US high court confronts Obamacare contraceptives challenge

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Opinion Journal: Little Sisters at the Supreme Court

WASHINGTON, March 23 (Reuters) - The U.S. Supreme Court began hearing arguments on Wednesday in appeals by Christian groups demanding a full exemption on religious grounds from a mandate under President Barack Obama's healthcare law to provide insurance that covers contraceptives.

Eight justices were hearing a scheduled 90 minutes of arguments on whether nonprofit entities that oppose the requirement for religious reasons can object under a 1993 U.S. law called the federal Religious Freedom Restoration Act to a compromise arrangement offered by the Obama administration.

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The 2010 Affordable Care Act, dubbed Obamacare, was passed by Congress over unified Republican opposition. It is considered Obama's signature legislative achievement. Conservatives have mounted numerous legal challenges to the law, with the Supreme Court in 2012 and 2015 issuing high-profile rulings leaving it intact.

Dozens of supporters of the Obama administration's position gathered outside the courthouse for a noisy rally ahead of the oral arguments. Several held signs featuring the slogan "my birth control, my business."

The argument, consolidating seven related cases, was being heard by eight justices, with the court one short following the Feb. 13 death of Antonin Scalia. The court is now divided 4-4 between liberal and conservative justices, and a split ruling along those lines was seen as possible.

See photos of rallies outside the Supreme Court:

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SCOTUS hears Obamacare contraceptives challenge
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US high court confronts Obamacare contraceptives challenge
Nuns, including Sister Maria Kolbe, right, of the Order of St. Francis, from Mishawaka, Ind., rally outside the Supreme Court in Washington, Wednesday, March 23, 2016, as the court hears arguments to allow birth control in healthcare plans in the Zubik vs. Burwell case. The Supreme Court is taking up a challenge from faith-based groups that object to an Obama administration effort to ensure their employees and students can get cost-free birth control. (AP Photo/Jacquelyn Martin)
WASHINGTON, DC - MARCH 23: Nuns supporting Little Sisters of the Poor, attend a rally in front of the US Supreme Court, March 23, 2016 in Washington, DC. Today the high court will hear arguments in Little Sisters v. Burwell, which will examine whether the governments new health care regulation will require the Little Sisters to change their healthcare plan, to other services that violate Catholic teaching. (Photo by Mark Wilson/Getty Images)
WASHINGTON, DC - MARCH 23: Nuns supporting Little Sisters of the Poor, attend a rally in front of the US Supreme Court, March 23, 2016 in Washington, DC. Today the high court will hear arguments in Little Sisters v. Burwell, which will examine whether the governments new health care regulation will require the Little Sisters to change their healthcare plan, to other services that violate Catholic teaching. (Photo by Mark Wilson/Getty Images)
WASHINGTON, DC - MARCH 23: Nuns supporting Little Sisters of the Poor, attend a rally in front of the US Supreme Court, March 23, 2016 in Washington, DC. Today the high court will hear arguments in Little Sisters v. Burwell, which will examine whether the governments new health care regulation will require the Little Sisters to change their healthcare plan, to other services that violate Catholic teaching. (Photo by Mark Wilson/Getty Images)
WASHINGTON, DC - MARCH 23: Nuns supporting Little Sisters of the Poor, attend a rally in front of the US Supreme Court, March 23, 2016 in Washington, DC. Today the high court will hear arguments in Little Sisters v. Burwell, which will examine whether the governments new health care regulation will require the Little Sisters to change their healthcare plan, to other services that violate Catholic teaching. (Photo by Mark Wilson/Getty Images)
WASHINGTON, DC - MARCH 23: Nuns supporting Little Sisters of the Poor, attend a rally in front of the US Supreme Court, March 23, 2016 in Washington, DC. Today the high court will hear arguments in Little Sisters v. Burwell, which will examine whether the governments new health care regulation will require the Little Sisters to change their healthcare plan, to other services that violate Catholic teaching. (Photo by Mark Wilson/Getty Images)
WASHINGTON, DC - MARCH 23: Nuns supporting Little Sisters of the Poor, attend a rally in front of the US Supreme Court, March 23, 2016 in Washington, DC. Today the high court will hear arguments in Little Sisters v. Burwell, which will examine whether the governments new health care regulation will require the Little Sisters to change their healthcare plan, to other services that violate Catholic teaching. (Photo by Mark Wilson/Getty Images)
Kate Perelman of Silver Spring, Md., left, with Americans United for Separation of Church and State, holds a sign saying "Notorious IUD" as a play on words with the nickname for Supreme Court Justice Ruth Bader Ginsburg, as she, and others, rally in support of birth control access regardless of employer, Wednesday, March 23, 2016, outside the Supreme Court in Washington. The Supreme Court is taking up a challenge from faith-based groups that object to an Obama administration effort to ensure their employees and students can get cost-free birth control. (AP Photo/Jacquelyn Martin)
FILE - In this March 25, 2015, file photo, Margot Riphagen, of New Orleans, wears a birth control pills costume as she protests in front of the Supreme Court in Washington, as the court heard oral arguments in the challenges of President Barack Obama's health care law requirement that businesses provide their female employees with health insurance that includes access to contraceptives. Some insurance plans offered on the health marketplaces violate the lawâs requirements for womenâs health, according to a new report from a womenâs legal advocacy group. The National Womenâs Law Center analyzed plans in 15 states over two years and found some excluded dependents from maternity coverage, prohibited coverage of breast pumps or failed to cover all federally approved birth control methods. (AP Photo/Charles Dharapak, File)
FILE - In this March 25, 2015, file photo, protestors one wearing a birth control pills costume participate in a demonstration in front of the Supreme Court in Washington, as the court heard oral arguments in the challenges of President Barack Obama's health care law requirement that businesses provide their female employees with health insurance that includes access to contraceptives. Religion, birth control and the Obama health care overhaul are about to collide at the Supreme Court yet again. Faith-affiliated charities, colleges and hospitals that oppose some or all contraception as immoral are battling the Obama administration over rules that allow them to opt out of covering the contraceptives for women that are among a range of preventive services that must be included in health plans at no extra cost. (AP Photo/Charles Dharapak, File)
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A 4-4 split would leave in place lower-court rulings favoring the Obama administration.

