A Christian publishing company last week was granted temporary relief from provisions of the federal health care reform act forcing it to include coverage for contraceptives under its employee health benefits.

In a ruling issued Friday in a U.S. District Court for the District of Columbia, Judge Reggie Walton permitted Carol Stream, Ill.-based Tyndale House Publishers Inc. to ignore its obligation under the Patient Protection and Affordable Care Act to provide employees access to certain contraceptive prescriptions and counseling, pending the outcome of its lawsuit against the Department of Health and Human Services.

Tyndale House and its president and CEO, Mark Tyndale, sued the federal government in October over the law's specific coverage requirements for “morning-after” prescriptions including Plan B and Ella, intrauterine devices and other forms of contraception that prevent fertilized embryos from attaching to the uterine wall, thus beginning pregnancy.

In his lawsuit, Mr. Tyndale claimed that the reform law forced his company executives to choose between violating their stated religious belief that life begins at fertilization — and that preventing pregnancy past that point is tantamount to abortion — or incurring “draconian” fines and penalties, which he said would almost assuredly cause the business to close. Mr. Tyndale noted that his company's self-insured health benefits plan already provides its 216 employees with coverage for contraceptives that prevent fertilization.

Mr. Tyndale has asked the court for temporary and permanent exemptions from the requirement, arguing that the law effectively denies the company's executives and board members their right to freely exercise their beliefs under the Religious Freedom Restoration Act.

In his Nov. 16 order, Judge Walton ruled in Mr. Tyndale's favor, concluding that the law placed the company's executives “in the untenable position of choosing either to violate their religious beliefs by providing coverage of the contraceptives at issue or to subject their business to the continual risk of the imposition of enormous penalties for its noncompliance.”

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“Such a threat to the very continued existence of the plaintiffs' business necessarily places substantial pressure on the plaintiffs to violate their beliefs,” Judge Walton said.

Though Judge Walton conceded that attorneys for the Health and Human Services Department had provided some evidence of a compelling government interest in the law's broad application to employers nationwide, it failed to prove a compelling interest in forcing Tyndale House in particular to cover all contraceptives required under the reform law.

“There is no specific finding that the government must ensure that Plan B, Ella, and intrauterine devices, as opposed to other forms of contraception, be covered under the plaintiffs' health plan in order to further the government's compelling interests,” Judge Walton said. “Given that the plaintiffs object to providing a very specific subset of contraceptive drugs and devices, while consenting to provide many others, it is not clear, and the defendants have not made it clear, how the government's compelling interests in promoting health care and equalizing access to health care are furthered by requiring the provision of the contraceptives at issue.”

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Judge Walton also noted that the law's exemption for “grandfathered” health plans — plans in effect prior to March 23, 2010 — and certain religious employers from the requirement undercuts any justification for enforcing the law on Tyndale House individually. The judge's comments echoed a July ruling in the U.S. District Court for the District of Colorado granting a preliminary injunction for Hercules Industries Inc., a Denver-based heating and air conditioning company also suing to block the law for religious reasons.

“The government has already granted exemptions to other employers, either by way of an explicit religious employer exemption or another broad provision that functionally excludes other sets of employers from the scope of the contraceptive coverage mandate,” Judge Walton said. “The existence of these exemptions significantly undermines the defendants' interest in applying the contraceptive coverage mandate to the plaintiffs.”

Another ruling, issued this month in the U.S. District Court for the Eastern District of Michigan, also fell in favor of Utica, Mich.-based outdoor power equipment company Weingartz Supply Co.'s request for a preliminary injunction but rebuked the Colorado court's rationale. In that case, Judge Robert Cleland noted that the exemptions were intended to effect the gradual implementation of the PPACA's provisions, and that it “seems to be a reasonable plan for instituting an incredibly complex health care law while balancing competing interests.”

In their argument for the law's enforcement, attorneys for the government referenced yet another federal judge's ruling, issued in September in the U.S. District Court for the Eastern District of Missouri. In that case, Judge Carol Jackson rejected St. Louis-based O'Brien Industrial Holdings L.L.C.'s request for a temporary exemption from the contraceptive requirements.

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Judge Jackson ruled that company executives' right to religious freedom had not been substantially burdened was only being asked to provide the coverage indirectly through its health insurer, and the actual use of the contraceptives — ostensibly the act to which the company objected — was ultimately in the hand of third parties, namely the plan participants.

However, Judge Walton said that the degree to which Tyndale House's executives' rights under the RFRA law were being burdened was substantially greater, largely because the company self-insures its health benefits plan.

“Tyndale itself directly pays for the health care services used by its plan participants, thereby removing one of the “degrees” of separation that the court deemed relevant in the O'Brien case,” Judge Walton said. “The plaintiffs' specific objection is not simply to the use of the contraceptives at issue, but to providing coverage for (the contraceptives) and related education and counseling in Tyndale's health insurance plan.”

Tyndale House is among the dozens of secular, for-profit employers that have filed lawsuits against the federal government over the contraceptive mandate in the last 12 months, but one of only three thus far that have been granted preliminary relief from the law. Most recently, Judge Joe Heaton of the U.S. District for the Western District of Oklahoma denied on Monday a request by the owners of Oklahoma City-based Hobby Lobby Stores Inc. for temporary sanctuary from the law. Judge Heaton ruled that while individual members of the family that owns and operates Hobby Lobby have religious rights, the companies themselves do not possess the same rights.