Topic: The Supreme Court ruling for Hobby Lobby

[consortium11]

The thing is Val. "Birth Control" is not used solely for birth control. Doctor's prescribe it for numerous medical reasons - all of which have been legitimately proven to aided by the use of birth control.

This company, based on their ignorant belief, is refusing to pay a medicine because it also has the effect of stopping pregnancy. Yet they will continue to cover the cost for vasectomies. Care to explain how that is fair?

To use Hobby Lobby's logic from this case, what they object to is birth control post-conception i.e. after fertilisation of an egg where an embryo would be destroyed. A vasectomy does not cause an embryo to be destroyed and thus does not cause the same issue.

[Zakharra]

To use Hobby Lobby's logic from this case, what they object to is birth control post-conception i.e. after fertilisation of an egg where an embryo would be destroyed. A vasectomy does not cause an embryo to be destroyed and thus does not cause the same issue.

 I wonder if they are for birth control methods that keep women from ovulating at all.

[Oniya]

I wonder if they are for birth control methods that keep women from ovulating at all.

Other than an ovectomy or hysterectomy, are there any?

[consortium11]

I wonder if they are for birth control methods that keep women from ovulating at all.

In this case they didn't object to having to fund the various birth control methods that prevent an egg from being fertilised, merely to the four FDA approved methods that may destroy the embryo. So if there are any FDA approved birth control methods that keep women from ovulating at all (in the short or long term), they are seemingly fine with it (I genuinely don't know if there are).

[Zakharra]

  I'm not sure if there are any. I know some women stop having periods when taking some forms of birth control (the pill and such), but I think those women are having an odd reaction that doesn't harm them.  Still, it is more than a little hypocritical for religious folk to be against some/many/most forms of female birth control, but don't really mention male birth control. Almost all of the onus is always put on the woman because she is the one that has to deal with the pregnancy that can result from having sex.

[Hades]

I can't say that I'm surprised by this ruling, though I think it is a terrible one for the court to make.  This court has shown quite often that they are willing to give a wide berth to religion when it comes to any sort of "religious freedom" issues.  Such as allowing 10 Commandment monuments, allowing government functions to start with prayers and so forth.

Then again, I'm personally in favor of the complete abolition of any preferential treatment for religions in this country, so I freely admit to my bias in this sort of situation.

[vtboy]

So, does ACA substantially burden a person's exercise of religion? I think the answer here is clearly yes. Whether one agrees with it or not (and I don't) one cannot deny that the opposition to birth control in these cases is part of a legitimate religious belief held by the owners. As such if they were to exercise their religion (i.e. not fund birth control) they would be liable for the fines of up to $1.3 million per day for one of the companies. That is pretty much the perfect definition of a burden on religious exercise.

Justice Ginsburg's dissent provides a compelling response to this.

Ginsburg begins by noting that the majority opinion conflates the factual question of whether a religious objectant's views are sincerely held with the legal question of whether a purported burden on religious exercise is "substantial." She then points out that an employer is not required to purchase birth control for its employees, to urge employees to avail themselves of any covered treatment, or otherwise to become in involved in its employees' health care decisions. All the law requires is that the employer direct money (which may include employee contributions) into funds used to purchase an extensive array of mandated medical benefits, including those in issue. The decision whether to use an abortifacient is made solely by the employee in consultation with her physician. Justice Ginsburg' concludes that the burden, if any, imposed by this regime on the employer's exercise of religion is far too attenuated to qualify as legally "substantial". To me, the conclusion seems unassailable.

That someone may believe a burden is substantial does not make it so.

[consortium11]

Justice Ginsburg's dissent provides a compelling response to this.

Ginsburg begins by noting that the majority opinion conflates the factual question of whether a religious objectant's views are sincerely held with the legal question of whether a purported burden on religious exercise is "substantial." She then points out that an employer is not required to purchase birth control for its employees, to urge employees to avail themselves of any covered treatment, or otherwise to become in involved in its employees' health care decisions. All the law requires is that the employer direct money (which may include employee contributions) into funds used to purchase an extensive array of mandated medical benefits, including those in issue. The decision whether to use an abortifacient is made solely by the employee in consultation with her physician. Justice Ginsburg' concludes that the burden, if any, imposed by this regime on the employer's exercise of religion is far too attenuated to qualify as legally "substantial". To me, the conclusion seems unassailable.

That someone may believe a burden is substantial does not make it so.

Ginsberg position doesn't hold up to me.

The two cases she cites in this part of her dissent don't do quite what she wants them too... and I respect her enough as a jurist to suspect she knows that. In both Kaemmerling and Bowen the Court rejected claims relating to the exercise of religion being infringed... but in both cases the key reasoning on that point was that the statutes in question (about collecting DNA and social security numbers respectively) didn't requite the complainants to do anything; there were no changes in behaviour or actions that the Acts required that the complainants objected to, rather they objected to the Acts pretty much in and of themselves. Thus the court held that there was no substantial burden on the exercise of religion... as in those cases there was no "exercise" to speak of; the complainants actions were not being directed in any way.

