A Deeply Divided Supreme Court Hears Argument Over ACA’s Contraceptive Coverage Requirement

Written by: Tina Batra Hershey, JD, MPH, Health Policy and Management
Copy editors: Linda S. Duchak, EdM, MCHES, Associate Director, and Kurt Holliday, Communications Specialist, Pennsylvania Public Health Training Center

US Supreme Court Building

Once again, the Affordable Care Act (ACA) came under fire before the Supreme Court on March 25, 2014.  Nearly two years ago, the high court heard extensive arguments regarding whether the landmark health reform law’s individual mandate and expansion of Medicaid were constitutional.  This time, the Supreme Court focused on the ACA’s requirement that for-profit employers with 50 or more employees offer such employees coverage for contraceptives.

Under the ACA, new private plans must provide coverage for a broad range of preventive services, including all methods of contraception approved by the Food and Drug Administration.  Houses of worship are exempt from the requirement.  The Obama administration also offered an “accommodation” for religiously affiliated nonprofits, such as church-run hospitals, parochial schools and charities.

Two for-profit secular companies brought suit, claiming that the contraceptive coverage requirement violated the tenets of their faiths.  Hobby Lobby, operated by the Green family who are Protestant, and Conestoga Wood Specialties, owned by the Hahn family who are Mennonites, filed separate suits that were then consolidated for review by the Supreme Court.  Hobby Lobby objects to Plan B and Ella (emergency contraceptives) as well as IUDs, claiming these types of contraception are abortifacients.  Conestoga Wood Specialties objects to Plan B and Ella on the same grounds. 

The case is considered to be one of the most important decisions of this Supreme Court term.  At issue is a question that has not been answered by the Court in previous decisions: Can a corporation exercise religion and thereby be entitled to protection under the Constitution and the Religious Freedom Restoration Act of 1993 (RFRA)?  Under RFRA, the government is prohibited from imposing a substantial burden on a person’s exercise of religion unless there is a compelling government interest and the means to achieve the interest are the least restrictive and most narrowly tailored.

The Court appeared deeply divided along ideological lines at oral argument.  As is frequently the case, Justice Kennedy seems to hold the key vote in the decision; however, it is unclear from his questions which way he will vote.  Although he expressed concern about the effect on employees when a religious employer denies contraceptive coverage, he was also troubled that a for-profit corporation could be forced in principle to pay for abortions if denied protection under RFRA.

There is some speculation among legal scholars that Chief Justice Roberts may be looking for a narrow ruling in favor of Hobby Lobby and Conestoga Wood Specialties that would apply only to closely held corporations, and not publicly traded companies.  Only time will tell, as the Court is expected to issue its ruling in June 2014.

Distilled Wisdom from the PAPHTC Grant Writing Class

Map of the Foundation Center's
Funding Information Network

For a number of years I have team-taught a grant writing class sponsored by PAPHTC as well as classes on how to find grant funding opportunities for audiences at the University of Pittsburgh and around the state of Pennsylvania. As a librarian and public health informationist, I usually teach the sections on how to find funding and evaluation of the funded activities. My colleague Pat Murphy, with her years of experience in non-profit management and grant writing teaches the rest.

Here are a few of the most important bits of information distilled from those classes:

• Rather than reacting to funding opportunities that pop up, have a plan. What do you want to accomplish as a researcher, an institution, a nonprofit organization? Seek funding that supports those goals.
• Don’t assume that you will get all the funding you need for a project from one source.
• The role of a grant proposal is to answer the funder’s questions. Don’t stray from that purpose, you will lose them.
• Follow the directions precisely. If the directions aren’t clear, or contradict themselves, contact the funder and get clarification. You don’t want them to ignore your proposal because you used the wrong size font.
• Become familiar with who funds work similar to yours. Include state and federal government, foundations, public charities, community foundations, and corporate giving programs in the types of funders you evaluate. For a list of resources to consider, see http://hsls.libguides.com/grants.
• Once you know the funding landscape, automate the receipt of new funding opportunities as much as possible by using tools such as email alerts, RSS feeds, and organizational newsletters.
• When writing your proposal, eliminate jargon. Don’t assume the funder knows your field. Have someone outside your field read the proposal and evaluate its clarity.
• Need help with grant writing? There are many fine books on the topic available at public libraries with Foundation Center cooperating collections and in academic libraries.