An Illinois appeals court has upheld the state’s requirement that health insurers provide abortion coverage, rejecting arguments from the Illinois Baptist State Association (IBSA) that the mandate violates religious freedoms. The court’s decision, issued on October 1, allows the state to continue its policy, which was enacted under the 2019 Reproductive Health Act, despite opposition from Christian organizations and abortion opponents who argue that the mandate forces them to act in ways contrary to their religious beliefs.

The Legal Challenge Against Illinois’ Abortion Mandate

The Illinois Baptist State Association (IBSA), representing nearly 900 Southern Baptist churches, challenged the state’s law requiring insurers to provide abortion coverage. The law, passed in 2019, mandates that all health insurance plans regulated by the state include abortion coverage, provided the plans also cover pregnancy-related benefits. The IBSA’s lawsuit argued that the state’s mandate forces them to violate their religious beliefs, as they oppose abortion on moral and religious grounds. The IBSA’s lawsuit followed another filed by a coalition of pro-life organizations in federal court.

State’s Right to Enforce Health Insurance Mandates

The Illinois Fourth District Appellate Court, led by Justice Amy C. Lannerd, rejected the IBSA’s claims, asserting that religious beliefs did not exempt the association from complying with the state’s abortion coverage mandate. The court ruled that the state was not compelling the IBSA to provide health insurance for its employees nor imposing a penalty for not complying with the mandate. The court found that the IBSA could easily purchase health insurance outside of the state’s regulatory system, which would not require abortion coverage.

Court’s Ruling on Religious Freedom

The IBSA had based its case on a U.S. Supreme Court ruling that allowed Hobby Lobby, a for-profit business, to opt out of providing certain contraceptive coverage under the Affordable Care Act, citing religious objections. However, the Illinois appellate court distinguished the IBSA case from Hobby Lobby’s, stating that the Illinois law did not force the IBSA to provide insurance nor penalize them for not complying. Instead, the IBSA had voluntarily chosen a state-regulated health insurance plan that included abortion coverage, which the court ruled did not impose a substantial burden on their religious beliefs.

Political and Legal Context of the Reproductive Health Act

Illinois lawmakers, led by Democratic Governor J.B. Pritzker, passed the Reproductive Health Act (RHA) with the aim of making Illinois a safe haven for abortion access. The law requires that all insurance plans regulated by the state must cover abortion services if they cover pregnancy-related benefits. This mandate has faced legal opposition from religious organizations, pro-life groups, and conservative critics who argue that it infringes on their religious freedom and forces them to support a practice they oppose. However, the state has defended the law as essential to protecting reproductive rights.

Court’s Rejection of Legislative Intent Argument

The Illinois Baptist State Association had attempted to argue that the state’s Religious Freedom Restoration Act (RFRA) should shield them from the abortion mandate, pointing to legislative history and intent during the passage of RFRA. However, Justice Robert J. Steigmann, writing a special concurring opinion, criticized the use of legislative intent in interpreting laws. Steigmann stated that relying on lawmakers’ remarks to interpret a law was misguided and should not influence the judicial process. His opinion suggests a possible shift in how Illinois courts interpret laws based on the intent of the legislature.

Pro-Life Groups Continue Legal Fight

While the IBSA’s case was rejected, pro-life organizations and religious groups are not giving up the legal fight. A separate lawsuit remains pending in federal court, where abortion opponents continue to argue that the state’s mandate violates their constitutional rights. Illinois Attorney General Kwame Raoul, who supports abortion rights, has argued that the state is not forcing anyone to purchase health insurance and that the federal law should permit the mandate. The legal battle over Illinois’ abortion coverage requirement is expected to continue as both state and federal courts review the cases.