In a 5-4 vote, the Supreme Court ruled for the first time Monday that closely held family-owned companies can have religious beliefs. The nation’s highest court decided in the case of Sebelius v. Hobby Lobby Stores that closely held corporations don’t have to comply with the Affordable Care Act’s (ACA) healthcare mandate to provide birth control coverage to female employees if the action violates the owners’ religious beliefs.
Monday’s ruling places privately held family-owned businesses in a similar category with religious employers such as churches and religiously-oriented nonprofits that have exemptions from the contraception mandate. Family-owned businesses account for 25 percent of the nearly 200,000 companies that make up the middle market, according to a report from the National Center for the Middle Market.
Under the ACA, the federal government mandates coverage of all forms of FDA-approved birth control as preventative care for women. Two companies owned by Christian families, Hobby Lobby and mid-sized Conestoga Wood Specialties, object to two forms of contraceptives – IUDs and morning-after pills - because their owners believe they prevent fertilized eggs from implanting in a woman’s uterus.
The companies had no objection to other types of contraception such as condoms, diaphragms, many kinds of birth control pills and sterilization, although other religious faiths do object to all of these forms of birth control.
The government, however, maintains that doctors should choose what types of birth control are best, and not employers. The IUD, for example, is widely considered to be one of the more effective forms of birth control, but it is also more expensive, which reduces access by low-income women.
Justice Samuel Alito represented the Court’s conservative justices in a majority ruling that the ACA’s contraception mandate violates the 1993 Religious Freedom Restoration Act (RFRA), which prohibits the government from imposing a “substantial burden” on a person’s exercise of religion. However, the decision does allow the federal government to step in and provide the coverage when companies choose not to offer it to their female employees.
Opponents of the ruling have promised to make contraception an election issue this fall as part of an ongoing national debate over women’s health and access to contraception, reports Politico. Senator Patty Murray (D-Washington) says she will work with colleagues to restore the legislation.
“Since the Supreme Court decided it will not protect women’s access to health care, I will,” she said.
A majority of Americans disagree with the ruling, and say employers should not have the ability to limit contraception coverage in their employee health plans based on religious beliefs, according to a new Reuters poll released Sunday.
Before passage of the ACA, women paid 68% more than men for their out-of-pocket medical expenses, mostly because of their reproductive health needs. So although denying contraception coverage may now be legal for some closely held companies, it may not be good for business.
Two-thirds of women rely on private insurers for health coverage. And with increasing numbers of women entering the mid-market workforce, denying female employees birth control coverage could have a significant impact on recruiting and employee retention.
“The court’s expansive notion of corporate personhood invites for-profit entities to seek religion-based exemptions from regulations they deem offensive to their faiths,” Justice Ruth Bader Ginsburg wrote in the Court’s dissenting opinion. That could include religious objections to vaccinations, blood transfusions, or even providing service to LGBT customers.
Justice Ginsburg co-authored the dissent with Justices Sonia Sotomayor, Elena Kagan, and Stephen Breyer. But Justices Breyer and Kagan disagreed with Ginsburg on one point, stating that in general, for-profit companies are allowed to claim religious rights under the RFRA.