Women's Health: Religiously Affiliated Chanties Must Comply With WCEA Requirements To Offer Birth Control Insurance Coverage-Catholic Charities of Sacramento, Inc. v. Superior Court of Sacramento County1-The Supreme Court of California held that the Women's Contraception Equity Act ('WCEA') does not violate the Establishment and Free Exercise Clauses of the U.S. and California Constitutions.2 In 1999, the California legislature enacted the WCEA to eliminate gender discrimination in healthcare benefits. Evidence had shown that women spent a great deal more on healthcare costs during their reproductive years than did their male counterparts. In addition, about 10% of California's commercially insured did not have coverage for prescription contraceptives. The WCEA requires that certain health care plans that include prescription drugs must cover prescription contraceptives. In passing the WCEA, the legislature asserted that the purpose of the law was to reduce discrimination in healthcare benefits. Catholic Charities of Sacramento ('Catholic Charities'), a church-affiliated employer, challenged the constitutionality of the WCEA.
In particular, Catholic Charities took issue with the WCEA's exception for religious employers. In order for a group to meet the definition of a 'religious employer' under section 1367.25 of the California Health and Safety Code, it must meet four criteria: '(A) The inculcation of religious values is the purpose of the entity[;] (B) The entity primarily employs persons who share the religious tenets of the entity[;] (C) The entity serves primarily persons who share the religious tenets of the entity[; and] (D) The entity is a nonprofit organization . . . .'3 Catholic Charities acknowledged that it did not meet any of these criteria.4 However, the organization asserted that the WCEA was unconstitutional because it interfered with the autonomy of the religious organization, burdened the right to free exercise, and that the WCEA would fail both strict scrutiny and rational basis tests.5
The court first analyzed the assertion that the WCEA interfered with Catholic Charities' religious autonomy. It has been decided by the U.S. Supreme Court that courts must accept decisions made by the highest church judicatories regarding questions of discipline, faith, ecclesiastical rule, custom, or law.6 In light of these holdings, Catholic Charities claimed that the WCEA interfered with matters of internal church governance. The court however, determined that the legislature had not decided any religious question in enacting the WCEA.7 Since no religious question had been decided by the legislature, this argument failed.8
Catholic Charities also made the argument that the WCEA burdened the right to free exercise of religion.9 Specifically, Catholic Charities argued that the WCEA effectively coerced a violation of religious beliefs.10 Regarding this matter, the California Supreme Court considered the U.S. Supreme Court's decision in Department of Human Resources of Oregon v. Smith.11 The California Supreme Court deferred to Smith's general rule that 'religious beliefs do not excuse compliance with otherwise valid laws regulating matters the state is free to regulate.'12 The Smith standard removes the need for a law to be justified by compelling governmental interest if it is 'neutral and of general applicability,' even when 'the law has the incidental effect of burdening a particular religious practice.'13 The court found that the WCEA applies to religious and non-religious organizations equally, except for those religious organizations that fall under the statutory exemption.14 The exemption, outlined above, does not impose a burden on any religious organization. Rather, it removes a possible burden from those religious organizations that meet the criteria.15
Catholic Charities contended that the law discriminated against the Catholic Church and other groups that engage in charitable work. The court did not agree with that contention, finding that Catholic organizations requested the exemption and that the exemption is justified as an accommodation of religious exercise.16 Although the exemption does not apply to all organizations affiliated with the Catholic Church, the court did not agree that this amounts to discrimination against the Catholic Church.17
Finally, Catholic Charities argued that strict scrutiny should be applied to the WCEA and that it would fail such a test. The court again disagreed. While a decision was not made regarding whether strict scrutiny should apply, the court found that the law would nevertheless pass under strict scrutiny standards.18 In reaching this conclusion, the court explained that the legislature had shown that the law was meant to achieve a compelling interest and that it was narrowly tailored to that purpose.19 As the court found, the true and declared state interest was the elimination of gender discrimination.20 Any narrowing of the law beyond its current state would decrease the positive intended effect the law would have on female employees.21 Further, because the law does not require any organization to offer prescription benefit coverage, Catholic Charities is not compelled to offer coverage for contraceptives.22
The outcome of this case may have a negative impact on commercially insured Californians. Those entities which do not want to provide coverage for prescription contraceptives may elect to do away with prescription coverage benefits altogether as the only legal way of avoiding the WCEA's requirements. Some organizations may attempt to oppose the law through civil disobedience, continuing to provide prescription benefits while denying coverage for prescription contraceptives. Moreover, because of the divisive nature of the issue, it is possible that this case will at some time be reviewed by the U.S. Supreme Court.
Theresa LeComte
1 85 P.3d 67 (Cal. 2004).
2 Id. at 74.
3 Id. at 74 n.3 (citing CAL. HEALTH & SAFETY CODE �� 1367.25(b)(1)(A)-(D) (West 2000 & Supp. 2004).
4 Id. at 75.
5 Id. at 76.
6 Watson v. Jones, 80 U.S. (13 Wall.) 679, 727 (1871).
7 Catholic Charities, 85 P.3d at 77.
8 Id.
9 Id at 81.
10 Id.
11 494 U.S. 872 (1990).
12 Catholic Charities, 85 P.3d at 81 (citing Smith, 494 U.S. at 877-82).
13 Id. at 82.
14 Id.
15 Id. at 83.
16 Id. at 84.
17 Id. at 84-85.
18 Id. at 91.
19 Id.
20 Id. at 92.
21 Id. at 93-94.
22 Id. at 91-92.
