“Hobby Lobby Arbitrage” and What It Means for US Health Care

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Dennis Thompson
Health Day Reporter

Friday, July 25, 2014 (HealthDay News)-US Supreme Court Decision contraception coverage- Affordable care method -According to some medical professionals, it can lead to legal swamps that can allow businesses to refuse insurance coverage for medical practices that violate religious principles.

However, other experts argue that such predictions are unlikely to come true.

The judge was Hobby Lobby Stores Inc last month. And Conestoga Wood Specialties Corp. Ruled 5-4 that it did not need to be provided. Contraceptive Reports that violated their religious beliefs. Prior to the ruling, US companies Affordable care methodThe controversial 2010 Health Reform Act is often Obama Care..

Some health professionals say they are currently preparing for follow-up proceedings from companies that may religiously challenge a variety of medical services, including: vaccination Or blood transfusion.

“The court’s decision is made by other commercial” tightly held “companies. [Affordable Care Act’s] “Requirements for coverage based on inconsistencies with the owner’s religious beliefs,” said Bob Doherty, Senior Vice President of Government Affairs and Public Policy, American Medical Association, in the ACP Advocate Blog.

Other pending proceedings are expected to further challenge the requirements of the Affordable Care Act. contraception Coverage, some observers predict.

Federal judges, including the Supreme Court itself, have already issued several injunctions allowing religious nonprofits to deny participation in contraceptive coverage with so-called “workarounds.” Under this arrangement, insurers intervene to provide contraceptive compensation that company officials oppose for religious reasons.

“I think there will be quite a few women who will not be able to use contraception because they may not be able to afford it on their own, and it is still unclear how alternatives that enable women will be introduced. It’s not clear. To get contraception in an affordable way. ” Ron Pollack, Founding Executive Director of Families USA, a non-profit advocacy group for health care consumers, said.

High Court ruling focused on “closely held enterprises”

The first news report considered the impact to be limited, as the June 30 Hobby Lobby decision only applied to “close” companies, such as family-owned businesses. The decision also included the statement that it would not be more widely applicable to other healthcare services that require the coverage of the Affordable Care Act.

However, “closely held” companies are estimated to account for nine-tenths of all businesses and employ 52% of the US workforce, Doherty said.

“Of course, most of them are unlikely to seek a religious exemption from certain compensation requirements, and if so, not all will win in court,” Dougherty said. “But some people disguised themselves as religious beliefs, perhaps for ideological reasons.”

Some experts predict that the Supreme Court’s ruling will almost certainly be used in other proceedings to challenge services such as vaccination.

“Roberts [Chief Justice John Roberts] Courts tend to publish their decisions in a narrow range, but in a way that opens the door to much larger applications, “Porak said. Oppose certain types of medical care. “

However, lawyers from religious groups involved in the post-Hobby Lobby proceedings said it was very unlikely that the court would support such a challenge to critical medical services.

Eric Niffin, a lawyer for the Catholic Benefits Association, said the court consistently ruled that it would be in the state’s interest to nullify religious objections on life-and-death issues. The group states that it is committed to “providing life-affirming health insurance that is consistent with Catholic values.”

For example, courts uphold the right of doctors to provide emergency medical care to their children, even if their parents have religious dissent in medical care.

“Our law already knows how to deal with those situations, and it will,” Kniffin said. “There is no real fear that this will open up a situation for Swiss cheese where the government cannot protect its employees under these other circumstances.”

Kniffin is leading a lawsuit against nearly 200 Catholic organizations and employers, including the Archdiocese, against the Affordable Care Act’s contraceptive coverage requirements. A federal judge granted an injunction exempting Catholic groups from fines or penalties for failing to provide such compensation while their objections were being discussed in court.

Federal “workaround” is unacceptable to many employers

Other federal lawsuits are by the Obama administration that insurers provide contraceptive compensation to workers without employer participation, as long as the employer fills out a short form confirming religious objections to providing contraception. It is intended for the “workaround” procedure created.

Just days after Hobby Lobby’s ruling, the Supreme Court issued a temporary injunction allowing Wheaton College, a Christian liberal arts college in Illinois, to refuse to comply with the workaround.

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Wheaton’s objection is that workarounds do not rule out employers’ moral responsibility for the practices they oppose, Kniffin said.

“To be exempt, we must instruct us to assign a legal obligation to do what we consider immoral to others, and that is not the solution,” he said.

Dr. Jeanne Conley, a former president of the American College of Obstetrics and Gynecology, said all legal uncertainties make it difficult for gynecologists to work with patients to find the best treatment for them. I did.

For example, doctors may encounter obstacles in matching women to women IUD, NS Contraceptive The device that is the subject of the Hobby Lobby decision.

Conry shows a fictitious example of a 34-year-old patient. Diabetes When High blood pressure..

“I’m trying to choose the best contraceptive method for her. The absolutely best one is IUD“We now have very good IUDs and they are contraception The pills and they work better. And now we have an employer teach us how to treat a patient, and that employer should not interfere with the health care of the woman. “

Thanks to Hobby Lobby’s decision, doctors who decided to place an IUD on a patient during routine care could fall into bureaucratic formalism, she said.

Cervical cancer On the screen, she puts the IUD in place and she goes out, “says Conry. “I’ve just put something that costs $ 600 to $ 800. She’ll get an invoice for it. If she pulls it out and the company refuses to cover it, she’ll have to pay.” Told.

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Source: Bob Doherty, Senior Vice President of Government Affairs and Public Policy at the American College of Physics in Philadelphia, Pennsylvania. Ron Pollack, Founding Executive Director of Families USA, Washington, DC. Eric Niffin, a lawyer for the Catholic Benefits Association. Jeanne Conry, MD, Ph.D. , Former President, American College of Obstetrics and Gynecology, Washington DC

“Hobby Lobby Arbitrage” and What It Means for US Health Care

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