Birth Control Question

[homersapien 12,172]

There still hasn't been an aswer to my original question, either.

What was it?

What makes BC so much more of an "essential benefit" that it must be the only Rx mandated by ACA to be offered for free?

Does ACA specify that deductibles or co-pays don't apply to BC?

[TitanTiger 21,068]

There still hasn't been an aswer to my original question, either.

What was it?

What makes BC so much more of an "essential benefit" that it must be the only Rx mandated by ACA to be offered for free?

Does ACA specify that deductibles or co-pays don't apply to BC?

Yes.

http://www.cnn.com/2011/HEALTH/08/01/free.birth.control/

[MDM4AU 337]

I would guess the consideration is, the effects of unwanted children on all of society.

Even with the abundance of avenues in which people can get BC for free? And to stay on that line of thinking, there is a choice to be made that will result in not needing the BC and not having unwanted children. There are other health issues that are rather expensive that are no result of someone's personal choices. Diabetes, MS, etc.

[homersapien 12,172]

There still hasn't been an aswer to my original question, either.

What was it?

What makes BC so much more of an "essential benefit" that it must be the only Rx mandated by ACA to be offered for free?

Does ACA specify that deductibles or co-pays don't apply to BC?

Yes.

http://www.cnn.com/2....birth.control/

Well, according to that article:

According to HHS Secretary Kathleen Sebelius the decision is a part of the Affordable Care Act's move to stop problems before they start. "These historic guidelines are based on science and existing literature and will help ensure women get the preventive health benefits they need," she said in a news release.

In July, the Institute of Medicine issued the results of a scientific review of women's health needs and provided recommendations on specific preventive measures to help them. Today HHS approved those recommendations.

So, I guess that's the answer to MDM's question. It's to emphasize the advantages of prevention over the (much more expensive) consequences of an unwanted pregnancy. I also noted that BC is not the "only" thing:

Besides contraceptive use, the list includes screenings for conditions such as gestational diabetes and the human papillomavirus (HPV), as well as breastfeeding support and counseling on sexually transmitted diseases. The full list is available on the Department of Health and Human Services website.

[homersapien 12,172]

I would guess the consideration is, the effects of unwanted children on all of society.

Even with the abundance of avenues in which people can get BC for free? And to stay on that line of thinking, there is a choice to be made that will result in not needing the BC and not having unwanted children. There are other health issues that are rather expensive that are no result of someone's personal choices. Diabetes, MS, etc.

So what's wrong with providing another "avenue" if it's a good thing?

And maybe if there was a cheap, effective preventative treatment for Diabetes and MS it would be free too.

[icanthearyou 4,468]

I would guess the consideration is, the effects of unwanted children on all of society.

Even with the abundance of avenues in which people can get BC for free? And to stay on that line of thinking, there is a choice to be made that will result in not needing the BC and not having unwanted children. There are other health issues that are rather expensive that are no result of someone's personal choices. Diabetes, MS, etc.

Is anything "free"? Is hoping people will always make good choices realistic, practical? I think your last sentence is true (can diabetes result from poor diet and exercise decisions) but, I don't understand the connection?

[channonc 466]

There still hasn't been an aswer to my original question, either.

What was it?

What makes BC so much more of an "essential benefit" that it must be the only Rx mandated by ACA to be offered for free?

This came from the recommendations of the Institute of Medicine, who made 8 recommendations with regard to preventative services for women:

• screening for gestational diabetes
  
• human papillomavirus (HPV) testing as part of cervical cancer screening for women over 30
  
• counseling on sexually transmitted infections
  
• counseling and screening for HIV
  
• contraceptive methods and counseling to prevent unintended pregnancies
  
• lactation counseling and equipment to promote breast-feeding
  
• screening and counseling to detect and prevent interpersonal and domestic violence
  
• yearly well-woman preventive care visits to obtain recommended preventive services
  

From the report (emphasis mine):

Existing Guidelines and Recommendations

Numerous health care professional associations and other organizations recommend the use of family planning services as part of preventive care for women, including ACOG, AAFP, the American Academy of Pediatrics (AAP), the Society of Adolescent Medicine, the AMA, the American Public Health Association, the Association of Women’s Health, Obstetric and Neonatal Nurses, and the March of Dimes. In addition, the CDC recommends family planning services as part of preventive visits for preconception health (Johnson et al., 2006).

