President Obama’s Patient Protection and Affordability of Care Act (PPACA) was a sweeping reform of healthcare that has not been without controversy. While the legal battles over the mandate to purchase individual health coverage have caught public attention, that measure is not the only part of PPACA that is courting controversy and garnering challenges as to whether or not it is constitutional. There is a strong debate on the requirement that employer provided health insurance plans cover all FDA approved forms of birth control (including the controversial “morning after” or “plan B” pill) and sterilization.
The Catholic faith is the largest and most visible of those in opposition to the law, but is not alone. Jewish, Muslim and some protestant faiths also oppose the measure (Jones & Scheiner, 2012). Employees who work directly for a church, mosque or synagogue are excepted from the mandate based on religious beliefs of the employer, but employees of church affiliated schools, charities and hospitals are not (Cooper, 2012). The mandate was originally written so that employers would bear the cost of birth control.
Religiously affiliated employers objected, stating that such a requirement infringed on religious beliefs which forbid such birth control measures. The federal government took note of the objections and withdrew the requirement for employers to pay for birth control measures. It was replaced by a requirement that employer provided health insurance plans include all FDA approved birth control and sterilization procedures with no co-pays or deductibles (Cooper, 2012). Several states have already had mandates in place to cover birth control with insurance plans, but these mandates have allowed exceptions for religious objections NCSL, n. d. ). Women’s groups support the measure, calling it a victory for women’s rights. They see the measure as a necessary protection so that a woman may determine the course of her own body, including when and if she has children. They contend that whether or not a woman chooses to take birth control is a private matter for her and her healthcare provider to decide, not one that should be impacted by where or for what group she works (McCrimmon, 2012). Religious institutions however are still in opposition to the measure.
Although the new mandate requires the birth control medications to be paid for by the insurance company rather than directly by the employee, some institutions view this as nothing more than an accounting trick since the cost of medications are reflected in the premiums employers pay. It is their claim that although they would be indirectly paying for birth control, they would still be forced to pay for something that is against their religious beliefs (Walker, 2012). The Archdioceses of Baltimore have come up with a solution that will comply with the mandate and keep their religious convictions intact.
They will simply drop health insurance benefits. Since the mandate only requires that employer provided insurance plans cover birth control, there is nothing to prevent an employer from dropping health insurance plans altogether and thereby not indirectly paying for something believed to be a violation of the church’s moral principles. About thirty five hundred people would lose health insurance (Walker, 2012). Franciscan University, a Catholic affiliated school in Ohio has ceased offering insurance plans to students in light of the mandate (Simon, 2012).
In other areas of the country, there are discussions of selling or closing church affiliated hospitals and charities (Jones & Scheiner, 2012). Seven states—Nebraska, Florida, Michigan, Ohio, Oklahoma, South Carolina and Texas—have sued to block the measure. They are joined by several private plaintiff groups. Arizona’s Judiciary Committee endorsed a bill that would allow employers to exclude birth control from insurance plans for non-medical reasons if birth control was against the religious beliefs of the employer. With federal law superseding state however, there is little chance of such a bill standing (Betancourt, 2012).
Those suing to stop the measure cite the first amendment of the Constitution which states “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof… (Domenech, n. d. )” They contend that the first amendment is intended to prevent this type of governmental interference that forces a religious group to pay to provide something it believes is morally wrong. There is nothing in the Constitution that specifically grants the right to healthcare. The closest the Constitution comes to mentioning healthcare is the general welfare phrase used in the preamble (Domenech, n. d. ).
An attempt by Congress to nullify the birth control coverage failed to pass by a 51-46 vote. Many voting against the bill stated that its provisions were too broad and that it would have allowed employers to exclude virtually any medical treatment on the grounds of morals. Voting was split along party lines with Republicans supporting and Democrats opposing the bill (AP, 2012). Supporters of the mandate contest that because hospitals, schools and other charities that are affiliated with religious groups serve and employ people of multiple faiths, the employer has no right to force religious beliefs on its employees.
They further contend that because it is the insurance company rather than the employer who is paying for the birth control measures, freedom of religion is not being violated (McCrimmon, 2012). The White House has given religiously affiliated employers an extra year to comply with the mandate (Simon, 2012). By such time, the courts will be involved and will be reviewing both sides to determine if the mandate is an intrusion on the freedom of religion or an acceptable exercise of federal powers. The decision rendered will affect the birth control overage for nurses as well as other employees who work for religiously affiliated hospitals, schools and charities.
AP (n. d. ). Bill to reverse Obama birth control policy defeated in Senate “ USATODAY. com. USA Today News. Retrieved June 20, 2012, from http://www. usatoday. com/news/washington/story/2012-03-01/birth-control-politics/53313252/1 Betancourt, T. A. (2012, March 12). Senate judiciary committee endorses controversial contraceptive bill | ASU News | The State Press | Arizona State University. ASU News | The State Press | Arizona State University.
Retrieved June 20, 2012, from http://www. statepress. com/2012/03/12/senate-judiciary-committee-endorses-controversial-contraceptive-bill/ Cohen, T. (2012, February 23). Seven states sue government over contraceptives mandate – CNN. Featured Articles from CNN. Retrieved June 20, 2012, from http://articles. cnn. com/2012-02-23/us/us_contraceptives-lawsuit_1_religious-liberty-coverage-religious-freedom-restoration-act? _s=PM:US Cooper, H. (n. d. ). The Birth Control Mandate is Unconstitutional. National Policy Analysis. Retrieved June 20, 2012, from http://www. ationalcenter. org/NPA632. html Domenech, B. (n. d. ). What the Constitution Says About Health Care | Heartland Institute. Home | Heartland Institute. Retrieved June 20, 2012, from http://heartland. org/policy-documents/what-constitution-says-about-health-care Insurance Coverage for Contraception State Laws. (n. d. ). NCSL National Conference of State Legislators. Retrieved June 20, 2012, from http://www. ncsl. org/issues-research/health/insurance-coverage-for-contraception-state-laws. aspx Jones, S. , & Scheiner, E. (2012, February 16).
Catholic, Lutheran, Baptist and Jewish Leaders Swear Disobedience to HHS Contraception Mandate . CNSNews. com. Retrieved June 25, 2012, from http://cnsnews. com/news/article/catholic-lutheran-baptist-and-jewish-leaders-swear-disobedience-hhs-contraception McCrimmon, K. K. (2012, February 28). Birth control battle escalates. Health Policy Solutions | Colorado Health Policy News and Opinion. Retrieved June 25, 2012, from http://www. healthpolicysolutions. org/2012/02/28/birth-control-battle-escalates/ Simon, S. (2012, May 15). Catholic college drops health plan over