More on the religious implications of the health care ruling

Michelle Boorstien of the Washington Post looks at the implications of yesterday's Supreme Court ruling upholding the majority of the Affordable Health Care act.

There are still fights ahead about whether religious institutions will be mandated to cover medical procedure that they deem contrary to their teachings. This means that fights over contraception, abortion rights, and other issues are likely to get more intense.

Some opposition was characterized — as on the progressive side — in more political terms, about the reach of government, but mostly criticism was focused on a White House-authored mandate requiring most employers to offer contraception coverage to employees.

The U.S. Catholic bishops had a measured response, saying they have long championed the general concept of universal health coverage but believe the law expands federal funding for abortion and doesn’t sufficiently include immigrants.

Conservative faith groups promised a fight.

Catholic bishops and the Catholic Health Association have different takes on the ruling. This reflects the difference between the theological and political leanings of some bishops versus the Catholic institutions that actually deliver health care.

The U.S. Conference of Catholic Bishops on Thursday repeated concerns that the law expands federal funding for abortions and doesn’t provide enough health care access for immigrants.

“The bishops want universal health care, but this doesn’t provide it. It’s flawed and needs fixing. We saw if you’re aborting children you’re certainly not giving them universal hyealth care. That would be one idea,” said Sister Mary Ann Walsh, a spokeswoman for the bishops’ conference.

The Catholic Health Association, the country’s largest private health care provider, said it was pleased the law would remain in affect.

The association has been a lightning rod for debate recently about health care, as its president, Sister Carol Keehan, bucked the bishops when she worked with the White House to get the entire law passed and initially said she was comfortable with the mandate. A few months ago Keehan – perhaps the White House’s most prominent Catholic ally – made news when she said she was deeply concerned that the White House has not expanded the mandate to exempt more faith-based groups.

“In the coming weeks and months we will continue working closely with our members, Congress and the Administration to implement the ACA as fairly and effectively as possible,” the association said in a statement on Thursday.

Those who want to expand the concept of religious liberty claims to fend off employee choice (and eventually marriage equality) are saying they will have a field day.

Attorneys in cases alleging religious liberty violations saw lots of fodder in Thursday’s ruling and predicted much more litigation now that the Act’s basic existence was affirmed.

“I think the court’s decision makes clear Obama is still subject to legal challenges and that the Supreme Court is willing to entertain that the HHS regulations violate the rights of religious freedom,” said Hanna Smith, senior counsel at the Becket Fund, a D.C. firm involved in some of the 23 pending lawsuits against the White House.

The lawsuits all focus on opposing a mandate announced by the Department of Health and Human Services after the law was passed.

Mark Rienzi, another Becket attorney, said in a phone conference call that the ruling today only spoke to whether Congress had the right to pass the act – not on the details of how it’s implemented.

“It seems to me the administration has won one legal challenge and there are 23 others waiting in the wings,” he said.

The attorneys honed in on two parts of Thursday’s ruling. One, from the majority opinion, said: “Even if the taxing power enables Congress to impose a tax on not obtaining health insurance, any tax must still comply with other requirements in the Constitution.”

The second, from Justice Ruth Ginsberg, said “A mandate to purchase a particular product would be unconstitutional if, for example, the edict impermissibly abridged the freedom of speech, interfered with the free exercise of religion, or infringed on a liberty interest protected by the Due Process Clause.”

Comments (2)

I believe that most of the press is missing the boat on an extremely important aspect of the Supreme Court ruling: the fact that it struck down Medicaid expansion. Millions of the working poor could be left uninsured as a result. There's a good article on the subject here: http://www.nytimes.com/2012/06/30/us/politics/some-states-reluctant-over-medicaid-expansion.html?_r=1&hp

Thanks for the link. In many places Medicaid is at breaking point. The fact that Illinois was 6 months behind on payments causing clinics and pharmacies to close is just another incentive for doctors not to take Medicare/Medicaid patients. And Illinois isn't the only state struggling. Many local doctors here have given up private practice to become hospitalists(no refills, no demanding patient calls, no business overhead) or moved away to areas with fewer Medicare/Medicaid patients. Should Medicaid expand here, there won't be any more doctors to see them and the current 2-3 month wait for an appointment will get much longer.

And as a pharmacy tech, it's a painful,poorly run system. Many patients on Medicaid have to prove income eligibility every month and the out of state company that organizes the information often doesn't have the full list of eligibles in their databases at the beginning of the month, so like every every month I'm going to spend the next week telling people who've been waiting for their paychecks/gov't money they can't have their meds yet,unless they pay cash, because the system says they aren't covered this month. After a week of hassle, their caseworkers and the database will work it out, but having thousands more people in that mess would be awful. Some here who are eligible, don't sign up because of the paperwork mess, and others still find being on Medicaid a humiliating stigma so they want regular insurance, not that.
Chris H.

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