Analysis Religion

Beyond Little Sisters: The Argument Against Signing the Contraception Mandate Exemption Form

Tara Murtha

Little Sisters has been getting a lot of attention as an example of how conservatives' battle against the Affordable Care Act's contraception mandate looks more like culture-war ritual than a good-faith effort to productively resolve the conflict between church and state. But there are many other, more typical cases.

Read more of our coverage on the Little Sisters of the Poor case here.

The new year kicked off with a dramatic bit of news regarding the fight against the Affordable Care Act’s contraception mandate. On New Year’s Eve, Supreme Court Justice Sonia Sotomayor issued an injunction for the Little Sisters of the Poor Home for the Aged, a group of Catholic nuns who operate nursing homes in Colorado and Maryland. The Little Sisters aren’t arguing against providing contraception; the group is exempt from the mandate already. Rather, the Little Sisters are arguing against signing the paperwork required to self-certify their exempt status.

As it turns out, the group operates under a “church plan,” a belatedly recognized category that means Little Sisters employees can’t get contraception coverage directly from the organization’s insurance company, as is the case for employees of most exempted nonprofits under the Affordable Care Act (ACA). So the Little Sisters are fighting against signing a form that, even if signed, wouldn’t lead to contraception coverage for its employees anyway.

Little Sisters has been getting a lot of attention because it is an idiosyncratic case, and from the perspective of critics, a sterling example of how conservatives’ battle against the ACA’s contraception mandate looks more like culture-war ritual than a good-faith effort to productively and logistically resolve the conflict between church and state.

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As Sarah Posner writes at Religion Dispatches, “I’m not sure which part is more inexplicable: that the government didn’t figure this out sooner, or that the religious objectors are still complaining about it.”

While the Little Sisters case exposed the “church plan” loophole, the majority of nonprofits filing federal suits against the mandate do not operate under such a plan. A total of 45 nonprofits have filed federal lawsuits against signing the opt-out paperwork. With most of these exempt nonprofits, employees procure contraception coverage directly from their insurer after their employers opt out of the process.

So what does one of these typical cases look like?

Geneva College is a Christian college founded by the Reformed Presbyterian Church of North America, located about a half hour north of Pittsburgh. It was quietly granted an injunction right before Christmas.

Similar to arguments made by the for-profit cases going to the Supreme Court, Geneva College doesn’t object to all forms of birth control, but rather just what it calls “abortifacient products such as ella, Plan B, and intrauterine devices,” according to court documents.

Ella, Plan B, and IUDs are not abortifacients; the Food and Drug Administration classifies them as emergency contraception. The contraception mandate does not cover abortion.

Nonetheless, “Geneva …  firmly believe[s] that the procurement, participation in, facilitation of, or payment of abortion”—including the use of what it incorrectly classifies as abortion-causing drugs—”violates the Commandment against murder.”

Echoing the argument made on behalf of the Little Sisters, Geneva College is arguing that signing the opt-out form violates the college’s religious freedom because it makes the institution the “sole trigger” and “central cog” for employees to obtain the services they object to.

In short, religiously affiliated nonprofits like Geneva College requested and received a mechanism to opt out of a mandate in the name of religious freedom, but are now claiming that using said mechanism also violates their religious freedom.

In discussing a similar case, Marty Lederman, deputy assistant attorney general in the Department of Justice’s Office of Legal Counsel, argued that the form isn’t an authorization—it’s essentially a release.

The argument against signing the paperwork demonstrates that for some of the groups challenging the contraception mandate, exemption is not enough, which raises the question: What would be?

“They’re saying that the government is not allowed to make any other arrangement for these women,” said Greg Lipper, senior litigation counsel with Americans United for Separation of Church and State, which has filed friend-of-the-court briefs supporting the mandate and represents Notre Dame students in that case. “It’s a hostage-taking maneuver.”

Geneva College is also a typical example of nonprofits that have filed suit against the mandate in that prior to the mandate, the forms of contraception the school now so vehemently opposes were actually covered by the school’s health insurance plan, unbeknownst to school leaders. According to court documents, “For a time, without the College’s knowledge, the insurer included coverage of ella, Plan B, and IUDs in the College’s employee health plan.”

Analysis Human Rights

Living in the Shadow of Counterterrorism: A Daily Struggle for Muslim Women

Kanya D’Almeida

In the second part of Rewire’s “Living in the Shadow of Counterterrorism” series, we look at how Muslim families, particularly women, are forced to confront state violence on a daily basis­­—from living with the stigma of terrorism, to repairing their broken homes, to navigating what they say is a brutal and biased prison system.