That's not the situation here. There is an exercise (having to fund birth control methods that they view as against their religious beliefs). While Ginsberg goes on to try to argue that the action in question is too distinct from the religious objection to be a substantial burden what she's doing there is arguing whether the belief is reasonable... something the Court expressly prevents itself from doing. To quote a case on that issue: "it is not for us to say that the line he drew was an unreasonable one". I'm pretty much certain Ginsberg knows that which is why she's so careful to try to coach her language to avoid appearing to do so.

The Court doesn't and cannot rule on whether a religious belief is reasonable or not... including the belief that it immoral to pay into a fund that in turn offers the four types of birth control at the centre of this case. The question of burden is about what impact exercising a religious belief would have under the law; in this case it would lead to significant costs (either due to fines or other expenditure). That is a substantial burden.

[Qt]

  I'm not sure if there are any. I know some women stop having periods when taking some forms of birth control (the pill and such), but I think those women are having an odd reaction that doesn't harm them.  Still, it is more than a little hypocritical for religious folk to be against some/many/most forms of female birth control, but don't really mention male birth control. Almost all of the onus is always put on the woman because she is the one that has to deal with the pregnancy that can result from having sex.

First, males don't have as many options compared to women when it comes to birth control.

Second, a female can opt out of parenthood whereas a male cannot and must pay child support. So I couldn't say everything falls on the female, if anything. The society provides various ways for females to alleviate that pressure.

[kylie]

             The point of having a national health system is to make things somewhat more cost-effective for people in general, all while bankrupting the government less than whatever came previously.  That is all quite regardless of however marginal the improvement may be, so long as it is at least aimed at some improvement: I'm not trying to redo the whole single payer v. corporate market debate, where single payer would probably make for much more savings.

              There are any number of things that could be found reprehensible on religious grounds.  And those views can be as sincere as anyone says.  So what.  Does one stop paying taxes because the government raises armies and goes to war?  Because it funds sex ed in other states?  Because there are executive orders favoring immigrant or trans or gender mobility today and maybe one doesn't like that?  One has no more active involvement in what the government does with your tax money, as one does in what an employee does after they are given a choice of health plans.  And the healthcare law also gave the companies the option to not get involved and to pay instead.  Now the companies are saying no, the government should pay because we disagree (if anyone has to pay at all) -- AS IF it made no difference to the consumer if prices go up when employers do not pay.  But that last supposition, is disingenuous to say the least.

            You could take a sincerely held religious view that it is repugnant to recognize the US government -- all of it, full stop -- if you wished.  Something akin to Clive Bundy's view that at the bottom line, the Constitution does not actually apply to him regardless of whether its rules are helpful to him or not (although he happens to still cite it when those rules happen to suit him, too).  Some factions will still argue (see quote below) that they should not even have to present their religious views to the government in order to get an exemption from federal laws that apply to anyone else -- because if they have to bother to report what they believe, then they are also appearing to support a situation where the default (the law unless you get an exception) is after all, exactly what they disagree with. 

To take advantage of the exemption, a closely held company owned by religiously devout individuals must file a form, specified by the government, in order to trigger the legal duty of the “middle man” to provide the coverage as a stand-in for the company or its owners.

Federal government lawyers have made it clear in court, over and over again, that the “middle man” will not have any authority to step in unless the company or its owners file that government form claiming an exemption for the mandate.

Some whose religions tell them to have nothing to do with some forms of birth control (often on the premise that they amount to a form of abortion) believe that even the filing of that formal declaration is itself an act of participation in the provision of those very services for people on their payroll.  The form sets in motion, this argument goes, the entire process that results in birth control being made available to the workers for free.

[consortium11]

Does one stop paying taxes because the government raises armies and goes to war?  Because it funds sex ed in other states?  Because there are executive orders favoring immigrant or trans or gender mobility today and maybe one doesn't like that?  One has no more active involvement in what the government does with your tax money, as one does in what an employee does after they are given a choice of health plans.

No; see Adams for a discussion on that exact point with regards to the RFRA. In essence there is a compelling governmental interest for the government to collect taxes and doing so uniformly is the least restrictive way of doing so, even if this puts a substantial burden on the exercise of religion. Paying taxes falls firmly within the exceptions put inside the RFRA. It may also be worth looking at the Lee case, which follows a similar logic with regards to the First Ammendment.

And the healthcare law also gave the companies the option to not get involved and to pay instead.  Now the companies are saying no, the government should pay -- AS IF it made no difference to the consumer if prices go up when employers do not pay.  But that last supposition, is disingenuous to say the least.

