The New Jersey Reproductive Freedom Act is a proposed law that would strengthen the right to abortion in New Jersey and improve access to the practice by codifying the elimination of various bureaucratic procedural hurdles. It would, however, have a detrimental impact to religious entities and interests with compromising conscience protections. This piece will cover some aspects of the bill that standout and should be cause for further critical reflection.

We begin with New Jersey state and federal case law that has served as a precursor for this proposed legislation.

Case Law

State

In Right to Choose v. Byrne, 91 N.J. 287 (1982) the New Jersey Supreme Court considered the question of the validity under the New Jersey Constitution of a statute that prohibits Medicaid funding for abortions “except where it is medically indicated to be necessary to preserve the woman’s life.” N.J.S.A. 30:4D-6.1 (1981). Medicaid paid for the costs of all childbirths and abortions to save the life of the mother but, because of the statutory prohibition, it did not pay for those therapeutic abortions needed to protect the health of the mother or for elective, nontherapeutic abortions. The court would, however, eliminate this barrier and ruled: “N.J.S.A. 30:4D-6.1 violates equal protection of the laws under the New Jersey Constitution by limiting funds to abortions medically necessary to preserve the mother’s life. We construe that statute to require Medicaid funding of all abortions that are medically necessary to preserve the mother’s life or health.”

In Planned Parenthood of Central New Jersey v. Farmer, 165 N.J. 609 (2000), the plaintiffs challenged a state statute that conditioned a minor’s right to obtain an abortion on parental notification unless a judicial waiver is obtained, but had imposed no corresponding limitation on a minor who sought other medical and surgical care related to pregnancy and her child. N.J.S.A. 9:17A-1;  §§ 1.2 et seq.  The New Jersey Supreme Court ruled that the classification created by the Legislature burdens the “fundamental right of a woman to control her body and destiny,” Right to Choose v. Byrne, 91 N.J. 287, 306, 450 A.2d 925 (1982), without adequate justification and cannot be sustained against plaintiffs’ equal protection challenge.

An unmarried, pregnant minor was now able to give consent to hospital, medical, and surgical care related to her pregnancy or child, without the need to notify her parents.

Federal

In Planned Parenthood of Central New Jersey v.  Farmer, 220 F.3d 127 (3rd Cir. 2000), the Third Circuit reaffirmed the ruling of the lower New Jersey federal district court in Planned Parenthood of Cent. N.J. v. Verniero, 41 F.Supp.2d 478, 504 (D.N.J.1998) which invalidated the New Jersey Partial-Birth Abortion Ban Act of 1997.

New Jersey’s partial-birth abortion statute prohibited “an abortion in which the person performing the abortion partially vaginally delivers a living human fetus before killing the fetus and completing the delivery.”  N.J.S.A. § 2A:65A-6(e).   The Act purported to define the phrase “vaginally delivers a living human fetus before killing the fetus” to mean “deliberately and intentionally delivering into the vagina a living fetus, or a substantial portion thereof, for the purpose of performing a procedure the physician or other health care professional knows will kill the fetus, and the subsequent killing of the human fetus.”  N.J .S.A. § 2A:65A-6(f). The Act provided a single exception whereby this otherwise banned procedure may be used:  namely, when the procedure “is necessary to save the life of the mother whose life is endangered by a physical disorder, illness or injury.”  N.J.S.A. § 2A:65A-6(b). The Third Circuit deemed it unconstitutional due to it being (1) void for vagueness; and (2) placing an undue burden on a woman’s constitutional right to obtain an abortion.

These cases are very important as it now relates to the proposed New Jersey Reproductive Freedom Act. The court decisions to invalidate the Partial-Birth Abortion Ban Act of 1997 specifically with regards to parental consent and the vaginal time frame of banning an abortion would now be codified. This would provide a bulwark in the statutory law governing abortion in this state despite the outcome of a potential future U.S. Supreme Court decision that could return the issue of abortion to the states as was the practice pre-Roe and that could encourage further fetal protections.

Some New Jersey Reproductive Freedom Act Points

Some other major points under the New Jersey Reproductive Freedom Act are provided as follows:

“The State: 

(1)   explicitly guarantee, to every individual, the fundamental right to reproductive autonomy, which includes the right to contraception, the right to abortion, and the right to carry a pregnancy to term;

(2)   enable all qualified health care professionals to provide abortion services in the State;

(3)   require all insurance carriers to provide coverage both for abortion care and for a long-term supply of contraceptives”

…..

The bill also makes clear that a fertilized egg, embryo, or fetus shall not have independent rights under the laws of the state of New Jersey. The bill would also amend the existing law pertaining to autopsies and medicolegal death investigations to eliminate the requirement that a medicolegal death investigation be conducted in a case where a fetal death occurs without medical attendance. A final major component of the bill, is potentially broadening the nature of the medical provider that would be legally permitted to perform abortions which raises similarities with the New York abortion law passed a couple years ago.