The USPSTF does not address prevention of unintended pregnancy. Bright Futures recommends that information about contraception be offered to all sexually active adolescents and those who plan to become sexually active (AAP, 2008).

The IOM Committee on Women’s Health Research recently identified unintended pregnancy to be a health condition of women for which little progress in prevention has been made, despite the availability of safe and effective preventive methods (IOM, 2010b). This report also found that progress in reducing the rate of unintended pregnancy would be possible by “making contraceptives more available, accessible, and acceptable through improved services (IOM, 2010b).

Another IOM report on unintended pregnancy recommended that “all pregnancies should be intended” at the time of conception and set a goal to increase access to contraception in the United States (IOM, 1995). Healthy People 2020 (HHS, 2011a), which sets health goals for the United States, includes a national objective of increasing the proportion of pregnancies that are intended from 51 to 56 percent. In addition, Healthy People 2020 sets goals to increase the number of insurance plans that offer contraceptive supplies and services, to reduce the proportion of pregnancies conceived within 18 months of a previous birth, and to increase the proportion of females or their partners at risk of unintended pregnancy who used contraception during the most recent sexual intercourse (HHS, 2011a).

Effective Interventions

Family planning services are preventive services that enable women and couples to avoid an unwanted pregnancy and to space their pregnancies to promote optimal birth outcomes. A wide array of safe and highly effective FDA-approved methods of contraception is available, including barrier methods, hormonal methods, emergency contraception, and implanted devices; sterilization is also available for women and for men (FDA, 2010). This range of methods provides options for women depending upon their life stage, sexual practices, and health status. Some methods, such as condoms, spermicides, and emergency contraceptives, are available without a prescription, whereas the more effective hormonal and long-acting reversible methods, such as oral contraceptives and intrauterine devices, are available by prescription or require insertion by a medical professional. Sterilization is a surgical procedure. For women with certain medical conditions or risk factors, some contraceptive methods may be contraindicated. These can be assessed clinically so that an appropriate method can be selected for the individual (CDC, 2010; Dragoman et al., 2010).

The effectiveness of contraceptives is determined by studying the rate of failure (i.e., having an unintended pregnancy) in the first year of use (Table 5-3). The failure rates of all FDA-approved methods in both U.S. and international populations have been well documented and are negligible with proper use (Amy and Tripathi, 2009; Hatcher et al., 2007; Kost et al., 2008; Mansour et al., 2010). Female sterilization, the intrauterine device, and the contraceptive implant have failure rates of 1 percent or less in the first 12 months of use (Fu et al., 1999; Hatcher et al., 2007). Injectable and oral contraceptives have use failure rates of seven and 9 percent, respectively, because some women miss or delay an injection or pill (Kost et al., 2008). Failure rates for both male and female condoms and other barrier methods are higher (e.g., 15 percent for the male condom) (Amy and Tripathi, 2009). These rates compare with an 85 percent chance of an unintended pregnancy within 12 months among couples using no method of contraception (Hatcher et al., 2007; Trussell and Kost, 1987).

In addition to this evidence of method effectiveness, evidence exists that greater use of contraception within the population produces lower unintended pregnancy and abortion rates nationally. Studies show that as the rate of contraceptive use by unmarried women increased in the United States between 1982 and 2002, rates of unintended pregnancy and abortion for unmarried women also declined (Boonstra et al., 2006). Other studies show that increased rates of contraceptive use by adolescents from the early 1990s to the early 2000s was associated with a decline in teen pregnancies and that periodic increases in the teen pregnancy rate are associated with lower rates of contraceptive use (Santelli and Melnikas, 2010).

As with all pharmaceuticals and medical procedures, contraceptive methods have both risks and benefits. Side effects are generally considered minimal (ACOG, 2011a,b,c; Burkman et al., 2004). Death rates associated with contraceptive use are low and, except for oral contraceptive users who smoke, lower than the U.S. maternal mortality rate (Hatcher et al., 1998). For example, the oral contraceptive death rate per 100,000 users under the age of 35 years who are nonsmokers was 1.5 per 100,000 live births (Hatcher et al., 1998), compared with 11.2 maternal deaths per 100,000 live births in 2006 (age adjusted) (CDC, 2010c).

