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US Justice Blocks Implementation of ACA Contraceptive Mandate
theodp writes "First approved for contraceptive use in the U.S. in 1960, 'The Pill' is currently used by more than 100 million women worldwide and by almost 12 million women in the U.S. But just hours before the Affordable Care Act was to go into effect, Justice Sonia Sotomayor issued a stay temporarily blocking a mandate requiring health insurance coverage of birth control, and gave the Obama administration until Friday to respond to the Supreme Court on the matter. Sotomayor's order applies to a group of nuns, the Little Sisters of the Poor, and other Roman Catholic nonprofit groups that use the same health plan, known as the Christian Brothers Employee Benefit Trust (PDF). The group is one of many challenging the federal requirement for contraceptive coverage, but a decision on the merits of that case by the full Supreme Court could have broader implications. One imagines Melinda Gates is none too pleased. So, will U.S. health care require a Department of Personal Belief Exemptions that are dictated by employers (PDF, 'The Trustees of CBEBT and the management of Christian Brothers Services are dedicated to protecting the employers participating in the CBEBT from having to face the choice of violating their faith or violating the law')?"
They need to quit acting like spoiled brats when they're told to get the fuck in line with an ethical society.
In an ethical society, citizens should have a right to petition their government for a redress of grievances. If the administration had properly responded, instead of stonewalling, then this stay would not have been necessary.
Yet you clicked on the link and read the article. You sure seem to be big on reading things you don't want to read. Are you a masochist? :)
By that logic you should also exempt organ transplants, blood transfusions and any other medical procedure that any group, religious or otherwise, objects to. In other words, you might as well give the fuck up and stop providing any coverage at all.
You either have healthcare or you don't. No picking and choosing what procedures or medications fit your chosen lifestyle.
A) This is supposedly about health *insurance*. Insurance is for contingent, unlikely, but potentially costly events. Contraception is none of those, being completely knowable, 100% predictable, and inexpensive.
B) In the olden days, by which I mean pre-Obamacare, you could indeed "pick and choose" what procedures and medications your policy would cover. It's the central conceit of Obamacare that Big Fed knows best and is going to make sure you get it, pounded down your gullet if necessary.
That's what they are arguing: Those that think contraception is wrong shouldn't have to buy it. As employers, they are being told to pay for something they believe is morally wrong. They believe that by being complicit, they risk hell. So they wish to simply not do it. They want to decide what is best for themselves. They don't like that others are dictating to them what they may or may not do.
Sometimes the rights or responsibilities of two people or two groups conflict and has to be hashed out in court.
The world is made by those who show up for the job.
It's lucky then that churches don't pay taxes, or they'd have to fund the wars the rest of us have to pay for - whether we agree with them or not.
The fundamental problem here is that the government has coupled health care and employers together. For some strange reason, the ACA did not fix this problem. We need to decouple health care and employers by eliminating the tax break that employers get. If we do that, then we'll no longer care what health care plan our employer offers, just as we don't care what car insurance plan our employer offers.
Please, please, for the love of debate, never again accuse somebody of committing the "straw man fallacy" when in fact they have not.
You have committed what is now called the Straw Man Fallacy Fallacy. That's when you commit a fallacy by accusing a fellow debater of having engaged in straw man fallacy when they have not.
And please refrain from ad hominem attacks upon other people here. Please do not call other people here "assholes", for instance, just because they advocate an idea that you personally disagree with. That is very poor debating style.
This is not reddit. We engage in intelligent discourse here, like mature adults. Please apologize, refrain from engaging in immature behavior in the future, and we can then all move on to more important discussion.
It all gets very complicated. It can work the other way too - there are plenty of companies which are clearly commercial entities, but happen to be owned and run by people of very strong faith. Chick-fil-A and Hobby Lobby have made headlines last year over just such a scenario. A broad religious exemption can quickly turn into a situation where believers are 'above the law' - able to simply declare that it doesn't apply to them when convenient.
In a modern healthcare system, prevention is preferred over treatment when possible, and it's generally cheaper. A healthcare system that covers only treatment but no prevention is... poorly designed, with perverse incentives that encourage people to never see a doctor or do anything about their health (because it's expensive) right up until the point that they're in the emergency room, and then we cover that. Which is precisely what people in the U.S. do (and what people nowhere else do, because no rational person would prefer going to the ER over seeing a GP, all else being equal).
The other nice aspect of integrated health coverage is no goddamn billing and trying to screw you over with fine print.
