Document ID: ./input/supremecourt_opinions/opinions/19pdf/19-431_5i36.pdf
Page Number: 76.0

20 

LITTLE SISTERS OF THE POOR SAINTS PETER 
AND PAUL HOME v. PENNSYLVANIA 
GINSBURG, J., dissenting 

J., concurring) (“The accommodation works by requiring in-
surance companies to  cover . . . contraceptive coverage for 
female employees who wish it.” (emphasis added)).  Under 
the  self-certification  accommodation,  then,  the  objecting
employer is absolved of any obligation to provide the con-
traceptive  coverage  to  which  it  objects;  that  obligation  is
transferred to the insurer.  This arrangement “furthers the
Government’s interest [in women’s health] but does not im-
pinge on the [employer’s] religious beliefs.”  Ibid.; see supra, 
at 18–19. 

2 
The Little Sisters, adopting the arguments made by reli-
gious organizations in Zubik, resist this conclusion in two 
ways.  First, they urge that contraceptive coverage provided
by  an  insurer  under  the  self-certification  accommodation
forms  “part  of  the  same  plan  as  the  coverage  provided  by
the employer.”  Brief for Little Sisters 12 (internal quota-
tion  marks  omitted).  See  also  Tr.  of  Oral  Arg.  29  (Little 
Sisters  object  “to  having  their  plan  hijacked”);  ante,  at  8 
(ALITO,  J.,  concurring)  (Little  Sisters  object  to  “main-
tain[ing] and pay[ing] for a plan under which coverage for 
contraceptives would be provided”).  This contention is con-
tradicted by the plain terms of the regulation establishing
that accommodation: To repeat, an insurance issuer “must 
. . .  [e]xpressly  exclude  contraceptive  coverage  from  the 
group  health  insurance  coverage  provided  in  connection
with  the  group  health  plan.”    45  CFR  §147.131(c)(2)(i)(A)
(2013) (emphasis added); see supra, at 6.25 

—————— 

25 Religious organizations have observed that, under the self-certification
accommodation, insurers need not, and do not, provide contraceptive cov-
erage under a separate policy number.  Supp. Brief for Petitioners in Zu-
bik  v.  Burwell,  O.  T.  2015,  No.  14–1418,  p.  1.    This  objection  does  not
relate to a religious employer’s own conduct; instead, it concerns the in-
surer’s conduct.  See supra, at 18–19.