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Even if they say that doing so violates the basic tenets of their religion, employers must provide coverage for contraception as part of employee health care plans, the state Supreme Court ruled Monday. The court said employers — even church-affiliated employers — must qualify as a “religious employer” in order to be exempt from a state law that requires contraceptive coverage by employers who also provide insurance for prescription drugs. The 6-1 decision upholds the constitutionality of the California Women’s Contraception Equality Act, passed by legislators in 1999 to eliminate gender discrimination. Studies had shown that women in their childbearing years spend at least 68 percent more than men on out-of-pocket health care costs, largely because of contraceptive prices and unintended pregnancies. “This is a huge victory for working women in California,” Attorney General Bill Lockyer, whose office defended the state, said in a prepared statement Monday. “California courts have consistently ruled that non-religious employers cannot use religion to discriminate against women in the workplace,” he said. “[This] ruling upholds the principle that all people, including women, must be treated as equals.” But the American Life League’s Crusade for the Defense of Our Catholic Church called the ruling “an outrageous affront” to all people of faith. “It seems that the state of California is intent on convincing the world that up is down, that wrong is right,” the Virginia-based group’s director, Joseph Starrs, said in a prepared statement. “It seeks to recognize rights where they don’t exist, while usurping the constitutional right of Catholic Californians to the free exercise of religion.” Catholic Charities of Sacramento Inc., a nonprofit corporation that provides health and social services for the poor, disabled and elderly, had challenged the state law, saying it conflicted with church teachings that contraception is a sin. The corporation, whose 183 employees’ health coverage is provided by Blue Shield of California and Kaiser Permanente, said forced contraceptive coverage violates the establishment clause and the state Constitution’s religious freedom clause. The agency claimed it qualified as a “religious employer,” exempting it from the Contraception Equality Act’s requirements. On Monday, though, Justice Kathryn Mickle Werdegar, who authored the majority ruling, held that Catholic Charities didn’t meet the criteria laid out for an exemption under the Contraception Equality Act. “Catholic Charities concedes,” she wrote, “that its purpose is not the inculcation of religious values, that it does not primarily hire and serve Catholics and that it does not fall within either of the relevant provisions of the Internal Revenue Code” to qualify as a nonprofit. Werdegar also dismissed Catholic Charities’ contention that its compliance with a law on health care benefits implicated free speech issues. “The law leaves Catholic Charities free to express its disapproval of prescription contraceptives and to encourage its employees not to use them,” she wrote. In dissent, Justice Janice Rogers Brown argued that the law in question was “an intentional, purposeful intrusion” by the state into an organization’s religious tenets and “sense of mission.” “The government is not accidentally or incidentally interfering with religious practice,” she wrote. “It is doing so willfully by making a judgment about what is or is not religious. This is precisely the sort of behavior that has been condemned in every other context.” Brown also scoffed at the criteria set forth concerning exemptions for religious employers. She called them narrow. “This is such a crabbed and constricted view of religion that it would define the ministry of Jesus Christ as a secular activity,” she wrote. “The stinginess of the exemption makes the structure of the act all the more baffling.” Brown also said that women of childbearing age to whom contraceptive coverage is a major concern are not prevented from finding “more congenial employment.” “The existence of WCEA’s mandate — to which the vast majority of California employers apparently have no religious objection — enhances their employment options,” she wrote. “In fact, the defection of talented female employees may cause Catholic Charities to reconsider its position.” In her majority opinion, Justice Werdegar noted that Catholic Charities could get around the state law by simply not offering coverage for prescription drugs. “The WCEA applies only to employers who choose to offer insurance coverage for prescription drugs,” she wrote. “It does not require any employer to offer such coverage.” In a footnote, Werdegar pointed out that Catholic Charities could cut the coverage and give employees a raise instead. “A raise,” she wrote, “might be far more expensive for the employer than insurance, and a law that indirectly made a religious practice more expensive might at some point become a constitutionally significant burden on religious exercise.” In a separate ruling, Justice Joyce Kennard concurred with the majority, but expressed doubts that the Contraception Equality Act’s exemption standards bore any close relation to the goal of gender discrimination. Sacramento-based Deputy AG Timothy Muscat said the court’s ruling “reaffirms that the Legislature is acting with a compelling state interest when it fights discrimination in the workplace, and reaffirms the important principle that when the Legislature adopts an exemption that it doesn’t violate the state or federal constitutions.” Catholic Charities’ lawyer, James Sweeney, a partner in Sacramento’s Sweeney, Davidian, Greene & Grant, referred calls to the California Catholic Conference, which failed to respond by press time. But a group called Catholics for a Free Choice applauded Monday’s ruling. “Hopefully, this decision will bring proper scrutiny on Catholic health care facilities that seek to circumvent state laws and deny women access to health care that they are legally entitled to,” Vice President Jon O’Brien said in a prepared statement. “This decision is particularly important to economically challenged women and men who rely on basic health care in hospitals. Justice has been served.” The ruling is Catholic Charities of Sacramento Inc. v. Superior Court (Department of Managed Health Care), 04 C.D.O.S. 1737.

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