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Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania

Supreme Court of the United States · 2016 · Civil Procedure

Civil ProcedureConstitutional LawCriminal ProcedurePropertyAdministrative Procedure ActAffordable Care ActReligious Freedom Restoration ActACA

Facts

The ACA requires certain health plans to provide women's preventive care and screenings as provided for in comprehensive guidelines supported by HRSA, but the statute does not mention contraception. The Departments had previously created the contraceptive mandate by regulation and, after years of litigation including Hobby Lobby and Zubik, issued 2017 interim final rules and 2018 final rules exempting certain employers with sincerely held religious or moral objections from that mandate. Pennsylvania and New Jersey argued that the Departments lacked statutory authority to create those exemptions and that the rules were procedurally invalid under the APA. One of the Little Sisters' homes intervened to defend the religious exemption.

Issue

Whether the Departments had statutory authority under the ACA to promulgate religious and moral exemptions from the contraceptive mandate, whether they could consider RFRA in doing so, and whether the 2018 final rules were procedurally invalid under the APA.

Rule

Section 300gg-13(a)(4) of the ACA gives HRSA broad discretion to define preventive care and screenings and to create religious and moral exemptions from the contraceptive coverage guidelines. In rulemaking, agencies may consider RFRA where federal law and its implementation may burden religious exercise. Under the APA, courts may not impose procedural requirements beyond the statute's text, and an interim final rule with a request for comments can satisfy notice requirements if it provides the required legal authority and substance of the proposed rule.

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One of 10 multiple-choice questions for this case. Pick an answer to see why.

Congress directs the Public Health Services Bureau to require employer health plans to cover 'additional preventive services as provided for in comprehensive guidelines supported by the Bureau.' The statute says nothing about which services must be included and says nothing about exemptions. After initially requiring infertility treatments, the administering departments later exempt employers with sincerely held religious objections to those treatments.

An affected state sues, arguing the exemption exceeds statutory authority because the statute authorizes only identifying covered services, not exempting objectors. How should a court rule under the majority's approach?

Explanation. The majority used a text-first approach. Where Congress gave HRSA broad authority to determine preventive care 'as provided for in comprehensive guidelines' and included no textual limit on exemptions, courts may not add one. The same reasoning supports agency authority here: if the statute leaves guideline content to the agency and is silent on exemptions, a court should not impose a restriction absent from the text.