Must Employers Provide Coverage for Gender Transition Procedures?

Learn why the Christian Employers Alliance (CEA) case is essential for business owners navigating religious freedom and federal mandates. This article highlights the importance of understanding RFRA protections and how legal precedents can shape company policies and practices.

Introduction

In recent years, there has been a lot of debate about religious freedom and employment laws. There have been several significant legal battles. One important case in this area involves the Christian Employers Alliance (CEA) versus the U.S. Equal Employment Opportunity Commission (EEOC), the Department of Health and Human Services (HHS), and some others. This case looks at the duties of religious employers under federal laws supporting gender transition procedures. It talks about how the Religious Freedom Restoration Act (RFRA), an important federal statute, protects them. The court protected the religious rights of these employers who were members of CEA.

Case Summary

The Christian Employers Alliance, which is a group of Christian business owners, did not agree with new rules from the Biden administration. These rules were issued by several agencies. They required businesses to cover gender transition surgeries and other related healthcare services in their employee health plans. The rules said that parents could file a complaint if their child was denied access to health care. Indeed, HHS guidance said that children as young as newborn can be surgically transitioned, and that denying this service is discrimination. The CEA argued that this went against their religious beliefs, that people are created by God and born as one gender or the other, which does not change. CEA members did not intend to provide this coverage.

On March 4, 2024, a North Dakota federal court ruled in favor of the CEA. It agreed that forcing its members to offer this insurance coverage for gender transition surgeries would violate their religious beliefs. And it burdened their religious free exercise rights under RFRA.  It granted the CEA a permanent injunction against the enforcement of these mandates by the EEOC and HHS. The court agreed that the government's interest in protecting transgender individuals is important (compelling, in legal language). But it could be achieved in other ways (less restrictive means) that don’t violate religious freedoms. This decision applies to all present and future members of CEA.

Key Takeaways for Business Owners

1. Understanding RFRA’s Strong Protections: Business owners should know that RFRA really protects religious practices when federal laws or rules threaten them (and create a substantial burden). In this case, the court agreed that fines or the threat of enforcement if they didn’t follow rules that contradict their religious beliefs are a substantial burden. It’s also worth noting that this holding would apply to nonprofits as well as to for-profit businesses.
2. Know Your Beliefs and Duties: Employers who do not share these specific religious beliefs should understand that they need to comply with the federal agency mandates.
3. Legal Precedents Matter: This case is an important legal precedent for religious employers. Courts have shown some willingness to protect religious freedoms against rules, when those religious beliefs are sincerely held and create a substantial burden. Business owners with strong religious beliefs should keep up with these cases, as they can significantly impact how laws are applied in practice. (Religious employees are also protected, in slightly different ways.)
4. Plan Ahead Legally: While the court sided with the CEA, the detailed legal arguments show why businesses need to plan their legal strategies carefully. Employers should work with legal counsel to make sure company policies match their religious beliefs and federal and state employment laws. Their attorneys should be aware of employment and religious freedom principles. Sometimes, going to court may be necessary if there is unavoidable conflict, but it should be a last resort.
5. Joining Forces: Finally, business owners who share similar beliefs can join the CEA or a similar group—especially since members of CEA are already protected on this issue. Such groups can offer a stronger voice, resources, and support in advocacy. Public interest law firms, such as the Alliance Defending Freedom, which won this case, can often do more to help a group of employers.

Conclusion

The Christian Employers Alliance v. EEOC et al case is an important moment in the ongoing discussion between religious liberty and government rules. For owners with deep religious beliefs, this case shows it is possible to stand up for these rights within the legal system.