Supreme Court Ruling/Contraception Coverage

This week (June 30, 2014) the Supreme Court ruled in favor of plaintiffs – Hobby Lobby, Mardel, and Conestoga Wood Specialties – in their respective challenges to the Affordable Care Act’s (ACA) contraception mandate.  The basis for their cases was simple in nature, but sweeping in scope, as there are over 90 similar cases currently pending in courts around the country.  The court’s decision was quickly followed by a tremendous amount of media coverage, some of which is patently false and misleading.  Here’s an overview of what we know at this point…

  • The Affordable Care Act (ACA) contains a provision requiring most employers to cover a range of contraception drugs and devices in their health plans, AT NO COST TO THEIR FEMALE EMPLOYEES.
    • Specifically, the ACA requires non-grandfathered health insurance plans to cover preventive health care services for women, which the Institute of Medicine defined to include all 20 contraceptive products approved by the Food and Drug Administration (FDA).
  • Previously, the White House granted an exemption for churches/synagogues, and accommodations for religious hospitals, schools, and non-profits.
    • Currently, there are 51 pending lawsuits that appear to be headed to the Supreme Court, all of which assert that the “religious exemption” was not adequate because employers have to sign forms assigning the objectionable coverage to insurance administrator’s.
  • The Supreme Court, in a 5-4 ruling, asserted that the Obama administration had failed to show that the contraception mandate contained in the ACA is the “least restrictive means of advancing its interest in providing birth control at no cost to women”.
  • The court ruled that “the Affordable Care Act cannot force closely held companies to cover contraceptives in employee insurance plans if the corporation owners have religious objections to birth control”.  Closely held companies are considered to be corporations where over 50% of the stock is owned by 5 or less individuals.
  • While many media reports have made the point that the case was about contraception in general, the focus was actually on four specific forms of contraception, known as abortifacients (i.e., drugs which induce abortions).
  • Hobby Lobby currently provides coverage for 16 different forms of contraception in its health insurance plan, and there is no reason to believe this will change as a result of the court’s ruling.
  • In its ruling, the Supreme Court referred to another existing law known as the Religious Freedom and Restoration Act.  The majority ruled that this law doesn’t allow the Obama administration to force private company’s to cover birth control methods like the “morning-after pill” and intrauterine devices, which some objectors say are tantamount to abortion.
  • Further guidance on the impact and application of the ruling is expected from Health and Human Services (HHS), and I’m sure, eagerly anticipated by affected companies.