This is the second article in Rewire’s “Living in the Shadow of Counterterrorism” series. You can read the other pieces in the series here.

When Virginia native Mariam Abu-Ali was 14 years old, her life abruptly turned upside down. It was 2003, two years after the September 11 attacks and well into an era of counterterrorism tactics that were systematically hollowing out Muslim residents’ civil liberties and constitutional protections in the United States. But the Abu-Ali family never imagined they would be caught up in the dragnet.

Mariam’s then-22-year-old brother, Ahmed Omar, had been studying in Medina, Saudi Arabia, when he was arrested in connection with a series of May 2003 terrorist attacks in Riyadh.

In an interview with Rewire, Mariam says her brother, who was born in Texas, was held in solitary confinement in a Saudi jail for nearly two years without ever being charged with a crime. During that time, Mariam tells Rewire over the phone, there is strong evidence that he was tortured. Although defense expert Dr. Allen Keller, director of the Program for Survivors of Torture at the Bellevue/NYU Hospital, examined Ahmed and testified at his U.S. trial to the evidence of torture, an appeals court eventually ruled that Ahmed’s statements to Saudi interrogators were “voluntary.”

When, after months of legal pressure from his family, he was finally returned to the United States, a court for the Eastern District of Virginia charged him with multiple counts, including conspiring with an Al-Qaeda cell in Medina to carry out terrorist attacks on U.S. soil. Following a trial that permitted the admission of what Mariam called “a coerced confession,” he was eventually sentenced to 30 years in prison, and later re-sentenced to life.

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Yet as legal experts like Elaine Cassel, author of The War on Civil Liberties: How Bush and Ashcroft Dismantled the Bill of Rights, have pointed out, “Nowhere in the indictment [was] Abu-Ali tied to any terrorist event or action”—either in the United States or in Saudi Arabia.

Instead, his case fell under the shadowy material support statutes that have governed much of the United States’ counterterrorism operation in the years since 9/11, under the USA Patriot Act of 2001. This set of laws allows the U.S. government to preemptively prosecute individuals for engaging in terrorism based on their perceived predisposition toward violence, rather than their actions.

Over the past 15 years, hundreds of Muslims have disappeared in a warren of these convoluted laws; they are currently locked up in high-security prisons around the country.

A constellation of families, scholars, activists, and civil rights organizations have long challenged the effects of material support charges, as well as the unfair trials and the lengthy and harsh prison sentences that tend to follow them. Over the past few years, they have come together in a campaign called No Separate Justice, an attempt to unite far-flung groups and individuals who are working to dismantle what they say is a parallel and unjust legal system for Muslim residents in post-9/11 America.

Women like Mariam Abu-Ali have been at the forefront of the movement—along with Zurata Duka and Shahina Parveen, whose stories Rewire has previously reported on—advocating on behalf of their loved ones.

In the second part of Rewire’s “Living in the Shadow of Counterterrorism” series, we look at how families, particularly women, are forced to confront state violence on a daily basis­­—from living with the stigma of terrorism, to repairing their broken homes, to navigating what they say is a brutal and biased prison system.

“Dangerous” Minds, Draconian Measures

Mariam Abu-Ali says her brother’s case represents many of the civil rights violations that have marred the decade and a half since 9/11, a sentiment that is echoed in the final opinion on Ahmed Omar’s case penned by the U.S. Court of Appeals for the Fourth Circuit.

In its unanimous decision to uphold the guilty verdict on nine terrorism-related counts against Ahmed in 2008, the three-judge bench wrote:

Persons of good will may disagree over the precise extent to which the formal criminal justice process must be utilized when those suspected of participation in terrorist cells and networks are involved … the criminal justice system is not without those attributes of adaptation that will permit it to function in the post-9/11 world.

While the opinion does not explicitly state what these “attributes of adaptation” are, studies on counterterrorism indicate they could refer to any number of legal practices that have become normalized since September 11. In particular, they could refer to the use of material support statutes, which have played a significant role in the prosecution of Muslim Americans like Ahmed Omar.

