Family wins freedom from Obamacare in federal court

When Missouri state Sen. Paul Wieland and his wife, Teresa, discovered their insurance provider no longer offered a plan without contraceptive coverage, they began to scour the internet for insurers who did. Finding none—because the Affordable Care Act mandates universal contraceptive coverage—the Wielands prepared to drop federal -funded health insurance altogether.

Then, they sued the Department of Health and Human Services (HHS).

“From the get-go in August 2013, the attorneys prepared us and said ‘This is going to be a long road’—about five or six years,” Paul Wieland, a Republican, told me.

Last week, U.S. District Judge Jean Hamilton ruled in favor of the Wielands. Her ruling enables Missouri insurers to allow the Wielands to opt in or out of healthcare coverage that offers contraceptives, abortifacient drugs, and sterilization.

Paul Wieland said the lawsuit is the only case where a single family has challenged the Affordable Care Act’s contraceptive mandate. The Wielands believe participating in contraceptive-inclusive plans, especially for their daughters who are ages 22, 21, and 15, defies their Catholic faith. Whenever Paul Wieland considered dropping coverage throughout the years, he consulted his priests, who deemed his refusal to “go along meekly with government plans” a moral one.

Up until 2013, a Missouri law allowed the Wielands and up to 10,000 other religious recipients since 2000 to opt out of the contraceptive package of the Missouri Consolidated Health Care Plan (MCHCP), said Tim Belz, the Wielands’ attorney.

“Opt outs worked just fine—nothing more than checking a box and a computer takes note of that. It’s real simple,” Belz told me.

In 2013, a U.S. District Court judge ruled federal Obamacare regulations superseded the state law, to the frustration of the Wielands and others. When Paul Wieland presented the lawsuit to a lower court in 2013, the judge told him he didn’t have the grounds to sue. However, a unanimous decision by the 8th U.S. Circuit Court of Appeals granted the Wielands the chance to argue their case in 2015.

In last week’s ruling, Judge Hamilton said HHS created a “substantial burden” for religious individuals like the Wielands by forcing their insurers, to whom they pay premiums, to pay a fee unless the insurers offer contraceptive coverage.

Like Burwell v. Hobby Lobby and similar cases on the contraceptive mandate, Hamilton upheld the Wielands’ claims under the Religious Freedom Restoration Act (RFRA). Unlike those cases, the Wielands’ lawsuit protects only families and individuals, not religiously affiliated corporations or non-profits.

For that reason, critics question how insurers will tailor healthcare plans to individuals’ beliefs and whether MCHCP will agree to offer “opt out” plans at all.

In court documents, HHS has claimed “insurance markets could not function—administratively or financially” if they allowed individuals to pick and choose which insurance plans suited their beliefs. They also claim the existing system is not a “substantial burden” on the family.

Douglas Laycock, a University of Virginia Law School professor and religious liberty expert, said, “If it’s unworkable, as the government says and I suspect, the insurers won’t do it and the plaintiffs will have no remedy.”

Even though Laycock said secular insurers like MCHCP “generally cannot or will not” alter their plans for religious objectors, he added they might be interested if the contraceptive-free plans are cost-free or even more profitable than inclusive plans—particularly in pro-life states like Missouri.

MCHCP declined to comment on whether it would provide contraceptive-free plans if Hamilton’s ruling held, but Belz pointed me to a record of a September 2012 MCHCP board meeting where officials said the company had prepared to offer plans without contraceptive packages if approved by the board.

So far, the HHS has not commented on whether it will appeal Hamilton’s ruling, but Paul Wieland, Belz, and Laycock believe the case will climb to higher courts—possibly even the Supreme Court.