Contraceptive methods often have benefits separate from the ability to plan one’s family and attain optimal birth spacing. For example, the non-contraceptive benefits of hormonal contraception include treatment of menstrual disorders, acne or hirsutism, and pelvic pain (ACOG, 2010a). Long-term use of oral contraceptives has been shown to reduce a woman’s risk of endometrial cancer, as well as protect against pelvic inflammatory disease and some benign breast diseases (PRB, 1998). The Agency for Healthcare Research and Quality (AHRQ) is currently undertaking a systematic evidence review to evaluate the effectiveness of oral contraceptives as primary prevention for ovarian cancer (AHRQ, 2011).

Education and counseling are important components of family planning services because they provide information about the availability of contraceptive options, elucidate method-specific risks and benefits for the individual woman, and provide instruction in effective use of the chosen method (NBGH, 2005; Shulman, 2006). Research on the effectiveness of structured contraceptive counseling is limited (Halpern et al., 2006; Lopez et al., 2010b; Moos et al., 2003). However, studies show that postpartum contraceptive counseling increases contraceptive use and decreases unplanned pregnancy (Lopez et al., 2010a), that counseling increases method use among adolescents in family planning clinics (Kirby, 2007), that counseling decreases nonuse of contraception in older women of reproductive age (35 to 44 years) who do not want a future baby (Upson et al., 2010), and that counseling of adult women in primary care settings is associated with greater contraceptive use and the use of more effective methods (Lee et al., 2011; Weisman et al., 2002).

Although it is beyond the scope of the committee’s consideration, it should be noted that contraception is highly cost-effective. The direct medical cost of unintended pregnancy in the United States was estimated to be nearly $5 billion in 2002, with the cost savings due to contraceptive use estimated to be $19.3 billion (Trussell, 2007). The cost-effectiveness of family planning is also documented in an evaluation of FamilyPact, California’s 1115 Medicaid Family Planning Waiver Program. The unintended pregnancies averted in this program in 2002 would have cost the state $1.1 billion within two years, and $2.2 billion within five years, for public-sector health and social services that otherwise would have been needed (Amaral et al., 2007).

In a study of the cost-effectiveness of specific contraceptive methods, all contraceptive methods were found to be more cost-effective than no method, and the most cost-effective methods were long-acting contraceptives that do not rely on user compliance (Trussell et al., 2009). The most common contraceptive methods used in the United States are the oral contraceptive pill and female sterilization. It is thought that greater use of long-acting, reversible contraceptive methods—including intrauterine devices and contraceptive implants that require less action by the woman and therefore have lower use failure rates—might help further reduce unintended pregnancy rates (Blumenthal et al., 2011). Cost barriers to use of the most effective contraceptive methods are important because long-acting, reversible contraceptive methods and sterilization have high up-front costs (Trussell et al., 2009).

Contraceptive coverage has become standard practice for most private insurance and federally funded insurance programs. For example, contraceptive services are covered for all federal employees and individuals who obtain their care through federally financed programs, such as VA, TRICARE for active-duty military and their dependents, and IHS. Federal programs provide funding for family planning services in community health centers through the Public Health Service Act, in family planning centers through Title X [Population Research and Voluntary Family Planning Programs (P.L. 91-572)], through the Maternal and Child Health Block Grant, and through the Medicaid program.

Since 1972, Medicaid, the state-federal program for certain low-income individuals, has required coverage for family planning in all state programs and has exempted family planning services and supplies from cost-sharing requirements. In addition, 26 states currently operate special Medicaid-funded family planning programs for low-income women who either no longer qualify for Medicaid or do not meet the program’s categorical requirements. In Massachusetts, family planning services with no copayments will be included as part of the preventive benefits offered to members of Commonwealth Care, a program of subsidized health insurance for low- and moderate-income people (Personal communication, Stephanie Chrobak and Nancy Turnbull, Massachusetts Health Connector, May 10, 2011).

Private employers have also expanded their coverage of contraceptives as part of the basic benefits packages of most policies. This expansion has occurred in response to state and federal policies. Twenty-eight states now have regulations requiring private insurers to cover contraceptives, and 17 of these states also require that insurance cover the associated outpatient visit costs (Guttmacher Institute, 2011) (see Chapter 3). A federal court ruling issued in 2000 by the Equal Employment Opportunity Commission found an employer’s failure to cover prescription contraceptive drugs and devices in a health plan that covers other drugs, devices, and preventive care to be discrimination against women in violation of Title VII of the Civil Rights Act (EEOC, 2000).