As FBI Assistant Director Gary Bald testified to the Senate Committee on the Judiciary in 2004:

It would be difficult to overstate the importance of the material support statutes to our ongoing counterterrorism efforts. The statutes are sufficiently broad to include terrorist financers and supporters who provide a variety of resources to terrorist networks. The statutes provide the investigative predicate which allows intervention at the earliest possible stage of terrorist planning to identify and arrest terrorists and supporters before a terrorist attack occurs. [Emphasis added.]

In short, material support statutes have enabled federal authorities to prosecute people based on suspicion of what they might do in the future rather than any overt criminal act. The statutes primarily refer to “support” for terrorist networks as weapons, arms training, or direct funding. Prosecutors, courts, and juries, however, have interpreted the laws much more broadly to encompass the sharing of religious or political texts online, casual conversations between friends, or charitable donations to organizations in areas controlled by terrorist groups.

In many instances, material support charges have amounted to nothing more than thought crimes, in which law-abiding Muslim residents have been penalized simply for expressing their religious and political views.

According to a 2014 report by Human Rights Watch, material support cases rose sharply in the decade following the September 11 attacks. Prior to 9/11, just six individuals had been charged under these laws in the United States. In the decade following, 168 of 917 domestic terrorism convictions analyzed by HRW fell under such statutes, accounting for 18 percent of all terrorism-related convictions in that time period.

Even a cursory look at some of these cases is sufficient to grasp the breadth of these laws, which have pushed deep into Muslim communities, tearing through many layers of social fabric along the way.

In 2012, the New York Times published an op-ed by Yale professor Andrew March on the case of Tarek Mehanna, a Pittsburgh-born doctor and community leader who was sentenced to 17 and a half years in prison because his opinions about Islam, expressed online, were deemed a form of material support for terrorist causes.

March wrote in the Times:

As a political scientist specializing in Islamic law and war, I frequently read, store, share and translate texts and videos by jihadi groups. As a political philosopher, I debate the ethics of killing. As a citizen, I express views, thoughts and emotions about killing to other citizens. As a human being, I sometimes feel joy (I am ashamed to admit) at the suffering of some humans and anger at the suffering of others. At Mr. Mehanna’s trial, I saw how those same actions can constitute federal crimes.

March’s op-ed illustrates a frightening truth about material support statutes: They allow for the preemptive prosecution of individuals who have not yet committed a crime but whom the government deems capable of possibly committing a crime in the future.

Other cases, such as the Holy Land Five, demonstrate a pattern in which material support laws have essentially criminalized charitable giving. The case involved the founders of the Holy Land Foundation, a Muslim charity that provided humanitarian aid to the needy, including women and children in Palestine. Though the government concluded that the Holy Land Foundation never directly aided a terrorist organization, it nonetheless prosecuted five of its members for funneling aid through charitable committees into areas controlled by Hamas, a designated Palestinian terrorist group, thereby violating material support statutes. Journalists called the verdict an attack on Islam itself, particularly the practice of zakat, which mandates that Muslims allocate a portion of their wealth or earnings for charitable causes.

Because cases based on material support statutes tend to paint the accused as extremely dangerous persons, they are often accompanied by harsh conditions of confinement, both pretrial and following a conviction.

From its very inception, the No Separate Justice (NSJ) campaign has fought this flawed notion, with mothers and sisters of the accused becoming the movement’s most prominent spokespeople. NSJ initially coalesced around the case of a Muslim American named Fahad Hashmi.

Hashmi had been working toward a master’s degree in international relations at London Metropolitan University when he was arrested at Heathrow Airport in 2006. In 2007 he became the first U.S. citizen to be extradited following the loosening of restrictions around the process after 9/11, according to an article by Jeanne Theoharis, a political science professor at Brooklyn College and co-founder of the NSJ campaign, who taught Hashmi as an undergraduate.

He was initially held in pretrial solitary confinement at the Metropolitan Correction Center (MCC) in downtown Manhattan. MCC’s notoriety was cemented in a 2010 New York Times article that quoted a former Guantanamo detainee, who was also held at the MCC, as saying the Cuban military prison was “more pleasant” and “more relaxed” than the federal detention facility in New York City.

Hashmi was also subjected to special administrative measures, government restrictions on a terror suspect’s communications that amount to a gag order on the case and their conditions of confinement. Advocates say these were drastic measures relative to the charges against him: Hashmi’s only crime, according to Theoharis’ article, was allowing an acquaintance to spend a night in his apartment, an acquaintance who would later deliver a suitcase of raincoats and waterproof socks to Al Qaeda members. This same acquaintance would later become a cooperating witness for the government in exchange for a more lenient sentence, and testify against Hashmi in a trial that ended with a guilty verdict and a 15-year sentence.

