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MEDIA ADVISORY: “Hobby Lobby” Decision and Access to Health Care

The ACA’s “Contraceptive Mandate”: Ethical Implications of the Supreme Court’s Pending Decisions for Access to Health Care

The Supreme Court rules this month on whether corporations have a constitutional right to refuse to participate in the Affordable Care Act’s mandate that employer-sponsored health plans cover all FDA-approved contraceptives. The closely watched decisions on Sebelius v. Hobby Lobby Stores, Inc., and Conestoga Wood Specialties Corp v Sebelius raise broad ethical issues about fairness in access to health care.

“The Supreme Court has held that corporations have constitutionally protected rights to free speech; Hobby Lobby and Conestoga Wood Specialties Corporation are claiming that corporations also enjoy religious protections under the 1993 Religious Freedom Restoration Act,” says Michael Gusmano, a research scholar at The Hastings Center. “Even if the court decides that religious protections can be extended to corporations, there is still a question: does such protection mean that employees should have to purchase – or go without – benefits that are supposed to be included in their employer- sponsored health plans under the ACA?”

Nancy Berlinger, a Hastings Center research scholar, added that cases like these can shed light on the extent and limit of “conscience clauses,” such as those that grant physicians and health care institutions the right to refuse to provide certain services. “Institutional policies that restrict access to medically appropriate treatment options based on the institution’s own religious or other commitments may be legally protected but ethically problematic,” she says. “For example, when some hospitals refuse to provide certain treatments or forms of care, the legal protection provided by conscience clauses should always be balanced by policies and procedures to protect patients. Considering whether corporations have similar rights of refusal also involves questions of balance, so we do not overprotect institutions and underprotect patients.”