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 yesterday on the Affordable Care Act's contraceptive coverage mandate, KQED's "State of Health" reports (Dembosky, "State of Health," KQED, 7/1).

Background on Case

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.

• The Supreme Court case involved two corporations:
• Hobby Lobby, an arts-and-crafts retail chain; and
• Conestoga Wood Specialties, a cabinet maker.

The owners of both companies oppose the use of intrauterine devices and emergency contraceptives, which they claim are tantamount to abortifacients, and thus object to offering comprehensive contraceptive 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 (California Healthline, 6/30).

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, the Los Angeles Times reports (Terhune, Los Angeles Times, 6/30).

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" (Adler, "KXJZ News," Capital Public Radio, 6/30).   

However, corporations that self-insure for coverage -- and therefore pay their own medical claims -- are exempt from WCEA, "State of Health" reports.

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 ("State of Health," KQED, 7/1).

Reactions to SCOTUS Ruling  

In a release, California Insurance Commissioner Dave Jones (D) that he is "deeply disappointed" by the Supreme Court ruling, adding, "Fortunately, employees whose insurance is regulated in California have some protection from this damaging decision" (DOI release, 6/30).

House Minority Leader Nancy Pelosi (D-Calif.) echoed Jones' statement and said the Supreme Court "took an outrageous step against the rights of America's women, setting a dangerous precedent that could permit for-profit corporations to pick and choose which laws to obey" (AP/U-T San Diego, 7/1).

Maggie Crosby, an attorney with ACLU of Northern California, said that women in California "should feel secure that if they have birth control coverage today, they will have it tomorrow" ("State of Health," KQED, 7/1).