Stunned by Hashmi’s conditions of confinement, a group called Theaters Against War linked arms with Educators for Civil Liberties and the Muslim Justice Initiative to host weekly vigils outside the MCC in 2009. These gatherings, which continue to this day, form the nucleus of the NSJ movement.

“We wanted to build a coalition so people from different backgrounds could bring their institutional expertise and moral conscience into the same arena as family members, and create a space where people could express outrage at what was happening,” Sally Eberhardt, one of NSJ’s earliest organizers, tells Rewire.

At first, larger civil liberties groups kept their distance, possibly because “this isn’t exactly the most funder-friendly issue in the world,” Eberhardt suggests. But advocates persisted, holding candlelight protests even on the bitterest winter nights, singing songs and chanting poems in the shadow of the detention center. Those intimate gatherings formed the basis of what is now a national movement, encompassing multiple organizations and dozens of families.

Two outspoken leaders are the Sadequee sisters, Bangladeshi Americans who have been among the strongest advocates of prisoners’ rights and the most public critics of the government’s targeting of Muslim men—including their brother, Shifa.

From the Streets to the Prayer Rug: Pushing Back Against State Violence

Ehsanul “Shifa” Sadequee was born in Virginia and grew up in Atlanta, Georgia, the youngest of four siblings in a Bangladeshi-American family. According to his sisters, he was a curious and exceptionally kind child, who by his early teens had grown into a devout and diligent religious scholar.

In 2005, when he was just 18 years old, Shifa traveled to Bangladesh. In April 2006 he got married, but 12 days after his wedding, Bangladeshi authorities took and detained him, apparently at the behest of the U.S. government, for allegedly making false statements to the FBI at John F. Kennedy Airport on his way to Bangladesh the previous year.

Shifa’s sister Sonali, who is based in Atlanta, tells Rewire that this initial charge and arrest, which the High Court Division of the Supreme Court of Bangladesh later deemed a violation of international laws, was a terrifying process for the entire family. For days after Shifa was taken they had no news of his whereabouts. Fears that he would somehow wind up in Guantanamo, ensnared in the web of the “war on terror,” gnawed at the edges of their minds but the family pushed these aside, telling themselves that because Shifa had done nothing wrong, they had nothing to fear. With the phone ringing off the hook and the television on 24/7, they gleaned what scraps of information they could from CNN news reports.

It transpired that upon his arrest in Bangladesh, Shifa was stripped naked, wrapped in plastic, and flown via Alaska to New York, Sonali says, where he spent over three months at the Metropolitan Detention Center (MDC) in Brooklyn before being transferred to the federal penitentiary in Atlanta, Georgia. Shifa spent more than three years in pretrial solitary confinement before ever being formally charged with a crime, his sister said.

Once Shifa was inside the criminal justice system, Sonali explains, federal authorities quickly dropped the initial charges against him and began to build a case around allegations of material support.

At the heart of the case was Shifa’s renown as an Islamic scholar with a larger-than-life online persona—he had studied classical Arabic and the history of religion as a student in Canada and was a gifted translator, often sharing interpretations of Islamic or political texts on the internet. The Sadequee family says Shifa’s trial was riddled with shortcomings, including the use of previously classified evidence and the selection of jurors who admitted to having anti-Muslim bias—which Human Rights Watch says is a common problem. In addition, the prosecution used Shifa’s ideology as a brush with which to paint him as a fearsome radical, on the verge of carrying out a violent attack on U.S. soil.

Although Shifa, according to Sonali, never engaged in any actions beyond practicing free speech, he was found guilty on four terrorism counts in 2009 and, at the age of 23, sentenced to 17 years in federal prison. He represented himself at the trial, making him one of the first Muslim youth to do so in a national security case, according to his sisters.

Both Sonali and Sharmin Sadequee, who is based in New York, have been mobilizing on his behalf for over a decade. After years of shielding themselves from the backlash of isolation and Islamophobia that invariably accompanies charges of terrorism, the young women have turned their advocacy into an art form.

In an interview with Rewire, Sonali explains that when her brother was arrested, the women in her family developed an organic division of labor that allowed them to form a united front against the horror and uncertainty that had descended on their lives.

