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Sharpe Holdings, Inc. v. United States Department of Health and Human Services

United States Court of Appeals, Eighth Circuit

September 17, 2015

Sharpe Holdings, Inc. a Missouri Corporation; Rita Joanne Wilson, a Missouri resident; Judi Diane Schaefer, a Missouri resident; Charles N. Sharpe, a Missouri resident; CNS Corporation, a Missouri Corporation; Ozark National Life Insurance Company, a Missouri Corporation; N.I.S. Financial Services, Inc. a Missouri Corporation; CNS International Ministries, A Missouri Non-Profit Corporation; Heartland Christian College, A Missouri Non-Profit Corporation, Plaintiffs - Appellees
v.
United States Department of Health and Human Services; Sylvia Mathews Burwell, in her official capacity as the Secretary of the United States Department of Health and Human Services; United States Department of the Treasury; United States Department of Labor; Jacob J. Lew, in his official capacity as the Secretary of the United States Department of the Treasury; Thomas E. Perez, in his official capacity as the Secretary of the United States Department of Labor, [1] Defendants - Appellants, American Civil Liberties Union; American Civil Liberties Union of Missouri; Julian Bond; National Women’s Law Center; American Association of University Women; American Federation of State, County and Municipal Employees; Black Women’s Health Imperative; Feminist Majority Foundation; Ibis Reproductive Health; Legal Momentum; MergerWatch; NARAL Pro-Choice America; NARAL Pro-Choice Minnesota; NARAL Pro-Choice Missouri; NARAL Pro-Choice South Dakota; National Organization for Women Foundation; National Partnership for Women and Families; Planned Parenthood of the Heartland; Planned Parenthood of Kansas & Mid-Missouri; Planned Parenthood Minnesota, North Dakota, South Dakota; Planned Parenthood of the St. Louis Region and Southwest Missouri; Population Connection; Raising Women's Voices for the Health Care We Need; Service Employees' International Union; National Health Law Program; American Public Health Association; National Family Planning & Reproductive Health Association; National Women's Health Network; National Latina Institute for Reproductive Health; National Asian Pacific American Women's Forum; Asian Americans Advancing Justice; Asian Americans Advancing Justice - Los Angeles; Asian & Pacific Islander American Health Forum; Forward Together; Ipas; Sexuality Information and Education Council of the U.S.; HIV Law Project; 30 for 30 Campaign; California Women's Law Center, Amici on Behalf of Appellant(s), Liberty, Life, and Law Foundation; Association of Gospel Rescue Missions; Prison Fellowship Ministries; Association of Christian Schools International; National Association of Evangelicals; Ethics and Religious Liberty Commission of the Southern Baptist Convention; American Bible Society; the Lutheran Church-Missouri Synod; Institutional Religious Freedom Alliance; Christian Legal Society, Amici on Behalf of Appellee(s)

Submitted December 10, 2014

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Appeal from United States District Court for the Eastern District of Missouri - Hannibal.

For Sharpe Holdings, Inc. a Missouri Corporation, Rita Joanne Wilson, a Missouri resident, Judi Diane Schaefer, a Missouri resident, Charles N. Sharpe, a Missouri resident, CNS Corporation, a Missouri Corporation, Ozark National Life Insurance Company, a Missouri Corporation, N.I.S. Financial Services, Inc. a Missouri Corporation, CNS International Ministries, A Missouri Non-Profit Corporation, Heartland Christian College, A Missouri Non-Profit Corporation, Plaintiffs - Appellees: J. Matthew Belz, Timothy Belz, Ottsen & Leggat, Saint Louis, MO.

For United States Department of Health and Human Services, United States Department of the Treasury, United States Department of Labor, Jacob J. Lew, in his official capacity as the Secretary of the United States Department of the Treasury, Thomas E. Perez, in his official capacity as the Secretary of the United States Department of Labor, Defendants - Appellants: Beth S. Brinkmann, Adam C. Jed, Alisa Beth Klein, Patrick Nemeroff, Jacek Pruski, Joshua Marc Salzman, Mark B. Stern, U.S. Department of Justice, Washington, DC; Christina Bahr Moore, Assistant U.S. Attorney, U.S. Attorney's Office, Saint Louis, MO.

For American Civil Liberties Union, American Civil Liberties Union of Missouri, Julian Bond, Amicus on Behalf of Appellant(s): Brigitte Amiri, Jennifer Lee, Senior Attorney, American Civil Liberties Union, New York, NY; Daniel Mac, American Civil Liberties Union Foundation, Inc., Washington, DC; Anthony E. Rothert, American Civil Liberties Union of Missouri Foundation, Saint Louis, MO; Gillian R. Wilcox, Aclu of Missouri Foundation, Kansas City, MO.