In 2007, NBGH recommended that employer-sponsored health plans include coverage of family planning services, without cost sharing, as part of a minimum set of benefits for preventive care. The Guttmacher Institute also calls comprehensive coverage of contraceptive services and supplies “the current insurance industry standard,” with more than 89 percent of insurance plans covering contraceptive methods in 2002 (Camp, 2011). A more recent 2010 survey of employers found that 85 percent of large employers and 62 of small employers offered coverage of FDA-approved contraceptives (Claxton et al., 2010).

Despite increases in private health insurance coverage of contraception since the 1990s, many women do not have insurance coverage or are in health plans in which copayments for visits and for prescriptions have increased in recent years. In fact, a review of the research on the impact of cost sharing on the use of health care services found that cost-sharing requirements, such as deductibles and copayments, can pose barriers to care and result in reduced use of preventive and primary care services, particularly for low-income populations (Hudman and O’Malley, 2003). Even small increments in cost sharing have been shown to reduce the use of preventive services, such as mammograms (Trivedi et al., 2008). The elimination of cost sharing for contraception therefore could greatly increase its use, including use of the more effective and longer-acting methods, especially among poor and low-income women most at risk for unintended pregnancy. A recent study conducted by Kaiser Permanente found that when out-of-pocket costs for contraceptives were eliminated or reduced, women were more likely to rely on more effective long-acting contraceptive methods (Postlethwaite et al., 2007).

[MDM4AU 337]

Homer,

I'm talking about Rx. Preventative screenings for men and women are different than free Rx. There are preventative Rx out there for people with certain conditions that help keep their health from deteriorating or causing more expensive problems. There are people on Medicare and Medicaid with children that could use help with their insulin, or betaferon, or avonex...

To your second question, The Gov is mandating another avenue that is only free to one segment of the population. (And then people have the nerve to bitch and moan when a couple of companies don't feel right providing 4 of the 20 approved methods.)

[Proud Tiger 4,261]

If the reason for providing BC is to reduce the number of unwanted children, why don't we close the border and reduce the thousands coming in?

[MDM4AU 337]

Channonc, your argument about anything other than BC for BC reasons only weakens your argument. There are all sorts of drugs that treat all sorts of conditions that they weren't originally manufactured for. I am so absolutely tired of this coming up froma certain portion of society EVRYTIME birthcontrol is discussed. I have no problem with the preventative screenings that males and females are allowed under the ACA.

Why force employer plans to cover such items when there are other ways to get them for free? Especially when there are choices that can be made to keep the unwanted preganacies from happening. Along the socio-economic lines, have Medicaid cover it for free. But why mandate that employer plans offer it for free? And, as I stated before, I am not advocating that BC not be covered at all.

[TexasTiger 14,071]

If the reason for providing BC is to reduce the number of unwanted children, why don't we close the border and reduce the thousands coming in?

Start your own thread on that if you want .

[icanthearyou 4,468]

If the reason for providing BC is to reduce the number of unwanted children, why don't we close the border and reduce the thousands coming in?

Yay buddy. We shoot a few of em and thayll stop comin. Word ill spred.

[TitanTiger 21,068]

It is tricky. Which makes another argument for single payer.

Or at least a system where people are able to purchase directly from insurers in open competition across state lines so that the employer's role is limited to perhaps using higher salaries or set aside monies used by an individual to purchase insurance on their own as a hiring incentive.

But in reference to one of your highlighted points, when an individual chooses to incorporate they are doing so because they have decided there are legal advantages to doing so-- so should one be able to retain all the rights of an individual while forgoing some of the responsibilities?

It appears that the court does not see those things as inextricably linked. You don't necessarily have to give up the all of your rights in order to incorporate.

[homersapien 12,172]

Homer,

1) I'm talking about Rx. Preventative screenings for men and women are different than free Rx. There are preventative Rx out there for people with certain conditions that help keep their health from deteriorating or causing more expensive problems. There are people on Medicare and Medicaid with children that could use help with their insulin, or betaferon, or avonex...