“I was already plugged into the social justice community in Atlanta, so I saw my role as tapping into that support network, bringing resources to my family to make sure we all understood the human rights issues involved, ensuring we had the skills to confront the media, which was bombarding us at the time,” she says. Her sister, meanwhile, dealt with the prisons, navigating bureaucratic visitation rules and ensuring Shifa had what he needed on the inside.

“Sharmin and my mother also reached out to the Muslim community, to mosques and other groups,” Sonali continues. “And the rest of the time, my mother was on the prayer rug. I don’t know how many hours she spent kneeling and praying.”

They built a website that is always fresh with the latest news about Shifa’s case and serves as a hub for their activism—they recently announced a letter-writing campaign to mark Ramadan, inviting more than 1,000 followers of a Justice for Shifa Facebook group to send greeting cards to Muslim prisoners. Countless hours are eaten up attending rallies, speaking on panels, or sitting with reporters, patiently unpacking the messy details of Shifa’s case.

The irony is that while the Sadequee sisters make a powerful team, they are constantly called upon to do what they say is the hardest thing of all: relive a time in their lives they would rather forget.

“I don’t like to do these interviews,” Sonali says bluntly. “I don’t enjoy them at all—but I recognize they have to be done. Only by sharing what happened to us, by talking about it, will others learn from it.”

They say they have been trying to create collective responses to state violence resulting from the “war on terror,” and hope to combat the government’s tactics of fear and isolation by building community power and resiliency. But this is easier said than done: Not only must the Sadequees contend with the lingering stigma of Shifa’s trial, but they also, until very recently, had to deal with the trauma of visiting their brother in a prison unit that has been described by former detainees as “Little Gitmo.”

CMUs: “A Religious and Political Quarantine”

Between 2009 and 2015, Shifa was imprisoned in the Communications Management Unit (CMU) at the federal detention center in Terre Haute, Indiana, a segregated portion of the prison comprised almost exclusively of Muslim men that has been the subject of a legal battle since 2010.

This past March, the Center for Constitutional Rights (CCR) urged the Court of Appeals for the District of Columbia to reinstate a lawsuit the group first filed six years ago challenging CMUs, which the Bureau of Prisons (BOP) quietly ushered into existence under the Bush administration—the first in 2006 in Indiana, and the second in 2008 in Marion, Illinois.

Conditions in these units, which house 60 to 70 prisoners combined, are harsh, according to the CCR: Although inmates are not held in isolation, they are banned from having any physical contact with family members during visits, and their calls are restricted to two per week, each for 15 minutes. By contrast, other BOP inmates are allowed 300 minutes worth of calls every month.

CCR claims the CMUs violate prisoners’ procedural due process rights, and argue that placement in these units is both arbitrary and retaliatory, with Muslim prisoners vastly overrepresented.

“Between 2006 and 2014, about 170 individuals filtered through these units and 101 of them—about 60 percent—were Muslims, even though Muslims only constitute 6 percent of the general federal prison population,” CCR Senior Staff Attorney Rachel Meeropol tells Rewire in a phone interview.

CCR reported in 2010 that in Marion, 72 percent of current CMU prisoners were Muslim, a 1,200 percent overrepresentation, while two-thirds of the CMU population in Terra Haute was Muslim, 1,000 percent higher than the national average of Muslim prisoners in federal facilities.

“We are challenging the lack of procedural protections before prisoners are placed in the CMU and also alleging that placement is in retaliation for protected political and religious speech,” Meeropol says, pointing out that inmates in the CMU are seldom given reasons for why they were moved into the units, and are routinely denied opportunities to earn their release into general population.

“CMUs are essentially a religious and political quarantine, the same kind of segregation that has supposedly been outlawed in this country,” she added.

In response to multiple requests for comment about these allegations, Justin Long with the Office of Public Affairs at the Information, Policy and Public Affairs Division for the BOP said in an email to Rewire, “The Bureau of Prisons cannot comment on matters currently in litigation,” and directed Rewire to the Bureau’s web page on CMUs.

In addition to being hard on inmates, Meeropol says CMUs are also “debilitating” for families, especially those with young children who cannot communicate with their fathers through letters, and often cannot understand why they are forced to speak to them through glass, using phones that are monitored by prison staff.

“Several mothers have told me that they’ve stopped bringing their children on visits because it was just too devastating,” Meeropol says.