I used to live in the U.S., and the billing there is insane and bureaucratic. If you go to the hospital once, for one day for an outpatient procedure, you will receive bills for months afterwards. The hospital itself, the anesthesiologist, the attending physician, the surgeon, the equipment, any drugs used, everything is billed separately and uncoordinated. Half of the bills are wrongly coded and your insurance denies them, requiring hours on the phone to correct. Nobody can tell you ahead of time what the price is, and what your out-of-pocket cost will be. It's a huge mess and extremely unpleasant for everyone except the useless paper-pushers it keeps in business.
Now I live in Denmark. If you go to the hospital, here is what happens: you go to the hospital, you have the procedure, and you leave. If appropriate, you have follow-up visits. At no point do you receive a bill or have to spend hours on the phone arguing with petty bureaucrats.
10 PRINT CHR$(205.5+RND(1)); : GOTO 10
Yet we get presented with totally irrelevant crap like this.
This story is less than an hour old and has 100+ comments. Below it is a 'tech' story that's nearly six hours old that has under 40. Seems to me this topic is of interest to the Slashdot crowd, and the Slashdot overlords are doing their job.
It gets a bit stickier when said religious organization must deal with people of different beliefs. If you accept Medicare / Medicaid (which the Sisters undoubtedly do) then you have to treat all of those people without respect to your religious belief (assuming that treatment is considered standard of care). If said patient wants / needs contraception then you must make arrangements for the person to get it. You don't have to prescribe the pills yourself, if that compromises your belief, but you may have to send them down to the (secular) doctor down the street who doesn't have an issue.
Clinicians who work for clinics or hospitals associated with religious orders have long worked around these 'issues'. At the Catholic hospital where I worked, we hid the oral contraceptives in a separate closet that we made sure was closed before one of the nuns walked in. And they would not walk in unannounced. Abortions, obviously, were not allowed on campus, but we could refer people to other providers.
The mandate that birth control be provided really is a straw man. Religious orders have been dealing with this for decades. I don't see how this mandate is functionally any different from, for example, a dominant private insurer who offers contraception as part of their insurance packages. All of the hospitals in town realistically have to deal with the insurer and accept their conditions (we're not going to discuss the implications of that right now - it is a very common situation in the US). You do your dance, as above. You get your money. No money, no mission.
Personally, I think the ACA blew it with the requirement that every insurance policy cover contraception (and maternity benefits). The argument for this has been that you need to expand the coverage base in order to keep insurance more affordable. However, the patient base of persons needing or desiring contraception is quite high enough to allow for economies of scale. 30% of the population (approximate number pulled out of my nether region) is big enough to fund a benefit.
Further, the ACA 'isn't' a tax (except it walks like a tax, looks like a tax and squawks like a tax). There is a longstanding precedent for being taxed for something you might not need personally but is considered a societal benefit (think school taxes). Again the construction of the ACA is that of a horribly flawed kludge (that's the nice word) that benefits the status quo in general and the insurance companies in particular. Rationale arguments get buried in the miasma of details that comprise the legislation and give everybody something to hate. Unfortunately, it was probably the best compromise Obama could make. Whether or not it actually improves health care for a majority of Americans is quite unclear.
Faster! Faster! Faster would be better!
I've heard it explained thusly: if car insurance worked like health insurance, then every time you put gas in your tank, got an oil change, bought tires, etc., you would file a claim.
If it worked like the UK National Health Service, all those things would be free at the point of delivery.
Everyone would pay for it in general taxation. But that amount added to taxation would be only 40% of what American's pay for their health insurance. And the payments would be progressive (more paid by the rich, less or nothing paid by the poor).
I'm glad someone else beside me said it first.
What these people don't seem to understand: Just because your health insurance covers contraception, doesn't mean you're required to obtain and use it! These people who are going on and on about their so-called "faith"? How about they consider this a test of their "faith" to not obtain or purchase it instead of jamming their fucking "faith" down everyone else's throats!
Women have a right to have control over their own bodies. Get over it already and move on.
Are YOU using the TOOL, or is the TOOL using YOU? Think about it!
For some strange reason, the ACA did not fix this problem. We need to decouple health care and employers by eliminating the tax break that employers get.
McCain wanted to do that in 2008
Didn't happen because politics.
When information is power, privacy is freedom.
This entire argument is completely skewed, it shouldn't be blocked due to religious considerations, it should be blocked based on the fact that government is dictating to the employers and employees as to how employers pay their employees! Where is the freedom? Where is the freedom to associate, freedom of contract? Where is freedom to run private property as one sees fit? Why are you all accepting as a fact that government can dictate to employers and employees must be paid in contraceptives rather than in cash?
The second valid argument is of-course the fact that government is dictating that insurance cannot BE insurance but instead must be some form of prepaid health management system.
What do contraceptives have to do with catastrophic events that insurance is supposed to cover? Why are contraceptives any more special than food or clothing or machine oil or fuel or housing for that matter?
