Too bad Chief Justice John Roberts and Justice Anthony Kennedy decided to wait until this session to not be insane about Obamacare. Not only did their Hobby Lobby decision make it okay for bosses to deny their employees health insurance plans that cover birth control (because that has everything to do with your job), they opened up the floodgates for all sorts of “religious freedom” claims in which people declare they won’t do something that their job requires them to do and they think is icky because God. But back to the birth control part, the Kaiser Family Foundation has a helpful explainer of the newly complicated world of trying to plan your family with health insurance.
Who has coverage of birth control, with no co-pays, thanks to Obamacare?
Women who have a non-grandfathered health insurance plan through an employer (either their own, their spouse’s or their parent’s) that does not have a religious objection to providing coverage for contraceptives are insured for the full range of prescribed FDA approved contraceptives without cost-sharing. Women who purchase an individual insurance policy that started August 1, 2012 or later also have full contraceptive coverage.
That’s where the straightforward part ends. If your private employer does have a religious objection—even if they’re not religiously affiliated at all, but are privately held (like Walmart)—they can refuse to pay. The good news here is that they can’t stop you from getting insurance that provides birth control—so far. They have to notify the insurer that they won’t pick up those policies, and the insurer will take care of it directly. Then there’s another category of “religiously affiliated nonprofits such as universities or health systems that have a religious objection to contraception typically have coverage for contraceptive services.”
If you work for one of them, upcoming court cases might be a problem for you. Right now, there are rules in place that work kind of like the accommodations for private employers—they file a statement of their objections, and the insurer can directly cover the employee. There are, however, a mess of pending cases challenging that accommodation, in which the plaintiffs say that even going as far as putting the organization’s name on a piece of paper that has anything to do with birth control is a religious affront and they won’t do it. As of this week, one more of those cases has gone down. The 10th Circuit Court of Appeals ruled Tuesday that the religious belief of the Colorado-based Little Sisters of the Poor Home for the Aged is not substantially burdened by having to fill out a form. It’s the sixth such finding from appeals courts, so this one might not actually make it to the Supreme Court, unless another appeals court disagrees and creates a conflict the Supreme Court would have to resolve.
That brings us to the final category of employer, which the religiously affiliated nonprofits suing seem to want to be counted as—actual churches. Houses of worship are completely exempt—if they want to be—from providing insurance plans that cover the icky stuff.
Thanks, Supreme Court, for making health decisions and family planning even more complicated than it was before our bosses got all up in it.