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San Francisco Marin Medical Society Blog

SCOTUS' Contraception Ruling Will Have Little Effect on California



California health insurance officials predict that most women in the state will not be affected by the U.S. Supreme Court's ruling on the Affordable Care Act's contraceptive coverage mandate.

The ACA's contraceptive coverage rules require most for-profit, private businesses to offer contraceptive coverage in their employer-sponsored health plans. Houses of worship are exempt from the requirement, and religiously affiliated not-for-profits are eligible for an accommodation that ensures they do not have to pay for or directly provide the coverage to their employees.

Details of Ruling

The U.S. Supreme Court in a 5-4 decision ruled that closely held companies can claim a religious exemption from the ACA's requirement that they offer birth control coverage in their employer health plans.

The majority opinion, by Justice Samuel Alito, said that the Obama administration had failed to demonstrate that the federal contraceptive coverage rules are the "least restrictive means of advancing its interest" in offering women no-copay birth control coverage.

Alito was joined in the majority opinion by Chief Justice John Roberts and Justices Antonin Scalia, Clarence Thomas, and Anthony Kennedy. Justices Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor, and Elena Kagan dissented.

Effect on California

Observers say that California women's access to contraceptive coverage largely will not be affected by the ruling because it applies to federal laws, not state laws.

Planned Parenthood Chief Counsel Beth Parker said California in 1999 enacted the Women's Contraceptive Equity Act, which “ensures that insurance companies must provide coverage for a variety of FDA-approved contraception”.   

However, corporations that self-insure for coverage—and therefore pay their own medical claims—are exempt from WCEA.

In addition, the Supreme Court’s ruling is limited to closely held companies, or companies that are owned by five or fewer individuals. Such corporations are governed by a federal law called the Employee Retirement Income Security Act. Therefore, Hobby Lobby—which has 26 locations in California—will not be required to comply with the state law and provide contraceptive coverage to their employees.

California Department of Insurance spokesperson Janice Rocco said the number of companies like Hobby Lobby that fall into both the categories of "closely held" and self-insured is likely to be small in California.

Source: California Healthline, July 1, 2014


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