The Christian groups object to a compromise first offered by the Obama administration in 2013. It allows groups opposed to providing insurance covering birth control to comply with the law without actually paying for the required coverage.

Groups can certify they are opting out of the requirement by signing a form and submitting it to the government. The government then asks insurers to pick up the tab for the contraception.

The challengers contend the accommodation violates their religious rights by forcing them to authorize the coverage for their employees even if they are not paying for it.

The case represents an uphill battle for the challengers, who lost all seven cases now before the Supreme Court in lower courts.

Scalia, a conservative Roman Catholic, was considered a reliable vote for the religious groups. In 2014, he was in the majority when the court ruled 5-4 that family-owned companies run on religious principles, including craft retailer Hobby Lobby Stores Inc, could object to the provision for religious reasons.

If the four conservatives who sided with Scalia in that case remain unified, the best result the challengers could get would be a 4-4 split.

A Colorado-based order of Roman Catholic nuns called the Little Sisters of the Poor that runs care homes for the elderly was among the groups challenging the requirement.

Among the other challengers were: Bishop David Zubik and the Roman Catholic Diocese of Pittsburgh; the Roman Catholic archdiocese of Washington, D.C.; Priests for Life; and East Texas Baptist University.

Roman Catholic priest Frank Pavone, national director of the group Priests for Life, said the dispute boils down to this issue: "the government cannot force believers to choose between following their faith and following the law."

"This accommodation is not an 'opt-out.' Rather, it is a hijacking of the mechanism of our insurance plans to further the immoral goal of expanding access to abortion-inducing drugs and other objectionable services," Pavone said.

Ilyse Hogue, president of the abortion rights group NARAL Pro-Choice America, said that "women must be empowered to make our own decisions about our bodies."

"No one should have to ask their boss for permission to get the healthcare they need. Period," Hogue said. "We hope that the Supreme Court will agree with that simple statement."

A ruling is due by the end of June.