To your second question, 2) The Gov is mandating another avenue that is only free to one segment of the population. (And then 3) people have the nerve to bitch and moan when a couple of companies don't feel right providing 4 of the 20 approved methods.)

1) I fail to see the point of distinguishing between a drug and a procedure.

2) Are you referring to the fact only women are directly affected? I don't understand.

3) Well, to you it may be "bitch and moan", but many women see it as a arbitrary, religious-based restriction of an otherwise legal drug they may need. (That sort of condescension is at the root of the so called "war on women" political slogan by the way.)

[TexasTiger 14,071]

It is tricky. Which makes another argument for single payer.

Or at least a system where people are able to purchase directly from insurers in open competition across state lines so that the employer's role is limited to perhaps using higher salaries or set aside monies used by an individual to purchase insurance on their own as a hiring incentive.

But in reference to one of your highlighted points, when an individual chooses to incorporate they are doing so because they have decided there are legal advantages to doing so-- so should one be able to retain all the rights of an individual while forgoing some of the responsibilities?

It appears that the court does not see those things as inextricably linked. You don't necessarily have to give up the all of your rights in order to incorporate.

They don't, but incorporating is a choice and carries benefits individuals don't have. One need not lose rights to run a business.

[MDM4AU 337]

Homer,

1) I'm talking about Rx. Preventative screenings for men and women are different than free Rx. There are preventative Rx out there for people with certain conditions that help keep their health from deteriorating or causing more expensive problems. There are people on Medicare and Medicaid with children that could use help with their insulin, or betaferon, or avonex...

To your second question, 2) The Gov is mandating another avenue that is only free to one segment of the population. (And then 3) people have the nerve to bitch and moan when a couple of companies don't feel right providing 4 of the 20 approved methods.)

3) Well, to you it may be "bitch and moan", but many women see it as a arbitrary, religious-based restriction of an otherwise legal drug they may need. (That sort of condescension is at the root of the so called "war on women" political slogan by the way.)

There is no restriction. They can still legally get it. They don't have the right to mandate their employer provide it. And it's your response regarding relious freedom and your snarky remarks about condescension that leads people to believe that liberals are incapable of seeing anything from a conservatives viewpoint (see Titan's post yesterday). I wasn't being condescending. You chose to label me with that. The hue and cry dripping in ficticious claims about rights to something that the "mean ol' boss man won't give me" are ludicrous at best. (that is condeascending and rightfully so) This has come from men and women alike so let me be clear that I am talking about men bitching and moaning, as well.

[DKW 86 7,866]

Sounds to me we are about to go down the rat hole of single payer.

As a Veteran that just spent 8 years arguing with the VA,

as a Veteran watching my fellow Vets dying waiting on horribly mismanaged incomprehensible delays after delays after delays,

as a Veteran that sees these things up close and personal, i think that single payer, LIKE THE VA, is the worst possible answer.

Set it up as Medicare for everyone, with only those multitude of problems, we can talk.

The VHA has been reason itself to be wary of Federally managed healthcare.

[Proud Tiger 4,261]

TexT.......don't need a new thread. One post was enough to make my point.

[TexasTiger 14,071]

Sounds to me we are about to go down the rat hole of single payer.

As a Veteran that just spent 8 years arguing with the VA,

as a Veteran watching my fellow Vets dying waiting on horribly mismanaged incomprehensible delays after delays after delays,

as a Veteran that sees these things up close and personal, i think that single payer, LIKE THE VA, is the worst possible answer.

Set it up as Medicare for everyone, with only those multitude of problems, we can talk.

The VHA has been reason itself to be wary of Federally managed healthcare.

Managed care is not the same as single payer.

[TitanTiger 21,068]

Another good explanation as to why the SCOTUS decision was reasonable:

Yesterday, on its final day of the 2013-14 term, the Supreme Court of the United States handed down a decision for Hobby Lobby and its owners, the Green Family, forbidding the government from requiring them to provide insurance coverage for the provision of abortion-inducing drugs or devices for their employees pursuant to regulations enacted by the Department of Health and Human Services in implementing the Patient Protection and Affordable Care Act, aka “Obamacare.”

