To protect this right, Con gress provided that the “[g]overnment shall not substantially burden a person’s exercise of religion even if the burden results from a rule of general applicability” unless “it demonstrates that application of the burden . . . Pursuant to this instruction, HRSA undertook, after consulting the Institute of Medicine,3 to state “what preventive services are necessary for women’s health and well-being and therefore should be considered in the development of comprehensive guidelines for preventive services for women.”4 The resulting “Women’s Preventive Services Guidelines” issued in August 2011.5 Under these guidelines, millions of women who previously had no, or poor quality, health insurance gained cost-free access, not only to contraceptive services but as well to, inter alia, annual checkups and screenings for breast cancer, cervical cancer, postpartum depression, and gestational diabetes.6 As to contraceptive services, HRSA directed that, to implement §300gg–13(a)(4), women’s preventive services encompass “all [FDA] approved contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity.”7. Reg. See post, at 18–19 (opinion of Ginsburg, J.) The Third Circuit reversed.  First, the ACA does not provide contraceptive coverage for women who do not work outside the home. The Supreme Court ruled on July 8, 2020 in a 7–2 decision that the new rules were valid, as the associated departments had the authority to promulgate the exemptions, and that the process to put the rules in place did not violate the APA.   1. The Departments had the authority under the ACA to promulgate the religious and moral exemptions. 24  Justice Alito ignores the distinction between (1) a request for an accommodation with regard to one’s own conduct, and (2) an attempt to require others to conform their conduct to one’s own religious beliefs. Under RFRA, a law that substantially burdens the exercise of religion must serve “a compelling governmental interest” and be “the least restrictive means of furthering that compelling governmental interest.” §§2000bb–1(a)–(b). 23  Even if RFRA sweeps more broadly than the Court’s pre-Smith jurisprudence in some respects, see Hobby Lobby, 573 U. S., at 695, n. 3; but see id., at 749–750 (Ginsburg, J., dissenting), there is no cause to believe that Congress jettisoned this fundamental distinction. Aside from these notice requirements, the APA mandates that agencies “give interested persons an opportunity to participate in the rule making through submission of written data, views, or arguments,” §553(c); states that the final rules must include “a concise general statement of their basis and purpose,” ibid. Against this backdrop, it is unsurprising that RFRA would feature prominently in the Departments’ discussion of exemptions that would not pose similar legal problems. Mother Loraine Marie Maguire, (C), of the Little Sisters of the Poor, at the US Supreme Court on March 23, 2016 in Washington, DC. The Federal Government appealed. Reg. Reg. The States challenged the exemptions not only as outside HRSA’s statutory authority, but also as “arbitrary [and] capricious.” 5  U. S. C. §706(2)(A). Petitioners, for their part, had agreed that such an approach would not violate their free exercise rights. 47794. ; see supra, at 18–19. 11  The only language to which the Court points in support of its contrary conclusion is the phrase “as provided for.” See ante, at 15. See State Farm, 463 U. S., at 43.4.  Other aspects of the Departments’ handiwork may also prove arbitrary and capricious. Respondents present two arguments on this score. In issuing the rule, the Departments chose to retain the contraceptive mandate itself. In 2017, responsive to the pleas of such employers, the Government abandoned its effort to both end discrimination against employed women in access to preventive services and accommodate religious exercise.   In 2017, the new administration took up the task of attempting to find a solution. Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania, 591 U.S. ___ (2020), was a United States Supreme Court case involving ongoing conflicts between the Patient Protection and Affordable Care Act (ACA) and the Religious Freedom Restoration Act (RFRA) over the ACA's contraceptive mandate.  Justice Thomas delivered the opinion of the Court. all [FDA]-approved contraceptives. Ibid. It does not, as Congress did elsewhere in the same section of the ACA, set forth any criteria or standards to guide HRSA’s selections. ... After the Little Sisters case… 13  We note as well that the Departments promulgated many other IFRs in addition to the three related to the contraceptive mandate. Automobile Ins. should be made permanent or subject to modification.” 82 Fed. Instead, Congress stated that coverage must include “such additional preventive care and screenings . . . See post, at 13 (quoting 80 Fed.  Our remand in Zubik put these two conflicting interpretations to the test. Reg. The Departments had the authority under the ACA to promulgate the religious and moral exemptions. “[E]xisting federal, state, and local programs,” including Medicaid, Title X, and Temporary Assistance for Needy Families, already “provide free or subsidized contraceptives to low-income women.” Brief for Petitioners in No. Those Guidelines mandate that health plans provide coverage for all Food and Drug Administration approved contraceptive methods. 9  Nonprofit and closely held for-profit organizations with “sincerely held moral convictions” against contraception also qualify for the exemption. Justice Ruth Bader Ginsburg, who had just undergone an emergency surgical procedure, called in from her hospital room while recovering to remind the court that "In this area of religious freedom the major trend is not to give everything to one side and nothing to the other side. In Thomas, a Jehovah’s Witness objected to “work[ing] on weapons,” 450 U. S., at 710, which is what his employer required of him. 15  On the broad scope the Court today attributes to the “ministerial exception,” see Our Lady of Guadalupe School v. Morrissey-Berru, 591 U. S. ___ (2020). Not contesting here that HRSA lacks authority to exempt group health plans from the children’s preventive-care guidelines, the Government attempts to distinguish paragraph (a)(3) from paragraph (a)(4). 