The government itself argues that insurers who cover companies who are exempted from the ACA birth control requirements and thus cover it themselves will not experience an increase in costs.

[Valthazar]

This ruling had much more to do with the financing of healthcare than access to healthcare.  Any employee of Hobby Lobby who uses IUDs or uterine implant birth control is likely still going to be able to use these under their existing employer-provided insurance plan.

The government is just going to add female employees of religious for-profit objectors to the same protocol the objecting non-profits go through.  The government will subsidize the cost of coverage for the IUDs and other excluded healthcare directly to Hobby Lobby's private healthcare provider.  In other words, after this gets sorted out, an employee of Hobby Lobby currently using IUDs is likely going to be able to retain their existing insurance plan with slight variances in their overall premium or copay for this particular service (depending on the government subsidy).

Suggesting that this particular issue (out of all the other expenditures the government wastes money on) is what is going to bankrupt our government is not accurate.

[Oniya]

So, if the objecting company refuses to file the form (because that ensures that their employees gets their prescription albeit through another source), what happens then?

[Valthazar]

So, if the objecting company refuses to file the form (because that ensures that their employees gets their prescription albeit through another source), what happens then?

The government subsidies go directly to the existing private insurance company for the objecting company - not the objecting company itself.  The private health insurance company and the objecting company are two separate entities.  The employer is not involved with any of these subsidies.

There is no reason to suggest why existing healthcare plans available to employees would change contractually between the private healthcare company and the objecting company (given that all healthcare plans currently in existence must meet the minimum standards under ACA).  Hobby Lobby certainly wouldn't gain or lose anything by changing providers.  All private insurance available now contains contraceptive coverage.

The only difference is that the private health insurance company is now receiving subsidies from the government for the excluded coverage, rather than from the employer.

Given how religious non-profits were dealt with under ACA, this is how I see things playing out.

[consortium11]

Given how religious non-profits were dealt with under ACA, this is how I see things playing out.

That's my thought as well; essentially extend the provisions for excluded religious non-profits from ACA to for-profits that can demonstrate a sincere religious belief that being made to fund certain methods of birth control is against their morals.

One thing to keep in mind with this is that the lead opinion by Alito is actually one of the strongest arguments for a single-payer healthcare service that I can remember being advocated by the Court. At times his wording during his discussion of the "least restrictive" element has a distinct undertone of "if only you'd gone for single payer this wouldn't be an issue" about it and, at least on this front, he's right; under a single payer system none of the objections raised in this case apply. Whether he likes it or not (I suspect he won't), Alito's opinion can now be held up and presented by supporters of a single-payer system as an argument for why a single payer system is one of, if not, the best ways to support religious freedom in healthcare.

In fact, if one was being truly cynical, one could use this judgement as the first step to getting a single-payer system in through the back door. Alito explicitly says that the straightforward way to resolve this issue would be for the government to fund the use of these birth control methods directly. If this judgement is, as those who oppose this ruling fear, merely the thin end of the wedge to far more objections then on the same basis (at least relating to ACA/healthcare) the most straightforward way to deal with the complaint is for the government to fund whatever is the cause of the objections directly. What you may well end up with is a large number of Supreme Court opinions all saying that a single-payer option is in essence the best one in a variety of different circumstances... and that's a pretty strong argument in favour of single-payer.

[Valthazar]

What you may well end up with is a large number of Supreme Court opinions all saying that a single-payer option is in essence the best one in a variety of different circumstances... and that's a pretty strong argument in favour of single-payer.

I see your reasoning, but this outcome is unlikely.  I do, however, see a long-term shift away from the employer-subsidized health insurance system.

Contrary to popular opinion, there is little, if any, economic incentive for companies to follow suit with Hobby Lobby.  Companies receive a tidy sum in tax benefits for the nature of their health insurance packages, so only companies with legitimate religious beliefs are likely to follow in Hobby Lobby's footsteps.  As such, the private health insurance market is quite alive and well in the US - and future Supreme Court decisions along this line are unlikely to deter their dominance (largely because even a growth in federal subsidies would be going to the private insurance companies themselves in line with the ACA).

Practical solutions include legislation which would eliminate the employer tax deduction for health benefits and replace it with a tax credit to individuals to purchase private health insurance in the open private market (without employer subsidization).  This would resolve all these issues of religious objection, and would most certainly be an improvement over what we have now.

[kylie]

Paying taxes falls firmly within the exceptions put inside the RFRA.

          It may, but my point is more that a can of worms has been opened where no one knows where the new (Alito) interpretation or test (he says, supposedly) "for" that law's scope seems to end.  There's something odd here where the religious right (and the Court) start and finish on fussing about things they supposedly "won't" decide.  Rather than declare more generally about whatever should positively be considered reasonable burden or accommodation or not, they both speak more to the effect of: "Hey precisely because the Court will not decide who is sincere, it has to assume all who say they are, ARE sincere in a belief and thus every belief on every identity and situation has to be tested as a separate case." 

