Supreme Court takes on 4th review of 5-year-old Obama health care law; focus is birth control

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FILE - In this June 30, 2014 file photo, demonstrators stand on the steps outside the Supreme Court in Washington, where the court was poised to deliver its verdict in a case that weighs the religious rights of employers and the right of women to the birth control of their choice. The Supreme Court is wading into its fourth dispute over President Barack Obama’s 5-year-old health care overhaul. The newest “Obamacare” case involves objections by faith-based hospitals, colleges and charities to the process the administration devised to spare them from paying for contraceptives for women covered under their health plans, and yet ensure that those women can obtain birth control at no extra cost. (AP Photo/Pablo Martinez Monsivais, File)

WASHINGTON — Religion, birth control and President Barack Obama's health care overhaul are converging in yet another high-profile dispute at the Supreme Court.

The justices on Friday stepped into the fourth legal challenge to the law since Obama signed the Affordable Care Act in 2010.

This time, the issue is the arrangement the Obama administration worked out to spare faith-based hospitals, colleges and charities from paying for contraceptives for women covered under their health plans, while still ensuring that those women can obtain birth control at no extra cost as the law requires.

The groups complain that the arrangement leaves them complicit in making available the contraceptives in violation of their religious beliefs because their insurers or insurance administrators assume responsibility for providing birth control.

The faith-based groups "can't help the government with its contraceptive delivery system," said Mark Rienzi, a lawyer who represents the groups. Among the challengers are Bishop David Zubik, head of the Catholic Diocese in Pittsburgh, the Little Sisters of the Poor, nuns who run more than two dozen nursing homes for impoverished seniors, and evangelical and Catholic colleges in Oklahoma, Pennsylvania, Texas and Washington, D.C.

White House spokesman Josh Earnest said the administration is confident "that the policy that we have in place appropriately balances the need for millions of Americans to have access to birth control while also protecting the right of religious freedom that is protected in our Constitution."

Arguments will take place in late March.

The high court has twice preserved the health overhaul — including in a decision in June that upheld the broad availability of subsidies to help pay for insurance premiums. But in a ruling last year, the justices allowed some "closely held" businesses with religious objections to refuse to pay for contraceptives for women.

In that case, the court agreed by a 5-4 vote with the Hobby Lobby chain of craft stores and other companies that said their rights were being violated under the 1993 Religious Freedom Restoration Act. The nonprofit groups are invoking the same law in asking that the government find a way that does not involve them or their insurers if it wishes to provide birth control to women covered by their health plans.

Houses of worship and other religious institutions whose primary purpose is to spread the faith are exempt from the requirement to offer birth control.

For other religious-affiliated nonprofit groups, the administration argues that the accommodation creates a generous moral and financial buffer between religious objectors and funding birth control. The nonprofit groups just have to raise their hands and say that paying for any or all of the 20 devices and methods approved by government regulators would violate their religious beliefs.

To do so, they must fill out a government document or otherwise notify the government so that their insurers or third-party administrators can take on the responsibility of paying for the birth control. The employer does not have to arrange the coverage or pay for it. Insurers get reimbursed by the government through credits against fees owed under other parts of the health law.

Some groups, including Little Sisters of the Poor, contract with church-based insurers, which themselves are exempt from having to provide contraceptives.

But dozens of colleges, hospitals, charities and other organizations have said in lawsuits they still are being forced to participate in an effort to provide coverage for contraceptives, including some which they claim amount to abortion. The government may impose fines on groups that do not comply.

Seven out of eight federal appeals courts have agreed with the administration that requiring the faith-based groups to make their objection known and identify their insurer or insurance administrator does not violate the federal religious freedom law.

Only the appeals court in St. Louis ruled for the groups, saying they probably have a right to refuse to comply with the administration rules.

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