The HHS regulations mandated coverage for some twenty types of contraceptives. Hobby Lobby and the Greens did not object to providing coverage for sixteen of these. They objected, on grounds of conscience, to providing the four that can or might cause the death of a developing child in the early embryonic stage, if conception has occurred. As devout evangelical Christians, they argued that the imposition of a requirement that they provide coverage for abortion-inducing drugs or devices violates their rights under the Religious Freedom Restoration Act.

This piece of federal legislation, signed into law by President Bill Clinton in 1993 after being passed by overwhelming bipartisan majorities in both houses of Congress, provides for conduct exemptions to laws of general applicability where such laws substantially burden religious practice or belief, unless the government can meet the high burden of demonstrating that a legal imposition is supported by a compelling governmental interest—the highest standard known to our law—and represents the least restrictive means of protecting or advancing that interest.

Hobby Lobby and the Greens, represented by attorneys from the Becket Fund for Religious Liberty (full disclosure: I am a member of its board of directors and executive committee), argued that the abortifacient mandates (1) substantially burden the practice of their faith; (2) are not supported by a compelling interest; and (3) do not represent the least restrictive means of pursuing the government’s objective of supplying these products to women. The Obama administration contested these claims and denied that RFRA protections apply at all to for-profit businesses (as opposed to religious organizations).

The decision’s most important feature is its rejection of that contention. The five justices in the majority—Alito, Roberts, Scalia, Thomas, and Kennedy—explicitly reject it, thus establishing as a matter of law the proposition that RFRA protections can apply to for-profit businesses, and do apply to closely held corporations. It leaves open the question, which is probably purely theoretical, whether RFRA protections apply to large, publicly traded companies. Two of the four dissenting justices—Breyer and Kagan—decline to reach or opine on the question of whether RFRA protects for-profit businesses—pointedly refusing to join this aspect of the dissent filed by Justices Ginsburg and Sotomayor who, alone, contend that for-profit businesses do not enjoy RFRA protections.

Friends of First Things will not be able to resist the feeling that the late Richard John Neuhaus, the founder of this journal and the leader of the opposition to the idea that religion is a purely “private” activity that has no legitimate role in the public square, is smiling down from heaven. Yesterday was Fr. Neuhaus’s big day. The Court ruled that the Greens did not forfeit their rights to run their business in line with their conscientious religious beliefs merely by choosing the corporate form.

Just as the for-profit company known as the New York Times enjoys the right to freedom of the press under the First Amendment, so Hobby Lobby enjoys the right to religious freedom protected by RFRA. Protection for religious liberty doesn’t stop where commerce begins. As Neuhaus tirelessly insisted, our religious lives cannot be restricted to what we do in our homes before meals or on our knees at bedtime, or to our prayers and liturgies in churches, synagogues, mosques, and temples. Religious faith motivates, or can motivate, our convictions and actions in the exercise of our rights and responsibilities as citizens, in our philanthropic and charitable activities, and in the conduct of our businesses and professions.

Once the Court establishes the principle that RFRA covers people of faith operating as corporations, just as it covers people doing business as sole proprietors—and protects them in their business lives just as it does in other spheres—the Court has no difficulty perceiving that the abortifacient mandates substantially burden the Greens’ freedom of religion and that, however one characterizes the governmental interest the mandates are meant to be advancing, there is no way plausibly to claim that they represent the least restrictive means of advancing that interest. Obviously, the government could, for example, provide women with abortion drugs or devices itself. And there may be other ways of providing those products without conscripting Hobby Lobby and the Greens into the process, thus forcing them to violate their consciences, pay crushing fines, or push their employees onto the state healthcare exchanges.

But what about the question of how to characterize the governmental interest? Being a good judicial craftsman, Justice Alito adheres firmly to the canon of legal interpretation that counsels against reaching an issue that need not be resolved in order to dispose of the case at hand. So, having determined that the abortifacient mandates flunk the “least restrictive means” test, he declined to address the question of whether providing abortifacients as part of employer-provided insurance plans constitutes a compelling interest.