          There was a time when conservatives so loved to pick on liberals for not having a singular, predictable way of living that made them all one manageable group (and moreover, for so horrifyingly daring to celebrate that as a reality!) ...  And now that the right has learned to play the language of a minority without really even having similar demographics or identical values as the side that once developed that playbook, look where "religious belief" is taking things in terms of policy demands... 

          So it's not so unreasonable for analysts to wonder if they won't do what Alito is reported to have done, and misread the RFRA as covering more than it does.  And on that note: Perhaps you can have the Lee standard if you like OR you can have the RFRA (whichever one feels should work), but from that earlier reading: It sounds like maybe we cannot actually use both simultaneously, not without papering over a conflict between them. 

          On top of that, it seems like it's turning into a fuss where every single possible objection winds up in court.  Which is the "minefield" Ginsberg has warned of.  I guess one might also feel that is just the court's job...  But in practice when much feels up for grabs again, there is a whole lot of vitriol and backstabbing going around in public during the years of waiting for cases to pass through the whole system, hoping to elbow in exceptions that were not so seriously considered before. 

         Also seems to me that "least restrictive" as used here, is sometimes hard to evaluate before the fact of implementation and development of an actual, working policy.  (How is one going to test that and make a sound prediction with all other factors covered, exactly -- does the Supreme Court really hand each case off to the Congressional Budget Office, if that were enough?)  If Canada had stopped building a national care system based on such objections when people found some issues with the first iteration, then I doubt they would have come to the same place they are in today.   The broader American faction that houses the religious right is also the one that tends to say it's all the poor's fault, they should have to pay for themselves and neither richer brackets nor companies (that is, none of those people with well over half the wealth) should have to contribute too much to bring down those general costs that are obviously tearing apart the whole national economy.

         There will always be someone saying there is some possible still more practical way...  But then, government is not always practical and one cannot always simply force it to be whatever one anticipates would be more efficient.  In practice, the US government (particularly the Court) lately tends to err well on the side of defending amorphous, often distant and dispersed (rather than simply "national") corporate interests through concepts like 'property' and expansive 'personhood' more than it worries about saving the average human being.  But it's not so easy to expect that to go away just because one is offended, either. 

            The left has been calling moral outrage for ages and only had very limited success where it has had any...  So I suspect there is no simple and obvious reason that the religious right screaming moral repugnance is going to be able to remove all but the most obviously 'efficient' laws any better.  Quite regardless of what one may think of the motives behind either side trying for change...  Everyone is getting a dose of kick in the face to their values?  Except I suspect, a few of the filthy rich maybe.

The government itself argues that insurers who cover companies who are exempted from the ACA birth control requirements and thus cover it themselves will not experience an increase in costs.

        Could you provide a link to how that works?  I thought the general point of getting corporations to pay a portion of so many things, was that without corporations contributing some standard amount, consumer costs of the services are higher.  Unless you are somehow arguing that the marginal costs of that particular service were somehow negligible in the first place.  I don't think many people would say that about abortion prices. 

           Though if the government somehow gets to turn around and tear down company price structures anyway (??), hey be my guest.   Or we could do that in the first place, and listen to the religious group complaints about how suddenly abortion was generally more affordable perhaps?  It would be quite ironic if the government were moved to do it only because companies like Hobby Lobby objected to paying for abortion policies at all.    Maybe there is more to this puzzle though?

[Valthazar]

Could you provide a link to how that works?  I thought the general point of getting corporations to pay a portion of so many things, was that without corporations contributing some standard amount, consumer costs of the services are higher.  Unless you are somehow arguing that the marginal costs of that particular service were somehow negligible in the first place.  I don't think many people would say that about abortion prices. 

This is within the Affordable Care Act itself.  Under the ACA, private insurers are required to cover recommended preventive services such as mammograms, pap smears, contraception, gestational diabetes screening, and breastfeeding supports, without cost sharing and at no additional cost to the consumer.

The initial regulations proved controversial among certain religious groups, most notably evangelicals and Lutherans, and especially the Roman Catholic hierarchy, whose hospitals, charities and educational institutions of higher learning, as well as other enterprises, oppose contraception on doctrinal grounds.[219] To accommodate those concerns while still guaranteeing access to contraception, the regulations were adjusted to allow religious organizations to opt out of the requirement to include birth control coverage in their employee insurance plans. In those instances, the insurers themselves will offer contraception coverage to enrollees directly, at no additional cost.

For quite a while now, the government has allowed religious non-profit organizations to opt out of these requirements on religious grounds. In those instances, as per the ACA, the insurers themselves must continue to offer contraception coverage to enrollees directly, at no additional cost to the consumer.

