Document ID: ./input/supremecourt_opinions/opinions/19pdf/19-431_5i36.pdf
Page Number: 43.0

Cite as:  591 U. S. ____ (2020) 

13 

ALITO, J., concurring 

auxiliaries, and associations.  76 Fed. Reg. 46623.  And be-
cause  of  the  way  the  accommodation  operates  under  the
Employee Retirement Income Security Act of 1974, the De-
partments  treated  a  number  of  self-insured  non-profit  or-
ganizations  established  by  churches  or  associations  of 
churches, including religious universities and hospitals, as
“effectively  exempted”  from  the  contraceptive  mandate 
as  well.  Brief  for  Petitioners  in  No.  19–454,  p. 4.    The 
result was a complex and sometimes irrational pattern of 
exemptions.

The  dissent  frames  the  allegedly  compelling  interest
served by the mandate in different terms—as an interest in
providing  “seamless”  cost-free  coverage,  post,  at  1,  14,  21 
(opinion of GINSBURG, J.)––but this is an even weaker ar-
gument.  What  “seamless”  coverage  apparently  means  is
coverage under the insurance plan furnished by a woman’s 
employer.  So  as  applied  to  the  Little  Sisters,  the  dissent
thinks that it would be a grave abuse if an employee wish-
ing to obtain contraceptives had to take any step that would 
not be necessary if she wanted to obtain any other medical 
service.  See  post,  at  16–17.  Apparently,  it  would  not  be
enough if the Government sent her a special card that could
be presented at a pharmacy to fill a prescription for contra-
ceptives without any out-of-pocket expense.  Nor would it 
be enough if she were informed that she could obtain free
contraceptives  by  going  to  a  conveniently  located  govern-
ment  clinic.  Neither  of  those  alternatives  would  provide
“seamless  coverage,”  and  thus,  according  to  the  dissent,
both would be insufficient.  Nothing short of capitulation on 
the part of the Little Sisters would suffice.

This  argument  is  inconsistent  with  any  reasonable  un-
derstanding of the concept of a “compelling interest.”  It is 
undoubtedly convenient for employees to obtain all types of
medical care and all pharmaceuticals under their general
health  insurance  plans,  and  perhaps  there  are  women
whose personal situation is such that taking any additional