In 2013, the Little Sisters of the Poor filed suit against the Obama administration, arguing that the ACA's contraceptive mandate requiring that they provide birth control and abortive drugs as part of their health care plan violates their religious beliefs. Lower courts ruled against them, but in May 2016 the U.S. Supreme Court granted relief to the charity, requiring the government to find a suitable solution which accommodates religious beliefs.
A year later, President Trump issued an executive order requiring that the Department of Health and Human Services (HHS) come up with such a solution. This has now taken the form of two new rules issued by HHS in October 2017 that provide additional protections for groups which object to the contraceptive mandate on religious or moral grounds.
However, the attorneys general of California and Pennsylvania have filed lawsuits against the new rules, arguing that they violates various facets of the Constitution and would burden states with paying for the birth control which exempted groups (such as the Little Sisters of the Poor) would not be paying for. California’s suit is joined by New York, Virginia, Maryland, and Delaware. In response, Little Sisters of the Poor is filing briefs to support the rules in an effort to defend the religious protections ordered by the Supreme Court.
For a sense of scale, California estimates that “25 employers in the state, with a combined 54,879 employees, will make use of the accommodation.” Assuming that half of those employees are woman and that birth control costs $600 per year (an oft-cited number), then were California to pay for the entire contraceptive cost the total would be approximately $16.5 million per year. For comparison, California’s budget is $183 billion per year, so the “burden” to the state for providing birth control to those not covered by employers is minuscule and effectively rounds down to zero. Alternatively, the women could simply pay for their own birth control, similar to how people pay for other items they need or want.
This ongoing saga with the contraceptive mandate illustrates the perils of ceding too much power to government. With the federal government enabled by the ACA to force people to buy health insurance and dictate what coverage companies provide, the situation creates a high stakes fight for control of these rules. It also dilutes market forces, since individuals are not free to purchase the coverage they desire on an open market and the true, actual cost of insurance and health care is obscured.
(Image: AP Photo/Jacquelyn Martin)