Even if for whatever reason, federal subsidies are not approved for the insurance companies of religious for-profit objectors, the onus is still on insurance companies to figure out a way to comply with ACA (at no additional cost to consumer). 

Much to the delight of insurance companies, studies have shown how the upfront costs of providing birth control are less than the long-term costs of prenatal and maternity care.  It is generally understood that insurers could handle the cost of contraception without drawing extra employer funds (and thus violating the ACA).
Guttmacher Institute

This entire healthcare law is a total mess, and yet another reason why the ACA should not have been rushed into law.

[KalebHyde]

From just my basic understanding of this case, HL still pays for 16 out of 20 contraceptive methods, so it is not as if they are denying their employees all forms of birth control.  Those specific 4 methods not covered all involve termination of possible conception, though I may not be stating that exactly right.  I assume HL sees this as supporting abortion which would fundamentally violate their beliefs.  It is hard to imagine that they or any other company would choose to fight the government or face the public backlash of their position on a whim.  It is their right as a privately owned company just as it is the right for any customer to take their business elsewhere. 

Speaking of free markets, the ACA is indeed a rushed mess evidenced by the multitude of changes that have been made since it passed.  For all the flaws of the private system, I have never understood how the federal government could run things better.  Changes were needed, but one look at the VA under all administrations should show where any sort of single payer system is going.  Some conspiracy theorists might even suggest that these issues with the ACA were intended to damage the system so much as to have the American people begging for single payer though I am not sure the government is that competent.

[kylie]

This is within the Affordable Care Act itself.  Under the ACA, private insurers are required to cover recommended preventive services such as mammograms, pap smears, contraception, gestational diabetes screening, and breastfeeding supports, without cost sharing and at no additional cost to the consumer.

           Maybe I just don't understand, or maybe it's the wording.  But it seems to me that a few posts ago, people in favor of this decision were saying that policies including abortion coverage should not be considered preventive or anything other than elective. 

           Now here, are you suggesting they actually are or should be considered preventive?  I could find some reasons to agree they should be --- but unless they are going to be treated that way under the existing law, we would have apples and oranges until if/when another law is introduced to make it so. 

For quite a while now, the government has allowed religious non-profit organizations to opt out of these requirements on religious grounds. In those instances, as per the ACA, the insurers themselves must continue to offer contraception coverage to enrollees directly, at no additional cost to the consumer.

          Yes and there I'm inclined to agree more with those who have said, but this is not equivalent to a church.  This is a company doing publicly available business. 
 
           If not, then every little photo shop on every other corner (or so many small communities with only one family-owned photo shop btw) comes along and says, we won't provide whichever services we think make same-sex couples look approved...

Even if for whatever reason, federal subsidies are not approved for the insurance companies of religious for-profit objectors, the onus is still on insurance companies to figure out a way to comply with ACA (at no additional cost to consumer). 

           I do think companies should have a more reasonable pricing structure to begin with.  But I can also imagine they might come to a place where after a certain quantity of objections begin to be raised (or objections to certain particularly hefty procedures?), they would also have a point in saying you know, there is some actual cost here.  And we're being told to pay all of these long list of things, based on "what" exactly, again?

Much to the delight of insurance companies, studies have shown how the upfront costs of providing birth control are less than the long-term costs of prenatal and maternity care.  It is generally understood that insurers could handle the cost of contraception without drawing extra employer funds (and thus violating the ACA).

           I'm sure they could, but what happens when someone has a religious objection to offering their employees an insurer policy that includes birth control?  Then are you going to say, well the employees or the government should pay for it all by themselves, because after all it's cheaper in absolute terms than having to pay for abortion or maternity coverage?  Oh...  It's cheaper than having to take leave from work to have a baby, too! 

           But we are in this conversation in the first place because certain religious exemptions were allowed.  On the same principle, one can stand up objecting to this too.  If that's what you say "could" be done instead.

           There was a time when some said much of the ACA should be scrapped because it paid through health care through tax policy, and that sort of taxation was unreasonable.  Now we have some people saying, oh no it's not like a tax --- if it were a tax then you do have to pay for whatever the government does for everyone with the tax (unless you refuse taxes of course).  Here you pick and choose, exempt this and that for religion.  Go figure.

[Pumpkin Seeds]

The four types of contraception not allowed by Hobby Lobby conveniently stand as one of the more expensive methods of reversible contraception.  Among these four are two forms of “morning after pill” which is the form of birth control whereby a woman takes the medication after having possible unprotected sex.  By this I mean rape, drunk one night stands, forgetting their pill, condom breaking, etc. etc.  The pill works by delaying ovulation, which would cause the sperm to miss the egg through timing and by also interfering with the fertilization of the egg.  The pile may also reduce the chance of implantation, but in no way damage or interferes with an egg that is implanted.  Now there is almost no medical professional that would state that a woman whose egg has failed to implant is having a miscarriage or to use the medical term, an abortion.  Hobby Lobby feels this is an abortion, despite the fact that the medical community says differently and all scientific information contradicts their feeling.

