In a ruling that will again change the Affordable Care Act, the U.S. Supreme Court on Monday sided with Hobby Lobby in a narrow, 5-4 decision that ruled a privately held business does not have to cover contraception services in its employee health care plan.
The decision overrules part of the 2010 Affordable Care Act that requires health plans to cover numerous types of contraception.
With the decision, the court has ruled the federal government cannot require closely held family businesses to provide health coverage that they feel goes against their religious beliefs.
Hobby Lobby is an Oklahoma City-based hobby and games retailer with more than 500 stores nationwide, including three in New Jersey.
The case did not specifically deal with birth control pills; Hobby Lobby argued that it objects to the morning after pill and intrauterine devices, which prevent a fetus from implanting in the uterus. Hobby Lobby had argued that these methods cause abortions by blocking the fertilized eggs from implanting in the uterus.
Planned Parenthood Federation of America spokeswoman Justine Sessions says the decision "opens the door for other corporations to be able to opt out of providing any form of birth control."
In her dissenting opinion Justice Ruth Ginsburg wrote that other companies may object to all contraception, and that Monday’s decision would seem to allow them to opt out of any contraception coverage.
How great an impact this ruling will have remains to be seen.
Christine Stearns, vice president of the New Jersey Business & Industry Association, said, "It is too soon to say how New Jersey will react to this decision. At this point, the employer community is studying the ruling to assess it's effect on health care coverage. The Supreme Court seems to have narrowly tailored their ruling and it would seem unlikely to have a broad impact."
Justice Samuel Alito, a New Jersey native, wrote the majority opinion in the case, saying the mandate to provide contraception is "unlawful" in its current form.
And while the court stressed that its ruling applies only to corporations that are under the control of just a few people, John Sarno, an employment lawyer and president of the Employers Association of New Jersey, said it could have a big overall impact in the state.
“(The ruling) will make it much more difficult to require health care plans to offer contraception on a mandatory basis,” he said.
Sarno said New Jersey health insurance law requires insurers to cover contraception.
“We have a New Jersey mandate that requires health insurance plans in New Jersey to provide contraception,” he said. “Certainly the state law is now of questionable validity.”
Sarno said the state’s contraception mandate could now be tested, based on the Supreme Court decision, but said he is not aware of any plans in New Jersey to challenge the state’s contraception mandate.
“The New Jersey mandate, if someone should test it, will be the same issue,” he said.
In 2005 the state legislature mandated that health insurers cover contraception, according to Marshall McKnight, spokesman for the state Department of Banking and Insurance. Contraception is one of a number of state mandated health insurance benefits.
McKnight explained that state mandates only apply to health insurance plans, but not to self-funded health plans where the employer is responsible for paying the medical claims.
Members of the state legislature had differing views on the issue.
State Sen. Joseph F. Vitale (D-Woodbridge), the chair of the Senate Health Committee, was dismayed by the ruling.
"There is a greater public health need here," he said. "Not all contraception is used for birth control, it is also used for other medical problem that women have."
Congressman Leonard Lance (R-Flemington) applauded the decision.
He called the ACA "a dramatic overreach into the personal freedoms and liberties that millions of Americans hold dear. Today’s U.S. Supreme Court decision is a welcome victory for religious freedom and I am pleased that the Court has protected this right."
The court's ruling got a mixed reception from health care policy advocates.
Linda Schwimmer, the vice president of the New Jersey Health Care Quality Institute, fears the ruling will have a broad-based impact.
“The court’s decision has significant implications for health care, and for the employees of non-public corporations,” she said. “From a public health perspective, access to adequate contraceptives is important, and this decision would seem to exempt a whole class of employers from having to abide by the contraceptive mandate in the ACA. To that extent, this decision is challenging.”
The Citizens' Council for Health Freedom called the decision "a step in the right direction for freedom in America. Obamacare has essentially trampled over the freedoms of all Americans, including those who want to be free from government health care altogether."
The national women's advocacy organization UltraViolet called the decision, "an outrageous precedent, putting women's health at risk. Birth control is a popular and medically necessary part of women's health care."
It is unclear how many companies will now stop offering contraception services. Some court watchers feel the decision will not be far-reaching.
The heavily respected SCOTUS blog said the ruling will be limited in scope: “This decision concerns only the contraceptive mandate and should not be understood to mean that all insurance mandates, that is for blood transfusions or vaccinations, necessarily fail if they conflict with an employer's religious beliefs.”
Groups that lobby for reproductive rights contend the drugs and devices prevent fertilization from occurring, and thus reduce the number of unwanted pregnancies that result in surgical abortions.
NJBIZ will update this story throughout the day as more reaction comes in.
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