1  The Health Resources and Services Administration (HRSA), a division of the Department of Health and Human Services, creates the “comprehensive guidelines” on “coverage” for “additional preventive care and screenings” for women, 42 U. S. C. §300gg–13(a)(4), but the statute is jointly administered and enforced by the Departments of Health and Human Services, Labor, and Treasury (collectively Departments), see §300gg–92; 29 U. S. C. §1191c; 26 U. S. C. §9833. 8  Brief for Petitioners in Zubik v. Burwell, O. T. 2015, Nos. Like Roy, my dissent homes in on the latter question. Reg. “[T]hey commit to constantly living out a witness that proclaims the unique, inviolable dignity of every person, particularly those whom others regard as weak or worthless.” Complaint ¶14. See Hosanna-Tabor Evangelical Lutheran Church and School v. EEOC, 565 U. S. 171, 188 (2012) (the First Amendment’s “ministerial exception” protects “the internal governance of [a] church”); 80 Fed. §2000bb–3(a). Unlike the earlier church exemption, the accommodation did not exempt these religious employers from the contraceptive mandate, but the Departments construed invocation of the accommodation as compliance with the mandate. 39871 (2013). 41325 (2015)). The mandate led to the Supreme Court case Burwell v. Hobby Lobby Stores, Inc.,[1] where the Christian-based retail franchise Hobby Lobby argued that the mandate violated their free exercise of religion rights established by the First Amendment of the United States Constitution and affirmed in the Religious Freedom Restoration Act (RFRA). 57581 (estimating that up to 126,400 women will be affected by the religious exemption). Specifically, the Departments stated their intent to promulgate additional rules to “accommodat[e] non-exempted, non-profit organizations’ religious objections to covering contraceptive services.” Id., at 8727. State Farm, 463 U. S., at 43.3,  And the rule’s overbreadth causes serious harm, by the Departments’ own lights. Finally, respondents argued that the purported procedural defects of the IFRs likewise infected the final rules. Moreover, the Government itself accounts for this textual difference: The children’s preventive-care guidelines described in paragraph (a)(3) were “preexisting guidelines . . . 930 F. 3d 543, 576 (CA3 2019). See 84 Fed. There, a Native American father asserted a sincere religious belief that his daughter’s spirit would be harmed by the Government’s use of her social security number. v. pennsylvania, et al. (relying on Bowen to conclude that accommodation was unnecessary). The District Court answered “no,” and preliminarily enjoined the blanket exemption nationwide. Abortion advocates have spent years trying to force the Catholic nuns to fund the destruction of unborn babies in abortions. as Amici Curiae 23–24, 26 (hereinafter NWLC Brief ), and “improves women’s social and economic status,” by “allow[ing] [them] to invest in higher education and a career with far less risk of an unplanned pregnancy,” Brief for 186 Members of Congress 5–6 (internal quotation marks omitted). First, they took strong exception to the requirement that they maintain and pay for a plan under which coverage for contraceptives would be provided. And the Solicitor General, when pressed at argument, could offer no evidence that, since the rule took effect, employers without the Little Sisters’ complicity beliefs had declined to avail themselves of the new exemption. See, e.g., 155 Cong. Reg. Instead, it enacted “ ‘expansive language offer[ing] no indication whatever’ ” that the statute limits what HRSA can designate as preventive care and screenings or who must provide that coverage. serve[d] people of different religious faiths.” 78 Fed. These cases concern regulations promulgated under a provision of the ACA that requires covered employers to provide women with “preventive care and screenings” without “any cost sharing requirements.” 42  U. S. C. §300gg–13(a)(4).2.  The statute does not define “preventive care and screenings,” nor does it include an exhaustive or illustrative list of such services. See Dept. The Government next points to the modifier “evidence-informed” placed in (a)(3), but absent in (a)(4).  Dept. The Little Sisters of the Poor, a Catholic religious group for women who have dedicated their lives to the service of the elderly, won their Supreme Court case on Tuesday against the Obama administration and their contraceptive mandate in Obamacare.. SCOTUS ruled the Catholic order of nuns cannot be forced to take part in providing cost-free contraceptives to employees. See 82 Fed. This accommodation is referred to as the self-certification accommodation. As the Court of Appeals explained, paragraph (a)(4), added by the Women’s Health Amendment, granted HRSA “authority to issue ‘comprehensive guidelines’ concern[ing] the type of services” group health plans and health insurance issuers must cover with respect to women. That issue is now ready for resolution, unaffected by today’s decision. Finally, obtaining care from a government- funded program instead of one’s regular care provider creates a continuity-of-care problem, “forc[ing those] who lose coverage away from trusted providers who know their medical histories.” NWLC Brief 18.  The second option for women losing insurance coverage for contraceptives is to pay for contraceptive counseling and devices out of their own pockets. 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