Second comes the IUD.  This is considered a long-term, effective form of birth control that does not require a woman to keep track of medications or prepare herself before having sex in order to prevent pregnancy.  Both IUDs prevent the sperm from meeting the egg by killing off the sperm and generating a toxic environment for the sperm to exist.  This is similar to the spermicide used on several devices that Hobby Lobby does cover.  Once more there is almost no medical professional that would say a woman failing to implant or even fertilize an egg if having an abortion.  Hobby Lobby simply “feels” this is an abortion.  Coincidentally these are the two most expensive of the reversible options.

Of the sixteen choices left, two are for men which include condoms and vasectomies.  Considering condoms are handed out for free at Planned Parenthood and almost any high school or college health clinic, this is a bit of a stretch for them to claim as insurance coverage.  Two of the other options are for permanent female sterilization.  Not really even in the same conversation as this one.  So now we are left with twelve options for women. 

Spermicides  are 70-80% effective, are known to cause irritation and obviously work best if applied near time of planned intercourse.  Not really the best option.

Female condom use is 72-82% effective.  Also the device must be properly placed before intercourse and is known to cause irritation and reduce enjoyment of the female.  Yes, now even women can complain about condoms not letting them enjoy sex.  Though considering that women require tactile stimulation rather than mechanical release for orgasm, I tend to believe women have a leg to stand on here.

Diaphragm, sponge and cervical cap with spermicide are at roughly 84% effectiveness.  These devices may also lead to increased risk of UTIs and can lead to toxic shock syndrome if left in place for more than 24 hours.  Little details right?

So then there is the multitude of pills.  Birth control pills are effective, largely inexpensive with insurance and easily obtained by most pharmacists.  Most pills do have an effectiveness rate somewhere in the high 90s, unless of course taken with antibiotics in which case there will be no sexual activity.  There is also the problem of missing a pill, taking the wrong pill.  Then there is finding the right one that won’t send the hormones into overdrive and then also there is a waiting period for their effectiveness.  So there are certainly some issues here. 

So that is twelve of the sixteen discussed with none offering what the IUD or the Plan B offers.  So this leaves the contraceptive ring, contraceptive patch, implantable devices and the shots.  The shots last around 3-4 months and require regular doctor visits to receive them.  Contraceptive rings are replaced every three weeks and patches every week.  So here again we have issues with obtaining and remaining consistent. 

Implantable rods are effective for 3 years. Hormonal IUDs are effective for 3-5 years, copper IUDs are effective for ten years.  This means that a woman at 18 can effectively not worry about getting pregnant until she is 28 years old.  This covers college, graduate school, careers and puts her at an age that most women would feel comfortable considering pregnancy.  All this with a single doctor’s appointment and insertion.  Let me say that again.  Hobby Lobby’s best option to match a Copper IUD is beat by SEVEN YEARs.  There is no man that I know of which would consider that large of a difference a comparable one.  Not to mention there is nothing comparable to Plan B offered by Hobby Lobby.  By the way, almost every other birth control measure recommends emergency contraceptive on hand.  So pretty much everything Hobby Lobby covers, recommends Plan B.

Simply put, each of these devices has pros and cons.  Downplaying the severity of limiting the choice is honestly insulting.  To tell someone, “I am sorry but we could offer you a more effective and easier to manage solution, but we don’t like them so we are giving you a less effective and more difficult to manage solution” does not work in any other aspect of medicine.  There is not one HIV patient being given an old regiment of medication when the new, combination medications are available and on hand.  People come into the Emergency Room and are given A SHOT of antibiotics in place of multiple doses and pills, because physicians know less is more effective. 

There is no other area of medicine where this argument flies aside from women’s health and contraception.  None.  The more effective procedures and medications are there and present, bought and paid for and those medications and procedures are given to the patient.  Except for this one issue and area.

[Valthazar]

Maybe I just don't understand, or maybe it's the wording.  But it seems to me that a few posts ago, people in favor of this decision were saying that policies including abortion coverage should not be considered preventive or anything other than elective.

I did not mention abortion in this thread.  Pumpkin Seeds may have been under the impression that abortion is included as an essential benefit under ACA.  It is not.

No private insurer is required to include abortion coverage, and abortion cannot be included as an essential benefit in insurance plans (except those under the Hyde Amendment - rape, incest and life endangerment).  No state will be required to provide abortion coverage, and a state can, in fact, pass a law that bars any plan covering abortion from the state-assisted exchange.

If a private insurance plan does cover abortion, the insurer must collect separate premium checks for that coverage and cannot use any premium tax credits or other federal funding for those services.  In certain situations, the states themselves may require abortion to be covered under all insurance plans.