Insurance is a bet that some event will take place and actuary science is used to calculate the probability of events based on individual participant's and then the bets are placed. What does it have to do with events that are of near 100% probability (that women will have sex?) Insurance is not there to provide you with every day items, in fact insurance shouldn't even cover child birth - it's an EXPECTED event, not an unexpected one, it's an event that people must prepare for and they even know with almost complete certainty when exactly this will happen and they must plan for it.
Medical complications during child birth might be covered by insurance but child birth itself is simply an expected procedure that should be paid OUT OF POCKET just like most doctor visits and most other things, like birth control.
The real issue is that it is a question of individual freedom, not a question of religious prejudice.
You can't handle the truth.
That's rewriting history slightly. Was it "rammed through" the Senate? Certainly. Though, if memory serves, the House was under Republican control at the time. Also, for the last goddamn time, the ACA is not a *leftist* law. The "left" is still pissed at Obama and Congress about getting knifed in the back over a public option. The ACA started life on the right at the Heritage Foundatrion in 1989. It's a testament to how hard the right worked throughout the '90s and the aughts to drag the country their way that the ACA became centrist enough for Obama to latch onto it like a limpet.
What does this button d$#%* NO CARRIER
So if my employer is a Christian Scientist I don't get coverage?
Clearly there has to be some sort of limitation on this sort of thinking.
Yeah, it really sucks to have to cover treatments that nobody in your church winds up using. E.g., if nobody in your church gets cancer this year, why the hell did the church have to pay for coverage of cancer? It's just a waste of money, right?
The whole point of health "insurance" is to spread the costs out so that everybody who needs medicine can get it, without breaking the bank for anybody. It's not so that we can each pick and choose what risks we choose to pay for. Oh, "contraceptives" aren't a risk? Incorrect. The hormones in birth control pills are used to treat a variety of health issues. Writing a health plan so that it excludes paying for particular medicines is antithetical to the goal of universal health coverage. It's making a petty point, at great expense to those who might need the medicine, because you, a supposed Christian, care more about winning than you do about caring for the sick. I'm pretty sure that's not what Jesus would do.
My response to them would be:
"If this were a matter of the employers chosing for themselves, plaintiffs would have a valid point. If this were a matter of plans churches were offering to their clergy, plaintiffs would have a valid point. But this is a case where the employers in question are not making personal choices and are not acting as a church, but are acting as ordinary employers offering coverage to employees who don't necessarily follow the same beliefs as their employer. And an employer does not have the right to dictate to their employees based on the employer's religious beliefs. Plaintiffs aren't asking merely to be allowed to follow their own beliefs. They are asking to be allowed, as an ordinary employer, to say that because they don't believe in X that their employees are not allowed access to X either. If plaintiffs arguments are valid, then it would be acceptable for a business run by a Jehova's Witness to offer coverage that forbade treatments involving blood transfusion simply because the business owner followed that belief system. And we don't permit that. We don't allow a business owner to force his employees to follow his beliefs just because they work for him. We don't allow him to say "Profess to follow my beliefs or you won't be allowed access to health insurance.". To allow that wouldn't be freedom of religion, it would be the antithesis of freedom of religion."
This is another very good example why a single payer system is better. Is it any of your employers business if you are using contraceptives? I would say no - even if you are a nun. With a single payer system only you and your doctor know what medical treatments you are using.
Anarchists never rule
So your saying that despite the constitution, as long as i consider it 'morally wrong' then i can go out of my way to not pay for it. Whoohoo, im going to call IRS and tell them out of all my taxes, i dont want one penny to go to bombs, wars, or anything that can be used to kill anyone.
Lets put it in a differnt term, They pay people with cash that can be used for anything, drugs, booze, whores...basically anything the church morraly objects to they hand over pieces of paper that allow that kind of behavior. Is the next stop going to argue they dont need to pay employees because of what they can do with cash?
Healthcare is a payment, They could just pay the fine and force employees to get heath insurance from the exchanges and BOOM..its out of there hands. This is not about stopping it, its about religious oppressment, something the cathcolic church is quite good at, and quite fond of.
As a Canadian, it seems that the only policy the Republicans have is "vote no to anything Obama or any Democrat proposes". We don't care that Obama won the presidential election, we will thwart the will of the people for our rich masters. We will do our best to raise taxes on the poor and middle class while giving the rich tax breaks. We will reduce food stamps to the poor. We will do our best to ensure the middle class have the worst access to health care of any western nation. We will continue to show we say we are Christians while doing exactly the opposite of what Jesus preached.
That last bit of hypocrisy is particularly galling.
Anarchists never rule
It is long past the time when any religion should expect the government to take any notice of its beliefs in a secular society. A secular society should ignore religion because if you don't, how do you draw the line? Should I be allowed to stone my neighbor to death if he doesn't observe the Sabbath? Allow my child to die from an easily cured malady because I believe in faith healing?