The Collective Trauma of “Supermax” Prisons and Solitary Confinement

The alternative, some might say, is even worse. All over the country, Muslim prisoners are serving decades-long sentences in solitary confinement, which the United Nations has recognized as a form of torture. Advocates and relatives of terror suspects, or those incarcerated on terrorism charges, have long cried foul over these conditions of confinement, which they say is a form of collective punishment on entire families.

Zurata Duka, whose three sons, Dritan, Shain, and Eljvir were arrested in a manufactured terror plot by the government in 2007, is well aware of the toll of solitary confinement. Her sons have spent dozens of years between them in complete isolation, including long stints at the maximum-security facility in Florence, Colorado.

“My sons are strong—they never let us see them cry, even when their daughters are crying on the other side of the glass,” she says to Rewire. “But once my son Dritan told me he nearly lost his mind in isolation.”

Before his arrest, Zurata tells Rewire, Dritan had been very close with his youngest daughter. Every night he would put her to sleep, stroking her hair and singing lullabies. In those early days after he was taken away, the little girl would lie awake at night, calling out for her father. Unbeknownst to the family, thousands of miles away, Dritan was experiencing something similar.

“He told me, ‘Mom, I don’t know what happened. For three days I just lay there, stroking my pillow, thinking it was [his daughter]. I didn’t know who I was and I don’t know how I came back,’” Zurata recalls him saying.

His daughter was so desperate to see him that one day she penned a note to the president. It read: “Dear Mr. Obama. Today is my birthday. I am five years old. Please, if you can, bring my father back just for one day, so I can hug and kiss him, and then, if you want, you can take him back again.” Zurata says she mailed the letter to the White House. She never heard back.

Almost every family has a similar story. According to Mariam Abu-Ali, conditions of confinement often come up at annual gatherings of affected families, which she organizes in her role as director of the Prisoners and Families Committee at the National Coalition to Protect Civil Freedoms.

“About 90 percent of the attendees are women,” she says in a phone interview with Rewire, “and they bring a lot of pain and anxiety into the room. But I’d say the meetings are cathartic,” she adds. “It’s the place where we build bonds with the only people who know what we’re going through.”

Several women who’ve attended the conference in the past tell Rewire they are powerful spaces, offering families a rare chance to speak openly about their lives without fear of being misunderstood, judged, or pitied. It is also a moment for families, particularly women, to share in the collective nature of their trauma, especially the pain of incarceration.

In the 13 years that her brother has served, Mariam says she has come to the painful realization that prisons don’t just lock up individuals—they are a form of bondage on the entire family.

Because Ahmed Omar is imprisoned 1,600 miles from the family’s home in Virginia, in one of the BOP’s maximum-security facilities in Colorado, they only see him once or twice a year. Visits are limited to three family members at a time, meaning Mariam has not seen Ahmed in two years. He reserves his two monthly phone calls for his parents, so she can only hope to talk to him when she visits them. Even these calls are a source of enormous frustration. As she wrote in a recent op-ed:

My mom has spent every Tuesday and Thursday of the last decade, at home, sitting by the phone, patiently waiting for a call that sometimes did not come. And when the call does come, what can one even discuss in 15 minutes? Do you ask him how he’s doing? How can you even ask him how he’s feeling? Do you discuss his prison conditions? His legal case? How do you break the news to him when his aunt or grandfather has passed away?

“What you have to understand is that my brother’s case wasn’t just one devastating ‘moment’ in our lives—it’s a lifelong struggle,” Mariam tells Rewire. “This is not something you ever get used to, or accept. It’s about learning new ways of coping every single day, like living with a chronic illness.”

Each day brings fresh challenges, and tough decisions. For instance, Mariam used to maintain a website, manage a Facebook page, and post daily updates on a Twitter account all relating to her brother’s case. One day she felt she just couldn’t do it anymore.

“At a point you have to ask yourself—do I work full time and provide for my family or do I advocate full time on behalf of my loved one?” she asks. “This work, it’s emotionally draining, it’s a daily struggle and it doesn’t necessarily get easier with time.”

CORRECTION: An earlier version of this article misidentified the officials whom Shifa Sadequee had been accused of making false statements to. It was FBI officers, not immigration officials.

Analysis Law and Policy

Religious Nonprofits Press Supreme Court for Full Exemption From Birth Control Benefit

Jessica Mason Pieklo

The Supreme Court ordered the Obama administration and religiously affiliated nonprofits to work out a solution to the challenges to the Affordable Care Act's birth control benefit. Not surprisingly, the religiously affiliated nonprofits refuse to do so.