Essential Benefits

Yes and there I'm inclined to agree more with those who have said, but this is not equivalent to a church.  This is a company doing publicly available business.

It is worth mentioning that 'religious non-profits' do not only represent churches or places of worship.  A non-profit is any organization that uses surplus revenues to achieve its goals rather than distributing them as profit or dividends.  The simple act of performing business to the public does not disqualify an organization from this status.

To tell someone, “I am sorry but we could offer you a more effective and easier to manage solution, but we don’t like them so we are giving you a less effective and more difficult to manage solution” does not work in any other aspect of medicine.  There is not one HIV patient being given an old regiment of medication when the new, combination medications are available and on hand.  People come into the Emergency Room and are given A SHOT of antibiotics in place of multiple doses and pills, because physicians know less is more effective. 

I think many here are under the impression that individuals will no longer have access to these four types of contraception.  This is not the case.

The employees of Hobby Lobby receive their health insurance from a private health insurance company - not Hobby Lobby.  Thus, the insurance company is legally obligated to comply with ACA minimum standards, regardless of the source of funding.  Regardless of this Supreme Court decision, the coverage options available for HL employees will not change.  As I said, the onus falls on their insurance company to figure out how to finance all of this, given that the employer no longer has to contribute this portion of the premium cost.  Either the insurance company will absorb the cost directly (plausible but unlikely), or federal subsidies will go directly to the insurance company, in-line with religious non-profits.

I guess you could say the real responsibility falls on the White House and Congress to figure out this mess now, since all enrollees of private health insurance plans are and will always be guaranteed to have access to these types of procedures.  Again, all the four types of contraception will continue to be available on the employees' insurance plans.

The reasoning for 'why' Hobby Lobby does not want to contribute to these four types of contraception was discussed earlier in this thread.

[Pumpkin Seeds]

I never mentioned abortion coverage.  Abortion is an elective surgery and I am also not stupid enough to believe that Hobby Lobby would fight these four forms of contraception, but not a mandatory funding of actual abortion coverage.  I am not sure why my name was included in this statement.

The insurance company will still have to provide plans that cover these four types of contraception, but will not have to offer this plan to Hobby Lobby.  If the court states that Hobby Lobby does not have to pay for them, the court cannot then tell the insurance company they must still offer the service without payment.  That is really at the crux of this situation.  Now the government may pay for these four forms of contraception, but considering the fight to simply include mandatory coverage for women under the ACA I doubt there will be any such law passed.  This means that women will be forced to pay for their own treatment or will have to qualify to go on the insurance plan marketplace to find coverage that does offer these four.  One poster said this is a conspiracy to offer one-payer system, but in truth the reverse argument is openly stated as opponents are slowly eroding and attempting to remove the teeth of the ACA.

Proof that practicing their religion is a substantial burden is not answered so easily.  Denying someone else a choice is not part of the Christian religion nor is this part of their doctrine.  Mass at a Church does not stop because condoms are being distributed elsewhere, baptisms aren’t being held up because an employer gave money to a 401K that funds abortion methods and Christians aren’t being beaten in the street because of a same-sex marriage law being passed.  There has to be proof that in some way the religious practices are being hindered to the point that the practitioners either crease or are burdened.  None of these practitioners are being burdened for practicing their religion, they are only being asked to pay into a system whereby forms of healthcare are covered and provided.  Nobody is forcing the people to use the medications, to sponsor the treatments or advocate them to their employees.  There is no part played by these employers other than paying a tax.  Will I now be able to not pay my taxes due to religious and ideological beliefs?

Hobby Lobby has also proven that their business model loses conviction when faced with financial concerns.  The company has refused to invest their 401K funds into religious minded investment groups; instead seeking financial return with non-Christian investment groups that invest their money into pharmaceutical companies that fund the very contraception Hobby Lobby claims is burdening their religious freedom.  Being closed on Sunday and playing Christian music in the store is not incorporating religious practice into business practice. 

The exemptions offered by the ACA to religious employers used to fall under this statement, “which refers to churches, other houses of worship, their integrated auxiliaries and conventions or association of churches, as well as the exclusively religious activities of any religious order.”  Hobby Lobby does not fall under any of this.  The Supreme Court has altered the provision drastically and without cause.  This sets an extremely dangerous precedent and already cases are on the heels of this one to extend the ban on coverage to other forms of contraception and to other businesses.  What will keep lower courts from taking this direction by the Supreme Court and denying women coverage?  As the dissenting opinion stated, what prevents other religious practices from being honored due to this ruling ?

[Valthazar]

I also didn't really know where kylie saw someone posting about abortion, but this is where I thought you were citing abortion:

Having to provide for women to have insurance for contraception, abortion and other reproductive related procedures does not prevent the ability of the company owner or their family members to exercise their religion.