Related: The history and evolution of birth control:

16 PHOTOS
History/evolution of birth control
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US high court confronts Obamacare contraceptives challenge
Closeup still life of Zorane tablets, a series of low-estrogen birth control pills. Shown are three packs, one open, two closed. (Photo by Hulton Archive/Getty Images)
Various big posters were hoisted in Saint Peter's Square by a group of persons favoring artificial birth control, as Pope Paul VI appeared in the central balcony of Saint Peter's Basilica to read his Easter message to the world and impart his blessing "Urbi et Orbi" (Over the City of Rome and the World) March 26, 1967. The huge poster in center reads: "Yes to the pill", while others read: "No to Abortion." (AP-PHOTO)
13th August 1968: Father Paul Weir expounds on his refusal to quit the Catholic church in the St Cecilia Presbytery in North Cheam. Father Paul, 31, was suspended from his duties because he disagrees with the Pope's ruling on birth control. (Photo by Keystone/Getty Images)
Birth control advocate Bill Baird, center, and Carol Morreale, left, as they led a demonstration outside the Immaculate Conception Church, Aug. 18, 1974 in Marlboro, Mass., protesting the denial of the baptismal sacrament to 3-month-old Nathaniel Morreale. Carol Morreale, the child's mother has publicly advocated that women be given the right to choose whether they will have an abortion. (AP Photo)
A woman holds a birth control pill dispenser indicating the day of the week in New York in August 1974. Though medical trials for the oral contraceptive started in the late 1950s, Enovid was approved by the Food and Drug Administration in 1960. The sexual revolution was born. Known as "The Pill," it changed the balance of hormones estrogen and progesterone in women to prevent pregnancy. It was invented by Dr. Gregory Pincus and Dr. John Rock with the support of Planned Parenthood founder Margaret Sanger. (AP Photo/Jerry Mosey)
FILE - This May 28, 1999, file photo shows a new birth control pill container designed to look like a woman's makeup compact for Ortho-McNeil Pharmaceutical Inc., of Raritan, N.J., displayed at the manufacturer's assembly line. More than half of privately insured women are getting free birth control due to President Barack Obamaâs health care law, part of a big shift thatâs likely to continue despite the Supreme Court allowing some employers with religious objections to opt out. (AP Photo/Mike Derer, File)
Graphic shows the Implanon implant, with contraceptive use stats among women ages 15-44. (AP Graphic)
Graphic shows preferred method of birth control for women by age; 1c x 3 1/2 inches; 46.5 mm x 88.9 mm
Chart shows failure rate of popular female contraceptives
Graphic shows the annual cost of the most effect birth control methods
Individually packaged hand-knitted uteri are placed on a countertop at the lobby of the State Capitol in Phoenix, Thursday, April 5, 2012. Critics of an Arizona proposal to limit birth control gave more than a dozen state lawmakers the personalized gift. The packages were delivered each in a clear plastic bag, labeled with a lawmakerâs name and containing a letter from a Tempe woman asking legislators to oppose the measure. (AP Photo/Terry Tang)
FILE - In this May 2, 2013 photo, pharmacist Simon Gorelikov holds a generic emergency contraceptive, also called the morning-after pill, at the Health First Pharmacy in Boston. The plaintiffs in a legal battle over emergency contraceptives say in a letter Wednesday June 12, 2013, the government has failed to comply with a New York judge's order to lift all restrictions on sales of the drug. (AP Photo/Elise Amendola, File)
A group of people organized by the NYC Light Brigade and the women's rights group UltraViolet, use letters in lights to spell out their opinion, in front of the Supreme Court, Monday, March 24, 2014, in Washington. Holding the "H" in "Hands" is Rep. Keith Ellison, D-Minn. The Supreme Court is weighing whether corporations have religious rights that exempt them from part of the new health care law that requires coverage of birth control for employees at no extra charge. (AP Photo/Alex Brandon)
Margot Riphagen of New Orleans, La., wears a birth control pills costume as she protests in front of the Supreme Court in Washington, Tuesday, March 25, 2014, as the court heard oral arguments in the challenges of President Barack Obama's health care law requirement that businesses provide their female employees with health insurance that includes access to contraceptives. Supreme Court justices are weighing whether corporations have religious rights that exempt them from part of the new health care law that requires coverage of birth control for employees at no extra charge. (AP Photo/Charles Dharapak)
(Photo via Getty)
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