NJ Reproductive Freedom Act Imposes Burden on Religious Interests

The NJ Reproductive Freedom Act imposed a significant burden on faith interests.

Per the text of the NJ Reproductive Freedom Act with clarifications:

A religious employer may request, and a hospital service corporation, pre-paid prescription service organization, individual health insurer, carrier, group health insured, health maintenance organization (*we will call X) shall grant, an exclusion under the contract for the coverage required by this section if the required coverage conflicts with the religious employer’s bona fide religious beliefs and practices.  A religious employer that obtains such an exclusion shall provide written notice thereof to subscribers and prospective subscribers, and “X” shall provide notice to the Commissioner of Banking and Insurance in such form and manner as may be determined by the commissioner.  The provisions of this subsection shall not be construed as authorizing “X” to exclude coverage for care that is necessary to preserve the life or health of a subscriber.  

In sum, a religious employer may request an exclusion, BUT, in requesting exclusion it is facilitating coverage with notice to the subscriber, potential subscriber and Commissioner of Banking and Insurance. This notice would then allow for some form of the contraceptive/abortifacient service requested by the subscriber to be provided even if not directly from the religious employer. The concepts of notice and facilitation themselves arguably can compromise religious conscience decisions as presented here.

Furthermore, the clause regarding “preserving the life or health of the subscriber” also raises issues. The “life or health of the subscriber” is not adequately defined. One must consider who will in fact be determining that “preservation of life” concept and how many medical professionals must agree that these steps are “necessary”.  This clause may be ripe for abuse. One must also consider that some faiths do not hold in their tenants any exception for an abortive procedure. The conscience and religious interests conflict with the law and are never fully resolved. In sum, there are not adequate facilitation protection interests in this bill. Faith entities would still be involved through notice with the coverage of a contraceptive/abortive procedure with or without an interest concerning the life of the mother.

How the U.S. Supreme Court has Considered Contraceptive and Abortifacient Challenges

The U.S. Supreme Court has dealt with related issues in the Burwell vs. Hobby Lobby matter and the Litter Sisters of the Poor litigation, in both of those situations stemming from the conflicts caused by the Affordable Care Act (ACA).

In sum, Hobby Lobby concerned a challenge by closely-held corporations that objected to providing some forms of abortifacient and contraceptive coverage to employees on the basis of religious beliefs. The court found that there was a least restrictive means of implementing the government’s interest in offering the coverage that would not substantially burden religion. The court applied its reasoning under the Religious Freedom and Restoration Act (RFRA) and the mandate to provide the contraceptive coverage as provided under the ACA was invalidated as to closely held businesses expressing their religious objections.

In sum, the Little Sisters of the Poor litigation has also dealt with fallout from the ACA. In this matter, the seminal issue was the requirement under the ACA of religious non-profits to complete a form, thus offering notice to the federal government of their intention to not provide contraceptive coverage and requesting an exemption. The federal government’s grant of the exemption, however, would enable it to find another provider for coverage even if not specifically the Little Sisters of the Poor. The Little Sisters of the Poor believed that they, therefore were part of the facilitation process that would be against their beliefs.

The Supreme Court has addressed this matter in a procedural context by focusing on legal flexibility of agencies in issuing regulations on the substance of wider or more narrow exemptions. Factually, the case is most similar to the issues potentially stemming from the New Jersey Reproductive Freedom Act, however, the Supreme Court has largely to this point not offered a definitive ruling on the core of the issue this matter presents. If the New Jersey Reproductive Freedom Act becomes law, it would be a good opportunity for suit to be brought in the hopes the Supreme Court would then issue more clarity. Defining the nature of facilitation and how bound up in substance it is to burden enumerated First Amendment Free Exercise protections would go a long way towards settling an understanding of this conflict.

Conclusion

The New Jersey Reproductive Freedom Act would codify the trend of controversial court decisions involving the state of New Jersey both at the state and federal level. One could argue that the substance of these decisions was not the soundest legal framework especially as we have come to understand more about the science of fetal life in the womb. This bill should invite debate and our leaders would be wise to listen to the arguments because on the surface it appears as a hasty response to the potential of the U.S. Supreme Court returning more of the issue of abortion to states (pre-Roe) or at the very least issuing a ruling on greater fetal protections. The New Jersey Reproductive Freedom Act does not address comprehensive scientific advancements that have surfaced since the time Roe v. Wade was decided. In addition, it presents the opportunity for further conflicts with faith entities as they wish to exercise their enumerated right to Free Exercise.