Obamacare’s Contraception Battle Heats Up in D.C.

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As the success of fixes to the federal healthcare website created under the auspices of the Affordable Care Act become apparent and the number of enrollees in health plans purchased via the online insurance marketplaces pick up, the focus of the American public will now be less divided. That means more attention will be placed on the quality of coverage offered by the Obamacare insurance policies and just what benefits they include.

For months, similar questions have occasionally broken through the noise created by the nation’s other Obamacare concerns, especially worries about the health care reform’s stance on birth control coverage. This week, the Obama administration renewed its efforts to defend employer-paid contraceptives.

One of the explicit purposes of the health care reform was to improve the quality of health insurance policies. To guarantee that insurers no longer offer the so-called bare bones plans, the Affordable Care Act mandated the policies provide ten essential benefits, including mental healthcare and contraceptives. While ostensibly a sweeping attempt to ensure all Americans have access to the services they need without having to pay an unaffordable premium, religious groups have seen the mandated insurance coverage of contraceptives as a threat to religious freedom.

Lawyers for Kathleen Sebelius — secretary of the United States Department of Health and Human Services — argued Friday that the U.S. Court of Appeals in Washington D.C. should reject a request from the city’s Roman Catholic archbishop to delay a decision in favor of the contraceptive coverage made by a lower court. However, the federal government argued that such an injunction is unnecessary; already, the Obama administration has created rules to exempt certain nonprofits and religiously affiliated organizations from the contraceptive requirements, and in those cases, women can receive coverage from another company at no additional cost.

D.C. Catholics “need only self-certify that they are nonprofit organizations that hold themselves out as religious and have religious objections to providing coverage for contraceptive services and provide a copy of their self-certification to their health insurance issuer or third-party administrator,” the government argued in court papers filed Friday. Comparatively, lawyers for the archdiocese claimed in court briefs seen by Bloomberg that the enforcement of Obamacare’s contraception coverage “constitutes impermissible facilitation of objectionable services in violation of the Catholic doctrines of material cooperation with immoral conduct and ‘scandal.’”

Last month, the Supreme Court agreed to examine another legal challenge to the Affordable Care Act. At the most basic level, the court’s ruling will decide whether employers with religious objections to birth control may refuse to provide their workers with insurance that offers contraceptive coverage.

But the case will also provide the Supreme Court an opportunity examine complex legal and constitutional questions about religious freedom, the equality of female workers, and whether any protections exist in the constitution or in federal statutes that excuse private, for-profit corporations from complying with the law because of their owner’s religious beliefs. These questions have preoccupied lower courts in recent months, just as they will engross the Supreme Court in coming months; oral arguments will likely be held in March with a ruling coming in late June.

The Supreme Court takes on cases when they involve questions related to constitutional law or a federal statute, some cases the nine-justice panels hear are original, and some an appeal of a lower court decision that has national significance. In regards to the issue of contraceptive coverage and the Affordable Care Act’s requirement, two lower courts returned opposite rulings on the whether the mandate is constitutional and the now the question is up for the review of the Supreme Court.

This is not the first occasion the future of the healthcare reform has been put in the hands of the highest U.S. court. In July 2012, Chief Justice John Roberts sided with Justices Ruth Bader Ginsburg, Sonia Sotomayor, Stephen Breyer, and Elena Kagan in deciding the healthcare law was a valid exercise of Congress’s power to tax, meaning the government could require individuals to purchase insurance or face a tax penalty.

Currently, nearly 50 pending lawsuits have been filed in federal court from various corporations challenging the birth control coverage mandate, and three federal appeals courts in Chicago, Denver, and Washington D.C. have struck down the contraception coverage rule while two other appeal courts have upheld. The fact that there was a “circuit split” made a Supreme Court review even more likely, even though the court agreed to hear two particular cases involving for-profit corporations: the craft store chain Hobby Lobby Stores Inc. and Conestoga Wood Specialties Corp.

Of course, the White House has not been silent on the issue. “The healthcare law puts women and families in control of their healthcare by covering vital preventive care, like cancer screenings and birth control, free of charge. Earlier this year, the Obama Administration asked the Supreme Court to consider a legal challenge to the healthcare law’s requirement that for-profit corporations include birth control coverage in insurance available to their employees,” explained a statement made by White House Press Secretary regarding Sebelius v. Hobby Lobby Stores, Inc. “We believe this requirement is lawful and essential to women’s health and are confident the Supreme Court will agree.” The title of the lawsuit refers to Department of Health and Human Services Secretary Kathleen Sebelius.

In determining whether non-religious should be exempt from the contraceptive insurance mandate, the Supreme Court will have to interpret the 1993 Religious Freedom Restoration Act. Justices will have to decide whether the federal law’s protections apply to companies, churches, and universities, or only to “persons.”

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