The case has the potential to affect thousands of universities, hospitals, religious orders and other nonprofits. Hundreds of those groups have sued over the issue, citing a federal religious-freedom law.

It comes to the high court as religious objections to gay marriage engender debates around the country.

The Supreme Court ruled in 2014 that closely held companies can refuse on religious grounds to offer birth-control coverage to their workers.

The newest case involves religious nonprofits, rather than for-profit companies, and centers on the adequacy of the Obama administration’s system for letting those groups avoid having to directly provide coverage.

The controversy stems from the Obamacare requirement that contraceptive coverage be included in health plans for employees and students.

Shift responsibility

The administration gives objecting nonprofits two options: They can shift responsibility onto their insurer by providing it with a "self-certification" form, or they can notify the U.S. Department of Health and Human Services of their objection and provide contact information for their insurer.

Either way, the federal government reimburses the insurer for the cost of the coverage.

"Taking either step relieves the employer of any obligation to provide, arrange or pay for the coverage to which it objects," U.S. Solicitor General Donald Verrilli, the administration’s top courtroom lawyer, argued in court papers.

The administration says neither option imposes the type of "substantial burden" on religious exercise that would trigger protection under the U.S. Religious Freedom Restoration Act. The administration also contends that the rights of religious groups aren’t affected just because the government requires the insurer or plan administrator to provide the coverage.

"In our pluralistic society, that sort of substitution of obligations is an appropriate means of accommodating religious objectors while also protecting the important interests of third parties, such as women’s interest in full and equal health coverage," Verrilli wrote.

Religious groups say they shouldn’t have to play any role in the administration’s birth-control program.

Religion violated?

"This case is only about whether the government can commandeer petitioners and their health plans as vehicles for delivering abortifacient and contraceptive coverage in violation of their religion," a group led by the Archdiocese of Washington, D.C., argued in an appeal. The group includes Catholic University in Washington and Thomas Aquinas College in Santa Paula, California.

Most of the federal appeals courts to have ruled on the issue have said the administration is adequately protecting religious rights.

Churches are exempt entirely from having to offer contraceptive coverage to employees, but most other religious groups must either provide coverage or invoke one of the administration’s two options.

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