Healthcare

Supreme Court rejects Obama, limits birth control mandate

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The Supreme Court delivered a blow to President Obama’s signature healthcare law on Monday, ruling that closely held companies cannot be compelled to offer their employees birth control as part of the law if they object to the provisions on religious grounds. [READ SUPREME COURT RULING.]

The 5-4 ruling written by conservative Justice Samuel Alito undermines the Affordable Care Act’s requirement that companies offer contraceptive services to workers as part of their insurance coverage, potentially affecting millions of women.

{mosads}But it leaves the requirement intact for publicly traded companies and, in a concurring opinion, Justice Anthony Kennedy argues that the government could decide to fill the void by covering the costs of the coverage itself.

The consolidated case, generally known as Sebelius v. Hobby Lobby, is the high court’s first judgment on the landmark statute since it upheld ObamaCare’s individual mandate two years and two days earlier.

The decision hinged on challenges to the mandate brought by a pair of companies: the Hobby Lobby craft store chain and Conestoga Woods Specialties, a Pennsylvania-based cabinetmaker.

The companies are owned by religious families who oppose some of the 20 FDA-approved forms of contraception that must be covered, under the mandate. 

They argued that the requirement violates both the First Amendment’s free exercise clause and the 1993 Religious Freedom Restoration Act (RFRA), which provides that, “government shall not substantially burden a person’s exercise of religion.”

In the splintered decision, which includes four separate opinions, the majority affirmed that argument.

“We doubt that the Congress that enacted RFRA — or, for that matter, ACA — would have believed it a tolerable result to put family-run businesses to the choice of violating their sincerely held religious beliefs or making all of their employees lose their existing healthcare plans,” Alito wrote.

Chief Justice John Roberts and Justice Clarence Thomas joined in the opinion. Kennedy, the court’s frequent bellwether, joined their decision and wrote a concurring opinion. The court’s liberals dissented in a pair opinions, one of which was penned by Justice Ruth Bader Ginsburg, and the other by Stephen Breyer and Elena Kagan.

The ruling’s reverberations were felt immediately across Washington, where opponents of the mandate hailed it as a triumph for religious liberty.

But the mandate’s backers and the court’s liberals warned of a slippery slope that could provide a means for companies to discriminate in hiring on the basis of race or gender, simply by claiming religious objections.

“Our decision today provides no such shield,” Alito pushed back. “The government has a compelling interest in providing an equal opportunity to participate in the workforce without regard to race, and prohibitions on racial discrimination are precisely tailored to achieve that critical goal.”

In deeming the mandate a violation of RFRA, the court essentially ruled that the law provides some businesses with the same protections as individuals.

Alito stressed that the ruling applies only to the contraception mandate, not other parts of ObamaCare – such as blood transfusions or immunizations – to which some companies might harbor religious objections.

The majority repeatedly emphasizes that the ruling affects “closely held” companies, yet does not define them, beyond they are owned and controlled by members of a single family.

The Internal Revenue Service, however, says a business is closely held if five or fewer people hold more than half of the value of its outstanding stock.

That would draw in the vast majority of American businesses, argued House Minority Leader Nancy Pelosi (D-Calif.) contends that more than 90 percent of companies, including giants like Koch Industries and Bechtel, could seek the exemption.

“This deeply misguided and destructive decision is a serious blow to Americans’ ability to make their own health decisions,” she said.

A 2009 Columbia University Study concluded that closely held companies account for 52 percent of the American workforce.

Ginsburg goes even further in predicting the implications of what she calls, “a decision of startling breadth.”

While the majority seeks to “cabin” its language to cover only closely held firms, its logic extends to all companies, she argues in her dissent.

“Little doubt that RFRA claims will proliferate, for the Court’s expansive notion of
corporate personhood—combined with its other errors in construing RFRA—invites for-profit entities to seek religion-based exemptions from regulations they deem offensive to their faith,” Ginsburg wrote.

However many firms, closely held or otherwise, offered their workers contraception before ObamaCare required it, and it is unlikely that large numbers of women who currently have free access to the full range of FDA approved contraception methods would suddenly lose their coverage.

“…the Court’s opinion does not have the breadth and sweep ascribed to it by the respectful and powerful dissent,” Kennedy wrote in his concurring opinion.

— This story was updated at 1:22 p.m.