4 Things to Know About the Supreme Court Review of the PPACA Contraceptive Mandate

Since the regulation was introduced, more than 80 corporations have challenged a Patient Protection and Affordable Care Act provision called the "contraceptive mandate."

The mandate requires all group health plans and health insurance issuers to provide, without cost-sharing, reproductive preventive care including all FDA-approved contraceptive methods and services, as well as patient education and counseling.

Both for-profit and nonprofit corporations and organizations have challenged the mandate on the grounds it violates their religious freedom under the First Amendment and unjustly burdens them under the Religious Freedom Restoration Act, which was enacted in 1993 to protect Americans from laws that infringe on their free exercise of religion. The controversy surrounding the mandate has escalated to reach the highest court in the land: The U.S. Supreme Court has announced it will consider two cases concerning the contraceptive mandate.

The court will hear one of the two cases Hobby Lobby v. Sebelius, on March 25. According to a Kaiser Family Foundation report, here are five key things to know about the court's consideration of the mandate and the implications of the eventual ruling.

1. The fundamental question: Does the guarantee of freedom of religion apply to secular, for-profit companies? The two cases the Supreme Court has agreed to hear both involve for-profit corporations run by religious families. Hobby Lobby Stores, a national chain of craft stores, is owned by the Green family. The Protestant family members say they operate their business in line with their faith, and their religious beliefs prohibit them from providing coverage for emergency contraceptives and intrauterine devices.

Likewise, the second case involves Conestoga Wood Specialties, a for-profit corporation owned by the Hahn family, practicing Mennonites who don't want to comply with the mandate for the same reason.  

2. Five federal circuit courts have already issued rulings on the Religious Freedom Restoration Act, the First Amendment and corporations. The 3rd Circuit and 6th Circuit have ruled the corporations don't have religious rights and the owners couldn't challenge the law on their own. The 10th Circuit and District of Columbia Circuit have ruled the owners, although not the corporation, would likely succeed on the merits of the RFRA challenge. Meanwhile, the 7th Circuit has ruled the owners and the corporations would likely succeed with the RFRA challenge. After the Supreme Court rules on the Hobby Lobby and Conestoga Wood Specialties cases, the circuit courts will apply that decision to pending cases.

3. The court must consider various questions to determine if the RFRA and/or First Amendment have been violated. The Supreme Court will need to consider whether a for-profit corporation can be classified as a "person" capable of religious expression under the RFRA. The court must also determine whether the corporation or its owners are "substantially burdened" by the mandate. If the corporation can prove it's substantially burdened, HHS will need to demonstrate it's furthering a compelling government interest in the least restrictive way.

As far as the First Amendment is concerned, the justices will need to decide if a for-profit corporation is capable of exercising religion.

4. The decision could have implications beyond healthcare. If the court grants for-profit, secular corporations an exemption from the mandate based on religious beliefs, the ruling would mean women's access to contraceptives would be potentially limited depending on the religious beliefs of their employers. Within the healthcare world, employers could raise similar religious objections to blood transfusions, vaccinations, psychiatry and other services.

The decision could be applied to the interpretation and enforcement of laws in various arenas, from civil rights to fair housing protections, according to the Kaiser Family Foundation.

More Articles on the Contraceptive Mandate:
Supreme Court to Consider PPACA Contraceptive Mandate in March
DOJ Asks Supreme Court to Lift Birth Control Mandate Block  
Justice Sonia Sotomayor Blocks PPACA Birth Control Mandate 

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