked statutory authority under the ACA to issue the final rules.
The panel also held that, regardless of the question of the agencies' authority under the Religious Freedom Restoration Act, the accommodation process likely did not substantially burden the exercise of religion. Furthermore, because appellants likely failed to demonstrate a substantial burden on religious exercise, there was no need to address whether the government had shown a compelling interest or whether it has adopted the least restrictive means of advancing that interest. Finally, the panel held that the district court did not abuse its discretion by concluding that the states were likely to suffer irreparable harm absent an injunction, and that the balance of equities tipped sharply in favor of the plaintiff states and that the public interest tipped in favor of granting the preliminary injunction.