By Dennis Thompson
HealthDay Reporter
FRIDAY, July 25, 2014 (HealthDay News) -- The U.S. Supreme Court's ruling on contraception coverage -- as mandated under the Affordable Care Act -- could lead to a legal quagmire that might allow companies to deny insurance coverage for any medical practice that violates their religious principles, some health care experts say.
But other experts counter that such predictions are unlikely to come true.
The justices ruled 5-4 last month that Hobby Lobby Stores Inc. and Conestoga Wood Specialties Corp. did not have to provide contraceptive coverage that violated their religious beliefs. Prior to the ruling, U.S. companies were required to provide such coverage under the Affordable Care Act, the controversial 2010 health-reform law often referred to as Obamacare.
Some health care experts say they're now bracing for follow-up lawsuits from companies that might have religious objections to a range of medical services, such as vaccinations or blood transfusions.
"The court's decision clearly opens the door for other for-profit 'closely held' companies to challenge the [Affordable Care Act's] coverage requirement on the basis that they conflict with their owners' religious beliefs," Bob Doherty, the American College of Physicians' senior vice president of governmental affairs and public policy, said in his ACP Advocate Blog.
Other pending lawsuits are expected to further challenge the Affordable Care Act's requirements for contraception coverage, some observers predict.
Federal judges, including the Supreme Court itself, have already issued several injunctions that allow religious nonprofits to refuse participation in contraception coverage in what's called a "workaround." Under this arrangement, insurance companies step in to provide the contraception coverage that company officials oppose on religious grounds.
"I think there will be a significant number of women who will wind up being unable to get contraception because they may not be able to afford contraception on their own. And it is not yet clear what alternatives will be put in place that will enable women to obtain contraception in an affordable manner," said Ron Pollack, founding executive director of Families USA, a nonprofit advocacy group for health care consumers.
High court's ruling focused on 'closely held corporations'
Initial news coverage framed the June 30 Hobby Lobby decision as having limited impact, because it applied only to "closely held" corporations, such as family-owned businesses. And the decision included language that said it can't be applied more broadly to other health services that are required coverage under the Affordable Care Act.
But, "closely held" corporations are estimated to represent nine out of 10 of all businesses, employing 52 percent of the American workforce, Doherty said.
"Most of them, of course, are not likely to seek a religious exemption from specific coverage requirements, and not all of them will prevail in court if they do," Doherty said. "But some will, perhaps for ideological reasons masquerading as a religious belief."
The Supreme Court's decision almost certainly will be used in other lawsuits to challenge services like vaccination, to which some religions object, some experts predicted.
"The Roberts [Chief Justice John Roberts] court tends to issue its ruling pronouncement in narrow terms, but in ways that open the door for much larger application," Pollack said. "It is very hard to say what the ultimate implications of Hobby Lobby will be in other matters where people have religious scruples against certain types of medical care."
But, lawyers for religious groups involved in post-Hobby Lobby lawsuits said it's very unlikely that courts would uphold such challenges to important medical services.
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