It isn’t hard to see, however, that it couldn’t possibly constitute such an interest. Countless employers of fewer than fifty full-time workers are relieved of the requirement to provide insurance to their employees under the ACA altogether, and many millions of other employees are in “grandfathered” plans unaffected by this HHS mandate. They are not required to provide coverage for contraceptives or abortifacients. For the whole of history, before Obamacare was signed into law only four years ago, no company in the United States was required to provide coverage for these products. So the Obama administration is hardly in a position to say that the provision of abortion drugs or devices, or coverage including them, constitutes a compelling governmental interest. Indeed, one wonders how the government’s attorneys could make that claim with a straight face.

What does today’s ruling portend for the other cases coming down the line concerning the mandates, including those for religious non-profit entities to whom the Obama administration has offered an “accommodation” that they, rightly in my view, regard as phony? Some language in Justice Alito’s opinion, and especially some language in Justice Anthony Kennedy’s short concurring opinion, is causing a bit of anxiety for religious freedom advocates. The Becket Fund explains the “accommodation” and what is fallacious about it:

Under this, an objecting organization will notify its insurer or plan administrator, which will make payments to employees for the mandated contraceptive services. The rule insists these payments are not “benefits” and are separate from the organization’s health plan. Nonetheless, the accommodation means that employees are guaranteed payments for objectionable services, specifically because they are covered under the organization’s plan. Furthermore, the accommodation requires a self-insured organization to “designate” its plan administrator as an agent who will make or arrange for payments for the mandated services. This “accommodation” fails to solve the moral problem created by the mandate for many religious organizations.

My own judgment is that Alito’s words needn’t and shouldn’t be interpreted as suggesting that he thinks the “accommodation” satisfies RFRA concerns about the religious freedom of Catholic and Evangelical colleges and other institutions that have filed lawsuits to prevent imposition on them of the contraception and/or abortifacient mandates. As I said, Alito is a good judicial craftsman. He doesn’t address issues that needn’t be resolved in order to dispose of the case at hand. It is a mistake to read him as signaling a favorable attitude towards the “accommodation.”

Kennedy, not uncharacteristically, is harder to read. I can’t say with confidence that he is not signaling a friendly attitude towards the “accommodation.” At the same time, I cannot say that he seems to have settled his mind on the question. When one of the cases presenting the issue makes it to the Supreme Court, it will be incumbent on the lawyers challenging the imposition of the mandates to do a good job of explaining how, despite the “accommodation,” they implicate the religious employer in the provision of contraceptives and abortifacients in violation of their conscientious opposition to providing these products.

In the mean time, the cases filed by non-profit institutions like Colorado Christian College and the University of Notre Dame, and by the Catholic television network EWTN and the redoubtable Little Sisters of the Poor, will work their way through the system—mostly winning in the lower federal courts. Notre Dame Law School professor Gerard Bradley, one of our nation’s most astute commentators on religious liberty issues, has noted that these cases are of two kinds: (1) those involving claimants who self-insure; and (2) those involving claimants who purchase insurance from companies. Professor Bradley believes that today’s decision should inspire a great deal of confidence for claimants in the first category. The situation for those in the second, considered in light of what Justice Kennedy says in his concurring opinion, is more uncertain. What is certain is that Kennedy’s vote will decide the cases that consider the “accommodation.” Lawyers on the competing sides can each count on four votes being with them and four against. So lawyers on both sides will be directing their arguments to Kennedy. As is often the case, he is The Decider.

All the while, politics will happen. Hillary Clinton, Sandra Fluke, Nancy Pelosi, and others are already warning that the Supreme Court has joined the alleged “war on women.” Left-wing pressure groups will whip their base into a frenzy for electoral and fund-raising reasons. Brandishing Justice Ginsburg’s overwrought dissenting opinion, they will compare the justices in the Hobby Lobby majority to leaders of the Taliban. Democrats in Congress, egged on by the Daily Kos, Planned Parenthood, NARAL and the rest, will propose reversing the Hobby Lobby decision by amending RFRA or repealing it altogether.

Friends of religious freedom must respond swiftly and strongly to the claims and political machinations of their adversaries. We must wield the sword of truth against the falsehoods and gross exaggerations that will become the currency of the other side’s attacks. Without resorting to their tactics, we must match their intensity and determination. Key elements of our religious freedom hang in the balance.