The insurance company will still have to provide plans that cover these four types of contraception, but will not have to offer this plan to Hobby Lobby. If the court states that Hobby Lobby does not have to pay for them, the court cannot then tell the insurance company they must still offer the service without payment.  That is really at the crux of this situation.  Now the government may pay for these four forms of contraception, but considering the fight to simply include mandatory coverage for women under the ACA I doubt there will be any such law passed.

You are correct that a Congressional solution to directly fund is unlikely, given that most Republicans still oppose the ACA, and maintain a majority in the House.  However, legal analysts have already suggested that the Obama administration will rewrite contraception regulations for companies affected by Hobby Lobby on its own (without Congress), and relatively quickly, and the Supreme Court seems to not mind a rewrite of the rules, either.
Supreme Court Advice to President Obama

As Justice Alito said, "HHS [Health and Human Services] itself has demonstrated that it has at its disposal an approach that is less restrictive than requiring employers to fund contraceptive methods that violate their religious beliefs... HHS has already established an accommodation for nonprofit organizations with religious objections."

It is worth mentioning that the Obama administration itself was the one who introduced the modified regulations for religious nonprofits last year to opt out of paying for contraceptive coverage (without Congressional approval being necessary). The nonprofit’s health care provider would then provide the coverage on its own, at no additional cost to employees.

It is not outlandish to assume that when Obama and the administration add new regulation for religious for-profits in the same manner (as per Alito's suggestion), that he would follow suit in ensuring no additional cost.

Hobby Lobby has also proven that their business model loses conviction when faced with financial concerns.  The company has refused to invest their 401K funds into religious minded investment groups; instead seeking financial return with non-Christian investment groups that invest their money into pharmaceutical companies that fund the very contraception Hobby Lobby claims is burdening their religious freedom.  Being closed on Sunday and playing Christian music in the store is not incorporating religious practice into business practice. 

Hobby Lobby isn't looking to restrict employee investment activity – any more than it is trying to restrict the legal availability of contraception for their employees.  To reiterate once again, employees of Hobby Lobby will not lose coverage for the 4 contraceptive methods, and nothing Hobby Lobby is doing will add to their employees' expenses (based to ACA regulatory precedent).  401(k) investments originate solely from pre-tax employee earnings, after payroll has been done.  These are not company finances any longer.  In the case of Hobby Lobby, they voluntarily match employee contributions not as a legal requirement, but as a benefit.  Realize that employer matches in 401(k) plans are not feeding into the company operations.  They benefit the employee, and not the business. 

From a financial perspective, making this criticism is akin to saying that Hobby Lobby is violating their Christian principles because an employee utilizes a portion of his/her paycheck to go to a strip club.  Although to most employees it may appear that 401(k) contributions are controlled by their employer, the reality is that it is the employee himself who makes this determination upon his hire as to how his/her pre-tax earning contributions are invested (from a selection of mutual funds).  Aware that these 401(k) investments are outside the realm of their business, Hobby Lobby responsibly offers a litany of mutual funds (more than 12), where 8 of them involve pharmaceutical companies.  Given that 401(k) matches are not a legal requirement, your assertion seems to suggest that it would be more in line with their "Christian mission" to not grant any 401(k) match at all.  These expenses are outside the realm of business operation since they do not feed into the operational and overhead functioning of the company.

[Pumpkin Seeds]

The insurance company does not provide coverage for those four types of contraception.  An insurance company will not provide coverage for something they are not being paid to cover.  There is no law that Congress will pass or any executive order that can be done that will force a company to give something for free.  These workers lose the ability to receive these four types of contraception unless someone steps forward and pays for them.  Whether this is the women paying an additional cost, which means they now pay more for the same health coverage as everyone else in the United States, or the government.  Which if the government begins to pay for some women’s birth control there will be a clamor for them to cover all women’s birth control.   

You keep saying the birth control will be provided at no additional cost but fail to say how that will be done.  According to the Supreme Court reporter for the New York Times interviewed on NPR yesterday, you are wrong.  If a company will not pay for coverage, the law is changed.  According to the ACA, women are to be covered for these procedures and contraception at no additional cost to them.  If the company does not have to pay for them, then the insurance company will not be obligated to offer those services.  The Obama administration made those changes to avoid this very conflict, knowing that this would open the door to removal of women's health from the ACA.

Also, Hobby Lobby chooses who controls the investments of the 401K.  They receive notices about who their 401K company is donating money to along with their employees.  Hobby Lobby selects which company and they also have the ability to stop funds to and alter the investments.  Hobby Lobby also matches those funds by their employees.  This is not one of their employees going to a strip club, this is Hobby Lobby asking which strip club they would like money set aside for their employee and offering to give him a little extra to buy a lap dance.  So I am glad Hobby Lobby doesn’t want to restrict investment opportunities, but I would like if they did not restrict healthcare opportunities for their female employees as well.