April 17, 2026
Health insurance occupies a uniquely vital place in everyday life. It is the safety net that cushions people from financial catastrophe, the quiet infrastructure that keeps families secure when health problems arise, accidents happen, or unexpected losses strike, and the framework that assists people in receiving needed services to maintain healthy lives. Yet despite its essential role, accessing adequate insurance remains a steep challenge for millions, a paradox that is further compounded for LGBTQ+ people.
– Amicus brief in John Doe v. Catholic Relief Services
One of the challenges in accessing adequate insurance arises when religiously-affiliated employers deny health insurance to LBGTQ+ employees’ partners. The PJC and allies recently filed an amicus brief in the U.S. Court of Appeals for the Fourth Circuit in a dispute over Catholic Relief Services’ (CRS) abrupt revocation of Mr. Doe’s husband’s health benefits, which he received from Mr. Doe’s employment with CRS as a data analyst. The case involves CRS’s attempt to expand the religious exemption from employment discrimination laws to limit health insurance coverage to LGBTQ+ employees across the board, not just those fulfilling the religious mission of the employer, contrary to statute and the Constitution. Mr. Doe’s case arises out of a growing trend of religious employers seeking to evade anti-discrimination laws through efforts to expand the church autonomy doctrine (which asserts that the courts must not resolve religious questions or settle disputes over institutional polity, leaving the religious institution the right to govern themselves without undue interference). Our amicus brief urges the Court to affirm a lower court’s decision so that LGBTQ+ individuals’ access to healthcare—something that is already difficult to obtain and too often denied—does not deteriorate further, and urges the Court to make clear that our legal system will not allow an already marginalized community to be pushed into even greater danger by reduced access to essential medical services.
Written by PJC Murnaghan Appellate Advocacy Fellow Sarah Miller and Lauren Pruitt of FreeState Justice, the amicus brief shows that the combination of discrimination from healthcare providers and the rising costs of care often lead to LGBTQ+ people avoiding, postponing, or being denied healthcare, which in turn harms individuals’ physical and mental health and has ripple effects on the health of communities. An employer’s refusal to provide health insurance to LBGTQ+ spouses makes the situation worse. Employer-sponsored health insurance plays a critical role in the U.S. healthcare system, and without it, millions of LBGTQ+ people would go uninsured. Meanwhile, coverage through the Affordable Care Act is becoming a less affordable alternative, with premiums skyrocketing and tax subsidies for participants expiring in 2026.
The brief argues that if the Court were to allow an expansion of the religious exemption from employment discrimination, LGBTQ+ people employed in religiously-affiliated hospitals, other healthcare facilities, and social service agencies could be stripped of basic workplace rights, deepening the systemic inequities they already face. And as religious hospitals make up an increasing number of healthcare facilities, LGBTQ+ people employed by these systems are likely to be most at risk and may consequently leave healthcare professions that are understaffed. We hope that the Court will affirm the lower court’s decision in favor of Mr. Doe so that religious employers cannot deny health insurance to LGBTQ+ spouses of employees.
Thank you to the many organizations that joined the amicus brief, including Equality California; Justice in Aging; Legal Aid at Work; National Employment Law Project; National LGBTQ+ Bar Association; Services and Advocacy for Gay, Lesbian, Bisexual, and Transgender Elders, Inc.; and Silver Spring United Methodist Church. Thank you also to FreeState Justice, PJC paralegal Najá Crockett, Office and Operations Manager Sabrina Harris, and Director of Finance and Administration Tamra Perkins for their assistance with the brief.
