By a 7 to 2 vote the Little Sisters of the Poor won a decisive and historic SCOTUS victory yesterday. The ruling upheld the religious and moral objections forcing them to subsidize contraceptive drugs in their employee insurance coverage. The ruling defended the First Amendment protection against participating in practices that one’s religious beliefs determine to be morally wrong. The 2010 Affordable Care Act (ACA) was a massive overhaul of the healthcare industry that Nancy Pelosi famously said, “We must pass it to know what’s in it.” The bill forced everyone to purchase an all-encompassing plan that included many unnecessary services. Devout Catholics and nuns were required to obtain contraceptive coverage knowing that they would likely never use that benefit. The contraceptive mandate was never part of the original bill that Congress passed without a single Republican vote. It was added to the ACA after its passage by members of the Department of Health & Human Services (HHS). It was staunchly defended by the Obama White House including Vice-President Biden, a long-time Catholic. Biden has since adopted the progressive Democratic pro-choice platform that supports abortion on demand up to the day of birth. The ACA was promoted as lowering healthcare costs but actually did the opposite; most individuals needed government subsidies to afford their premiums. The ACA also included a mandate that everyone purchase insurance; those who failed to do so were fined every year in which they did not comply. The contraceptive mandate forced everyone to subsidize contraception and abortifacient drugs for those demanding them. Any employer refusing the contraceptive mandate could face heavy fines despite an exclusion that was later added for religious or moral grounds. A rule generated within the Trump administration expanded exemptions to religiously-affiliated groups and some for-profit companies allowing them to opt-out of providing contraceptive coverage to their employees. Lower court rulings ruled against the administration and a nationwide injunction placed a hold on all exemptions pending the SCOTUS ruling.
In June 2014 the Supreme Court ruled in favor of Hobby Lobby by a margin of 5-4 in their religious-based refusal to follow the contraceptive mandate within the ACA. This was an critical ruling because Hobby Lobby is a “closely-held” for-profit corporation run on religious principles. Justice Alito written opinion emphasized that the ruling had a limited scope. The Court appears to have based much of their decision on the Religious Freedom Restoration Act (RFRA). This federal law asks the question: Does the law place a substantial burden on an organization’s religious exercise? If so: Has the government found the “least-restrictive” way to accomplish its original goal in passing that law or is there another less restrictive way of doing so? Yesterday’s ruling was not only a victory for the Little Sisters of the Poor but for all religious groups and religious principled companies. If the Little Sisters of the Poor had lost this case and still refused to provide contraceptive coverage they would have faced fines estimated at $75 million a year. I have been a proponent of “cafeteria-style” health insurance where we can pick and choose the options that suit our needs rather than a one-size fits all type insurance. Other than catastrophic coverage (an option that should be available for all) we should be free to determine the coverage we need. Health insurance is a necessity but it should not be a burden.