Robert P. George is McCormick Professor of Jurisprudence at Princeton University and author, most recently, of Conscience and Its Enemies (ISI).

http://www.firstthings.com/web-exclusives/2014/06/what-hobby-lobby-means

[homersapien 12,172]

Homer,

1) I'm talking about Rx. Preventative screenings for men and women are different than free Rx. There are preventative Rx out there for people with certain conditions that help keep their health from deteriorating or causing more expensive problems. There are people on Medicare and Medicaid with children that could use help with their insulin, or betaferon, or avonex...

To your second question, 2) The Gov is mandating another avenue that is only free to one segment of the population. (And then 3) people have the nerve to bitch and moan when a couple of companies don't feel right providing 4 of the 20 approved methods.)

3) Well, to you it may be "bitch and moan", but many women see it as a arbitrary, religious-based restriction of an otherwise legal drug they may need. (That sort of condescension is at the root of the so called "war on women" political slogan by the way.)

There is no restriction. They can still legally get it. They don't have the right to mandate their employer provide it. And it's your response regarding relious freedom and your snarky remarks about condescension that leads people to believe that liberals are incapable of seeing anything from a conservatives viewpoint (see Titan's post yesterday). I wasn't being condescending. You chose to label me with that. The hue and cry dripping in ficticious claims about rights to something that the "mean ol' boss man won't give me" are ludicrous at best. (that is condeascending and rightfully so) This has come from men and women alike so let me be clear that I am talking about men bitching and moaning, as well.

This reminds me of that saying about being able to hold two contradictory ideas in your mind at once... can't remember exactly how it actually goes.

Like I said, I don't think employers should be required to provide healthcare insurance to their employees either. I do believe those employees - like everyone else - do have a legal right to obtain said insurance in some way, preferably (IMO), directly. As I said, the employer mandate is a holdover from what became a common practice. IMO it will be an interim phase at any rate.

Sorry if you took direct offense to the "bitch and moan" crack. I didn't mean to imply you had any sort of misogynistic intent in using it. I was just trying to be helpful by pointing out that many women would take it that way. Lots of people on this forum just can't understand why the so called "war on women" gets any traction. Some of that traction comes from innuendo or implication, intended or not.

[homersapien 12,172]

TexT.......don't need a new thread. One post was enough to make my point.

As it normally is.

[RunInRed 18,113]

Taking a step back and looking at the bigger picture, I pretty much agree with this line of thinking:

Where once the religious right sought to inject a unified ideology of traditionalist Judeo-Christianity into the nation's politics, now it seeks merely to protect itself against a newly aggressive form of secular social liberalism.

In other words, Hobby Lobby isn't the mark of a Religious Right movement on the offensive, it's one that is trying to carve out exemptions as popular culture and American public opinion grind it to irrelevancy

http://www.dailykos.com/story/2014/07/03/1311251/-Hobby-Lobby-isn-t-a-conservative-victory-it-s-a-rear-guard-action

[TitanTiger 21,068]

Taking a step back and looking at the bigger picture, I pretty much agree with this line of thinking:

Where once the religious right sought to inject a unified ideology of traditionalist Judeo-Christianity into the nation's politics, now it seeks merely to protect itself against a newly aggressive form of secular social liberalism.

In other words, Hobby Lobby isn't the mark of a Religious Right movement on the offensive, it's one that is trying to carve out exemptions as popular culture and American public opinion grind it to irrelevancy

http://www.dailykos....ar-guard-action

Can't say I disagree. Though the reason for that "grinding" is more what I posted before...that modern liberals seem to have lost the capacity to put themselves in the place of another and see the world through their eyes. They're aggressive alright.

[homersapien 12,172]

Taking a step back and looking at the bigger picture, I pretty much agree with this line of thinking:

Where once the religious right sought to inject a unified ideology of traditionalist Judeo-Christianity into the nation's politics, now it seeks merely to protect itself against a newly aggressive form of secular social liberalism.

In other words, Hobby Lobby isn't the mark of a Religious Right movement on the offensive, it's one that is trying to carve out exemptions as popular culture and American public opinion grind it to irrelevancy

http://www.dailykos....ar-guard-action

Can't say I disagree. Though the reason for that "grinding" is more what I posted before...that modern liberals seem to have lost the capacity to put themselves in the place of another and see the world through their eyes. They're aggressive alright.

Actually, the research indicates just the opposite. Liberals are inherently more empathetic than conservatives. (See Haidt, "The Righteous Mind")