In late March, the U.S. Supreme Court heard oral arguments in Zubik v. Burwell, the lead case challenging the Obama administration’s process for accommodating religious objections to the Affordable Care Act’s birth control benefit. It was apparent then that the remaining eight justices were deadlocked as to whether the process did enough to protect the religious objections of the nursing home operators and university administrators who had launched this latest round of lawsuits.

Hoping to avoid a split decision—which would subject some religiously affiliated nonprofits to penalties if they failed to follow the accommodation process and not others, depending on their appellate court circuit —the justices ordered the government and the religious objectors to try and find a solution both sides could work with and present it to the court via briefing in April. Well, the nonprofits and the Obama administration have filed that first round of briefing. And if the Roberts Court thought the religious objectors were interested in any sort of real solution to the problems posed in their lawsuits, it was mistaken. The negotiating position for the religiously affiliated challengers remains: full exemption from the requirement or bust.

In its order asking for supplemental briefing, the Roberts Court asked parties on both sides to address whether “contraceptive coverage may be obtained by petitioners’ employees through petitioners’ insurance companies, but in a way that does not require any involvement of petitioners beyond their own decision to provide health insurance without contraceptive coverage to their employees.” According to the nonprofits, “[t]he answer to that question is clear and simple: Yes.”

If only it were that clear and that simple.

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In the remaining 20-plus pages of the nonprofits’ brief, their lawyers set out a variety of options that could, they say, provide seamless contraception coverage while preventing the nonprofits from in any way “facilitating” the sin of providing health insurance plans that include contraception. But the thing is, none of those options are actually accommodations to the ACA’s requirement that employer-provided health insurance plans cover contraception at no additional cost or co-pay.

One of the religious objectors’ solutions, for example, is to have the government directly require insurance companies to create entirely new and separate contraception-only plans. The companies would then contact plan beneficiaries directly with information about the policy and how to enroll. These separate plans, objectors offer, could take the form of individual insurance policies or of group health plans sponsored by the government.

In other words, one option is for the government to come up with an entirely different regulatory scheme for dealing with contraception altogether. That scheme would apply to religiously affiliated nonprofits and presumably the secular for-profit companies like Hobby Lobby that petitioned the Roberts Court for the very same accommodation now regarded by objectors as too onerous for compliance.

The fact this is one option offered up by the religiously affiliated nonprofits should come as no surprise. It’s right out of the anti-choice playbook with regard to insurance coverage for abortion. As states set up their own insurance exchanges during the implementation of the ACA, anti-choice politicians were quick to put restrictions on the kinds of coverage for abortion that insurance companies could offer in individual or employer-sponsored plans. So far, 10 states ban abortion coverage generally, while 25 ban abortion coverage in their exchanges. In other words, if you happen to live in Idaho, Indiana, Kansas, Kentucky, Michigan, Missouri, Nebraska, North Dakota, Oklahoma, or Utah, you cannot purchase a health insurance plan that covers abortion. At all. Including through your employer. Meanwhile, states like Arizona, Florida, North Carolina, Virginia, and Wisconsin—just to name a few—prevent comprehensive health insurance plans that cover abortion from being sold on their state exchanges.

Do we really think that if this “contraception insurance” plan offered by the religiously affiliated institutions were to become the “solution” to these legal challenges, the result would look any different than it has for insurance coverage for abortion? Hypothetically, broad contraceptive coverage could end across the country, with many states banning the coverage altogether. This, of course, is the exact scenario the Supreme Court is hoping to avoid.

All of the objectors’ “solutions” are, in fact, just other ways of granting exemptions from the birth control benefit. In other words, they seem to be saying, if and when religiously affiliated hospitals, nursing homes, and day care centers can be treated under the law the same way as churches, synagogues, and mosques, then the lawsuits will stop.

That doesn’t sound so much like a compromise as it does a threat.

The Obama administration has until April 20 to respond directly to the petitioners’ arguments. It has already filed its own briefing arguing the process as it stands completely accommodates any religious objections in a way that balances the government’s compelling interest in promoting nondiscriminatory health insurance coverage for employees while respecting the beliefs of those who see contraception as sin.

But perhaps most importantly, the government’s brief argues that any additional tinkering with the accommodation process, rather than a ruling on the merits by the Roberts Court that the current process is sufficient, will only result in many more years of litigation. And it’s a point the petitioners pretty much concede by failing to offer up any workable compromise at all.