Religion has no place in making the laws of a secular nation.
Anarchists never rule
The Democrats had the majority, but the Republican's used the pseudo-filibuster bullshit to prevent any legislation from passing. When they realized that the ACA they let slip through was much bigger for Obama than they expected, after major negotiations neutering it and in-fact supporting the individual mandate as a compromise, they panicked and since then just "filibuster" instead of trying to negotiate on everything. (Saying your negotiating and compromising when its 'my way or the highway' every fucking time even after concessions are made by Democrats on the various legislation pieces does not actually equal negotiating and compromising).
The Dems had majority, but the Reps used the loopholes to command the power like they were the majority. That's why people can be confused about it.
This is my sig. There are many like it, but this one is mine.
I don't want to fund a *lot* of things my federal tax funds on moral grounds, I still have to pay it.
Sorry, I don't have a lot of sympathy here. If they get to weasel out of buying contraceptives on moral grounds, then I get to decide where my income tax money is spent on moral grounds. No special privileges.
Comment of the year
Stop masturbating over weird definitions of things. It makes you a mass murderer of babies.
Religion A says that pill X is against their religion. Insurance company is a Religion A organization, but government says that Insurance company cannot refuse to give pill X regardless of what they believe. In short, the government has decided that you must provide a service you believe is immoral.
Jehovah's Witnesses believe that blood transfusions are immoral. Christian Scientists believe that most modern medicine is immoral. The Church of the Holy Buck believes that any treatment that negatively affects the bottom line is immoral. Should all of those be allowed to refuse to pay for any of them? If a religious organisation finds that it is immoral to perform a particular service, then they are welcome to get out of the business of providing that service.
No one is forcing churches to be in the insurance business and I can cite several passages from the bible, including quotes from Jesus and St. Paul that indicate that they shouldn't them. If they want to be religions, they can have any crazy rules that they want. If they want to be businesses, then they have to abide by the rules that apply to businesses.
I am TheRaven on Soylent News
wrong.
this is about religious organizations with employees with the same religious values. here's a pro-tip, don't work for a religious organization if you don't hold their beliefs.
Wrong. The argument is not that religious *organizations* ought to have some special privilege, it's that employers in general have a right not to cover medical treatments they disagree with.
Medical treatment choices should be matters of *personal* conscience. The Church has every right to teach its opinions to anyone it pleases; it has no right to force its opinions about legal, private behavior on its employees, or to punish them for their purely private behavior.
Post may contain irony: discontinue use if experiencing mood swings, nausea or elevated blood pressure.
...shut down your business. Seriously, if these convictions are truly heartfelt, then the rational thing to do is to sell/get out of the business. (I'm thinking about the Hobby Lobby case here, more than anything else.)
I personally know a Quaker or two who intentionally keep their earnings below the taxable level, so they won't have to pay federal income taxes - and therefore indirectly support war. This causes them a great deal of personal hardship, but... hey, havin' principles isn't always easy.
As an American, it has become increasingly clear that neither side has a real agenda outside of protecting the interests of their financiers (big business on one side and unions/the entertainment industry on the other). Both sides choose a handful of issues to rattle their sabers about during elections, but neither actually want to get what they argue for or they will have to find something new to stir people up with.
Obama ran on a platform of protecting civil liberties and then stood up in front of the nation and defended the NSA spying on each and every citizen. Bush ran on a platform of fiscal conservatism and then spent far more than his predecessor.
Modern American politics consists of distracting the public while you sell their rights to whoever funded your campaign. Championing one side or the other is naive.
I find drones "repugnant". In fact, my religious beliefs demand that I not participate or support such indiscriminate killing.
Do I get to take a pro-rated reduction in the amount of taxes I pay so I don't have to violate my faith and support this repugnant activity?
That's first. Second is that the religious organization or corporation or employer in question is not really paying for the insurance. It's part of the compensation of the employee. That means when the insurance is purchased, it is done so with money that has been earned by the employee. There is no direct payment for birth control or any of the stuff that the Church finds icky. Unless you think those benefits are provided out of the goodness of the hearts of the organizations. No, they do it as part of the compensation package. They're not buying health insurance for anyone who doesn't work there.
Finally, can a corporation really have a religion? Let's be clear: the employers in this case are not religious institutions. They are corporations formed by the religious institutions. Paychecks aren't being signed by the bishop or any religious figure.
But I would think that allowing religious groups to have special exemption from certain laws based upon their beliefs is going to be a road that at least five of the Supreme Court justices will not go down.
After all, we all have religious objections to paying taxes, no? You want to open that can of worms?
You are welcome on my lawn.