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Federal Judge Strikes Down Mo. Contraceptive Coverage Refusal Law Over Conflicts With Federal Rules

Federal Judge Strikes Down Mo. Contraceptive Coverage Refusal Law Over Conflicts With Federal Rules

March 19, 2013 — A federal judge has struck down a Missouri law (SB 749) allowing employers and health plans to refuse to cover contraception for moral, ethical or religious reasons, the AP/Huffington Post reports (Lieb, AP/Huffington Post, 3/18). The law -- approved by the state Legislature in September to override a veto by Gov. Jay Nixon (D) -- also allows employers and health plans to refuse to cover abortion and sterilization.

The law revised a 2001 Missouri statute that stated insurers "may" offer individuals and employers policies without contraceptive coverage if they request it. The new law said that insurers "shall" offer plans without the coverage. The new law also established grounds for the state attorney general and others to file lawsuits claiming religious infringement if entities that object are required to cover birth control (Women's Health Policy Report, 1/3).

Health insurers were concerned about conflicts between the new law's contraceptive coverage provision and federal rules requiring most health plans to cover contraceptive services at no additional cost to beneficiaries (AP/Huffington Post, 3/18). A group representing insurers filed a lawsuit to challenge the law, and in December, U.S. District Judge Audrey Fleissig issued a temporary restraining order preventing the state from enforcing the law. The state had already issued orders imposing civil penalties against two health insurers for not excluding contraceptive coverage from their health plans.

Details of Ruling

In her latest ruling, Fleissig cited a provision in the U.S. Constitution that holds that federal law takes precedence over contradictory state laws. "The court is hard-pressed to see how" the state law does "not create a direct conflict for Missouri insurers," Fleissig wrote (Geisel, Crain's Business Insurance/Modern Healthcare, 3/18).

Fleissig refrained from taking a position on the merits of the contraceptive coverage requirement. She also did not issue a permanent injunction against the law, noting that the state insurance department has agreed to not enforce it and withdraw its administrative complaints against the two insurers.


Brent Butler -- government affairs director for the Missouri Insurance Coalition, which filed the suit -- said the group is satisfied with the decision. The ruling "clears up what law they have to write the policies under, and that's all we were asking," he said (AP/Huffington Post, 3/18).

In a statement, Planned Parenthood of Kansas and Mid-Missouri President and CEO Peter Brownlie praised the ruling for ensuring that "all Missouri women -- no matter who their boss is -- have access to basic preventive health care without a co-pay, including birth control" (Machetta, Ozarks First, 3/19).

The Missouri attorney general's office has not indicated whether it plans to file an appeal (Gordon, KCUR, 3/18).