University of Notre Dame v. Burwell

The University of Notre Dame (Notre Dame) (plaintiff), a Catholic university, provided insurance to its employees via plans administered by Meritain Health, Inc. (Meritain) and contracted Aetna, Inc. (Meritain’s parent) to provide health plans to its uninsured students. Because Catholicism forbade contraceptives, Notre Dame never covered contraceptives for its employees and restricted Aetna from covering contraceptives for its students. The Affordable Care Act (ACA), enacted in 2010, required health-insurance companies to cover contraceptives in an attempt to reduce unintended pregnancies. Notre Dame did not originally qualify for the ACA’s religious exemption and therefore filed suit, claiming that the contraceptive requirement infringed its right to free exercise under the First Amendment and the Religious Freedom Restoration Act. However, the government (defendant) subsequently expanded the ACA’s exemption to include Notre Dame and similar institutions, and therefore, the suit was dismissed. To assert the exemption, the ACA required Notre Dame to sign an exemption form and send copies to Meritain/Aetna. Thereafter, Meritain/Aetna communicated directly with the students/employees and covered the contraceptives, and the government ultimately reimbursed the companies. Although Notre Dame took advantage of the ACA’s expanded exemption, it sought a preliminary injunction in district court to enjoin the government to allow Notre Dame to restrict Meritain/Aetna from covering contraceptives. Notre Dame argued that, because Notre Dame had contracts with Meritain/Aetna and had signed the exemption forms that led to Meritain/Aetna covering contraceptives for Notre Dame’s students/employees, Notre Dame was a conduit for, and complicit in, the sin of contraception in violation of its right to free exercise. Notre Dame also argued that its sending of the exemption forms was the cause of Meritain’s obligation to provide contraceptives. Notre Dame also argued that the government could have achieved its goal by other means, and it proposed several costly and inefficient alternatives. The district court denied the preliminary injunction. Notre Dame appealed.