For National Women's Law Center, American Association of University Women, American Federation of State, County and Municipal Employees, American Federation of State, County and Municipal Employees, Black Women's Health Imperative, Feminist Majority Foundation, Ibis Reproductive Health, Legal Momentum, MergerWatch, NARAL Pro-Choice America, NARAL Pro-Choice Minnesota, NARAL Pro-Choice Missouri, NARAL Pro-Choice South Dakota, National Organization for Women Foundation, National Partnership for Women and Families, Planned Parenthood of the Heartland, Planned Parenthood of Kansas & Mid-Missouri, Planned Parenthood Minnesota, North Dakota, South Dakota, Planned Parenthood of the St. Louis Region and Southwest Missouri, Population Connection, Raising Women's Voices for the Health Care We Need, Service Employees' International Union, Amicus on Behalf of Appellant(s): Leila Abolfazli, Gretchen Borchelt, Marcia D. Greenberger, Emily Martin, National Women's Law Center, Washington, DC; Charles E. Davidow, Karin Dryhurst, Andree J. Goldsmith, Paul & Weiss, Washington, DC.

For National Health Law Program, American Public Health Association, National Family Planning & Reproductive Health Association, National Women's Health Network, National Latina Institute for Reproductive Health, National Asian Pacific American Women's Forum, Asian Americans Advancing Justice, Asian Americans Advancing Justice - Los Angeles, Asian & Pacific Islander American Health Forum, Forward Together, Ipas, Sexuality Information and Education Council of the U.S., HIV Law Project, 30 for 30 Campaign, California Women's Law Center, Amicus on Behalf of Appellant(s): Martha Jane Perkins, Dipti Singh, National Health Law Program, Carrboro, NC.

For Liberty, Life, and Law Foundation, Amicus on Behalf of Appellee(s): Deborah Jane Dewart, Swansboro, NC.

For Association of Gospel Rescue Missions, Prison Fellowship Ministries, Association of Christian Schools International, National Association of Evangelicals, Ethics and Religious Liberty Commission of the Southern Baptist Convention, American Bible Society, The Lutheran Church-Missouri Synod, Institutional Religious Freedom Alliance, Christian Legal Society, Amicus on Behalf of Appellee(s): Kimberlee Wood Colby, Christian Legal Society, Springfield, VA.

Before WOLLMAN, COLLOTON, and BENTON, Circuit Judges.

OPINION

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WOLLMAN, Circuit Judge.

Contending that the district court[2] abused its discretion, the Departments of Health and Human Services (HHS), Labor (DOL), and Treasury, as well as their respective Secretaries, (collectively, the government) appeal from the entry of a preliminary injunction enjoining the government from enforcing certain provisions of the Patient Protection and Affordable Care Act (ACA), 42 U.S.C. § 300gg-13, against CNS International Ministries, Inc. (CNS) and Heartland Christian College (HCC), each of which is a nonprofit religious organization that offers healthcare coverage to employees through a self-insured plan.[3] We affirm the order granting the preliminary injunction.

CNS, a Missouri nonprofit corporation with more than fifty employees, provides full-time residential services to men, women, and children with behavioral problems or who suffer from alcohol or drug dependencies,

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and it operates a school that serves the children of individuals in its recovery program, as well as its employees' children. HCC, also a Missouri nonprofit corporation but with fewer than fifty employees, provides post-secondary higher education to employees and residents of CNS and their dependents. Christian belief and practice are integral to the identities of both CNS and HCC, and they strive " to promote certain moral and ethical standards in their employees, including . . . a belief in the sanctity of life which precludes abortion on demand." As part of their religious mission to promote the well-being and health of their employees, both CNS and HCC offer healthcare coverage to employees through self-insured group health plans, although HCC, with fewer than fifty employees, is not required by the ACA to offer healthcare coverage.

Under authority granted by the ACA, HHS promulgated regulations requiring " group health plan[s]" and " health insurance issuer[s] offering group or individual health insurance coverage" to cover, " [w]ith respect to women, . . . preventive care and screenings provided for in binding comprehensive health plan coverage guidelines supported by the Health Resources and Services Administration." 45 C.F.R. § 147.130(a)(1)(iv). At the recommendation of the Institute of Medicine, HHS adopted guidelines providing that nonexempt employers generally must provide " coverage, without cost sharing, for '[a]ll Food and Drug Administration [(FDA)] approved contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity'" (the contraceptive mandate). 77 Fed.Reg. 8725, 8725 (Feb. 15, 2012); see 29 C.F.R. § 2590.715-2713(a).[4] Contraceptive methods approved by the FDA include intrauterine devices (IUDs), levonorgestrel (Plan B), and ulipristal acetate (ella), each of which " may have the effect of preventing an already fertilized egg from developing any further by inhibiting its attachment to the uterus." Burwell v. Hobby Lobby,134 S.Ct. 2751, 2762-63, 189 L.Ed.2d 675 (2014). In general, any employer that offers employees a group health plan must comply with the contraceptive mandate or face ...


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