Next Steps in Religious Expression and Health Care Reform: the Impact of Zubik v. Burwell

(288 Ratings)

Produced on: September 26, 2016

Course Format On Demand Audio

Taught by


Course Description

Time 63 minutes
Difficulty Advanced

On May 16, 2016, the Supreme Court announced its decision to send back to the lower Courts of Appeals the seven cases consolidated in Zubik v. Burwell, which involved a challenge to the Affordable Care Act’s requirement that religious non-profit employers must either cover contraceptives as part of their health plans or submit a form to their insurer or the Federal Government stating that they object on religious grounds to providing contraceptive coverage. Currently, when notice is provided by an employer to the insurer or the federal government, the employees are funneled into a system established to provide contraceptive coverage directly to the employees without further participation by the employers.

Since the Supreme Court declined to address Zubik on the merits, uncertainty regarding the rights of religious non-profit employers to object to currently covered health care benefits will remain. Most importantly, it remains unclear if religious non-profit employers can block access to mandated preventive care, including contraceptive care, but also to other health services they may object to such as vaccinations, HIV screening, mental health care, or gender transition services, by invoking the Religious Freedom Restoration Act. Despite the recently released Affordable Care Act “Nondiscrimination in Health Programs and Activities” regulations, which prohibit discrimination on the basis of race, color, national origin, sex, age or disability, and do not include a religious exemption, further litigation as to how the mandates of the Affordable Care Act and the Religious Freedom Restoration Act interact may be forthcoming.   

This course places Zubik in the context of previous religious expression and health law cases, including Burwell v. Hobby Lobby. The course then discusses the unusual nature of the Supreme Court decision, as well as the case’s likely continued evolution. Lastly, the course focuses on the interplay between religious exemptions and health care law and policy, including discussing the new anti-discrimination regulations. This course is presented by Carmel Shachar, clinical instructor at Harvard Law School’s Center for Health Law and Policy Innovation.

Learning Objectives:

  1. Understand the Religious Freedom Restoration Act and relevant portions of the Affordable Care Act
  2. Evaluate the unusual outcome of Zubik
  3. Explore the immediate impact of Zubik and likely evolution of the remanding cases
  4. Assess potential future impact of religious exemptions on health care law and policy


Carmel Shachar

Center for Health Law & Policy Innovation

Carmel Shachar joined the Harvard Law School Center for Health Law and Policy Innovation in September 2014. Carmel earned her J.D., cum laude, in 2010 from Harvard Law School and her M.P.H. in 2010 from the Harvard School of Public Health. She clerked for Judge Jacques L. Wiener, Jr. of the U.S. Court of Appeals for the Fifth Circuit from 2010-2011. Carmel is a licensed member of the bars of the State of New York and the Commonwealth of Massachusetts.

Prior to joining the Center for Health Law and Policy Innovation, Carmel was an associate in the health care group of Ropes & Gray LLP. She focused her practice in regulatory and compliance work, including advising client on topics such as data privacy and security, implementation of health care reform and public payer billing and reimbursement. Carmel has significant experience advising on managed care network construction, regulation and strategy for non-profit and for profit clients. She also served as temporary-in house counsel to a large medical device company. During her time at Ropes & Gray, she authored two articles on Medicaid premium assistance programs in Bloomberg BNA’s Health Care Policy Report, an article on the placement of laboratory staff in physician offices in G2 Intelligence and an overview of data privacy and security regulations for health insurance exchange entities in Bloomberg BNA’s Health IT Law & Industry Report.


Heidi E.

I really enjoyed this CLE. A very clear explanation of the key cases and the challenges that remain.

Noreen C.

Good presenter!

Julie J.

Excellent teacher

David K.

The speaker was easy to listen to. I would invite her to do more

Ruth G.

Interesting and timely. Accessible to those who are not constitutional law specialists.

Edward M.

Very even-handed and fair presentation

Brooktynn B.

I appreciated her factual analysis of this topic

F Antone A.

Carmel, should lead a class on how to make dry topics, interesting.

Herbert F.

Excellent Program

Alison C.

Very well presented.

Joyce M R.


Anthony N.

The faculty member was very clear and comprehensive in her presentation

Hong N.

This was one of the more informative and well presented CLEs here. I really enjoyed this one. The presenter was very organized and knowledgeable!

Mariam C.

Great course, I hope to see another follow up item as the topic progresses!

Terry S.

This was one of the better online CLEs I've taken in a long time. Presenter did a great job organizing a difficult topic. Thanks.

Laticia A.

The instructor was very articulate. The material and lecture was very organized and useful for such a complex topic. Thank you!

Rhonda G. W.

Thank you for this superb presentation -- clear, thorough, and well-organized.

Heather M.

Excellent presenter. Extremely well-versed on the material

John W.

The presenter did a great job presenting a controversial topic in a balanced, informative fashion.

Jack F.

Complicated issues were extremely well presented.

Richard M.

Very informative. Well presented.

Marc L.

Outstanding presentation; one of the best I've attended.

Kay H.

Presenter did an excellent job of explaining and rephrasing difficult concepts. She was also engaging and professional.

Elizabeth F.

One of the best presentations ever

Bradley S.

Terrific program and delivery. Thanks!

Linda M.

great content and speaker

Load More


$ 59 Constitutional Law, Health Care Law, Civil Rights, and Public Interest Law In Stock


Get Unlimited Access to Lawline Courses

Unlimited CLE Subscription gives you access to take almost any course from our catalog and earn as much CLE credit as you need.