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Reproductive Health
May 15, 2020

Supreme Court to Decide Fate of Affordable Care Act Contraceptive Coverage Mandate

Author Affiliations
  • 1Solomon Center for Health Law and Policy, Yale Law School, New Haven, Connecticut
  • 2Deputy Editor, JAMA, Chicago, Illinois
JAMA Health Forum. 2020;1(5):e200605. doi:10.1001/jamahealthforum.2020.0605

The US Supreme Court recently heard its third case regarding the contraceptive coverage mandate of the Patient Protection and Affordable Care Act (ACA), which requires all health insurance plans to cover US Food and Drug Administration (FDA)–approved contraceptives without cost sharing. The pair of consolidated cases,1 Little Sisters of the Poor v Pennsylvania and Trump v Pennsylvania, concerns the Trump administration’s regulations2 that vastly expanded the universe of employers exempt from the mandate. The rules would exempt from this ACA requirement any employer with a religious or nonreligious moral objection to providing contraceptive coverage. In July 2019, the Third Circuit Court of Appeals upheld a nationwide injunction, so the rules have not yet taken effect. If the US Supreme Court reverses the decision of the Third Circuit and upholds the new rules, many employers could remove contraceptive coverage from their insurance plans. For women with employer-sponsored health insurance, such a decision could leave many without contraceptive coverage and thereby undermine public health.

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