Document ID: ./input/supremecourt_opinions/opinions/19pdf/19-431_5i36.pdf
Page Number: 52

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

3 

KAGAN, J., concurring in judgment 

Here, the Departments have adopted the majority’s read-
ing  of  the  statutory  delegation  ever  since  its  enactment. 
Over  the  course  of  two  administrations,  the  Departments
have  shifted  positions  on  many  questions  involving  the 
Women’s  Health  Amendment  and  the  ACA  more  broadly. 
But not on whether the Amendment gives HRSA the ability
to  create  exemptions  to  the  contraceptive-coverage  man-
date.  HRSA adopted the original church exemption on the 
same capacious understanding of its statutory authority as
the  Departments  endorse  today.  See  76  Fed.  Reg.  46623
(2011)  (“In  the  Departments’  view,  it  is  appropriate  that 
HRSA, in issuing these Guidelines, takes into account the
effect on the religious beliefs of certain religious employers 
if  coverage  of  contraceptive  services  were  required”).1 
While the exemption itself has expanded, the Departments’ 
reading  of  the  statutory  delegation—that  the  law  gives 
HRSA  discretion  over  the  “who”  question—has  remained
the same.  I would defer to that longstanding and reasona-
ble interpretation.

But that does not mean the Departments should prevail 
when  these  cases  return  to  the  lower  courts.   The  States 
challenged the exemptions not only as outside HRSA’s stat-
utory authority, but also as “arbitrary [and] capricious.”  5 
—————— 

1 The First Amendment cannot have separately justified the church ex-
emption,  as  the  dissent  suggests.
  See  post,  at  12–13  (opinion  of 
GINSBURG, J.).  That exemption enables a religious institution to decline 
to provide contraceptive coverage to all its employees, from a minister to
a building custodian.  By contrast, the so-called ministerial exception of 
the First Amendment (which the dissent cites, see post, at 13) extends 
only to select employees, having ministerial status.  See Our Lady of Gua-
dalupe School v. Morrissey-Berru, 591 U. S. ___, ___ (2020) (slip op., at 
14–16);  Hosanna-Tabor  Evangelical  Lutheran  Church  and  School  v. 
EEOC, 565 U. S. 171, 190 (2012).  (Too, this Court has applied the min-
isterial exception only to protect religious institutions from employment
discrimination suits, expressly reserving whether the exception excuses 
their non-compliance with other laws.  See id., at 196.)  And there is no 
general constitutional immunity, over and above the ministerial excep-
tion, that can protect a religious institution from the law’s operation.