For this entry I decided to wade into a little more
controversy than I have in the past, but thought it was worthwhile to explore
some of the issues that have arisen because of this Supreme Court decision. I
have had a chance to read a few articles from all sides of this issue, and I
think my strategy will be to wait a day or two to see if I can have a more
sober analysis. I will admit that my initial reaction has tempered a little
since I have had the chance to dig in a little bit more to what exactly was
decided. I will say though, that the long-term ramifications could be much
larger than people realize, and probably not in the way that people that
initially liked this ruling may agree with.
For those that follow this will know that the Supreme Court
ruled that Hobby Lobby does not need to provide some of the forms of
contraception that were mandated by the Affordable Care Act (Obamacare) for
employer provided health plans. This was based on an interpretation of the
Religious Freedom Restoration Act (passed 97-3 in the Senate) holding that
corporations will have the same rights as individuals and that they do not have
to “engage in conduct that violates their sincere religious belief that life
begins at conception.”
As mentioned, the scope of this case involves not all
contraception, but three specific types (out of 20 total that are part of the
mandate). As someone who has a wife in the medical profession, I know more
about contraception than perhaps I should. Those covered in this ruling are the
morning after pill and two types of IUDs. My understanding is that the morning
after pill and one of the IUDs work by preventing a fertilized egg from
implanting in the uterus, while the other IUD works by preventing ovulation.
The argument of Hobby Lobby (and others that hold a similar position), is that
this is a form of abortion and thus violates their deeply held beliefs.
There is perhaps some cynicism towards Hobby Lobby but I
certainly give them the benefit of the doubt and trust that they hold these positions
and think of this mechanism as abortion. I would personally disagree with this
interpretation. I, like most people, am no fan of abortion, but I don’t see the
processes that these three forms either allow or prevent would constitute
abortion. Natural processes generally have the same outcome that comes about
from either the morning after pill or IUD (that is, often the egg is never
fertilized, if fertilized if often doesn’t embed, and if it embeds, it will
often not come to term – there are percentages for each of these instances that
are surprisingly high). But of course this is where the debate lies.
The flip side is the limitations that this puts on
reproductive health decisions for women. The morning after pill can be utilized
in instances of sexual assault to prevent the embedding of a fertilized egg. I
am no expert of IUDs, but there are medical reasons (such as hormonal) why they
would be necessary instead of using other forms of contraception, and this
ruling will limit those options for employees of Hobby Lobby and similar
companies.
One final thought on the decision itself is that it is
pretty limited in the present. It covers specific birth control for specific
corporations. Religious affiliated business (such as churches, Catholic
universities, etc) already receive this exemption from the Obamacare mandate.
This does not mean that people who work at these companies can’t have access to
these contraceptives, it just means that the employer does not have to pay for
them. The government can take on the cost and distribution itself.
This brings me to two more thoughts. The first is that it
exposes another example of the silliness of employer provided health insurance
as the primary driver of health insurance. There are certainly better ways than
continuing to utilize a relic of World War II days when companies tried to
entice workers with extra compensation during a time of wage controls.
The second point is that this is ultimately about abortion.
I have many thoughts on the topic that I am not going to share on the blog
(yet), but it does strike me as a continuing land mine as health care continues
to shift. As entrenched as the abortion debate currently is, one reasonable
compromise that has bi-partisan support is to not have any direct federal
funding for abortion. That is, people are not compelled through taxation to
fund abortion. That is the crux of this issue. Exemptions have been granted to
religious organizations and now to 90% of corporations could potentially be
impacted by this as well. However, as mentioned, the Supreme Court kept open
the possibility that these forms of contraception are allowed if distributed by
the government. This fact may open up a whole new issue in the not too distant
future.
All this brings me to the final point, which is the idea of
religious freedom. For people that are cheering for this decision, that is what
they most cite. The first thing to notice is that this decision gives
“closely-held” corporations (corporations where 5 or fewer people own 50% or
more of shares) now count as people when considering religious freedom. While
this was a narrow decision in the present, it could lead to further issues down
the line. What if corporations use religious beliefs to discriminate against
classes of people? What about other health care procedures that are not allowed
by religious faiths (ie blood transfusions with Christian Scientists or
vaccinations)? What might happen when the Supreme Court has a much more liberal
bent and uses this decision as a method of destroying protections currently
seen by religious institutions? I fear the main ramifications of this decision
will be seen down the line. To avoid making these decisions is to imply that
concerns about birth control are “legitimate” religious concerns, while the
other concerns such as opposition to vaccinations, blood transfusions, certain
types of medicine, etc. are not “legitimate” religious concerns, and that is a
dangerous position for the Supreme Court to go.
The key point that I also think of is that religious freedom
certainly covers freedom from religion. It wouldn’t take much to start defining
what this really means in our country. There is a sense, I suspect, that
religious freedoms are on the decline. I don’t think this is true. I think the
issue is that the influence of a specific religion, Christianity, is waning.
While this may seem like a victory that stems this tide, I, as mentioned above,
am a little skeptical that is the case in the long term. Religious freedom is
surely something to explore more in the future.
On a personal note, I am committed to making sure this
decision has no impact one way or another on the business I give to Hobby
Lobby.
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