The country's abuzz about a recent ruling by the Supreme Court of the United States (SCOTUS) involving the retail chain Hobby Lobby, that dealt with employer-provided health insurance and whether they're obligated to cover certain controversial birth control methods.
But this case also delves into the timely questions of how healthcare coverage will be doled out in this country going forward, and how some employers might ride the coattails of this new court ruling by claiming that covering certain treatments may be at odds with their belief system.
Of course, contraception is a moral controversy and diabetes is not... but what's to stop a particular employer from claiming that they believe in faith-healing, therefore they shouldn't be forced to cover medicines for their employees?
And who's to say companies won't start exploiting this "religious freedom" claim for even less pure intentions, like improving their bottom line by rejecting certain coverages... Like health benefits for LGBT employees? Or even devices like glucose meters, insulin pumps, and insulin, for that matter?
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That's where this issue could potentially impact our Diabetes Community in a very negative way.
With the court decision having just been announced, we're all still in that "what happens now?" phase and everyone from the mainstream media to legal pundits to everyday moms and teens on social media is speculating about the impact this big case will have.
You can get a sense of it all just by skimming the headlines:
"Hobby Lobby rulings much more than abortion" states CNN.
And the LA Times writes about "The broad reach of the narrow Hobby Lobby ruling."
There's lots of chatter in our own healthcare-skittish community, too; in one recent Facebook discussion, a fellow type 1 posted this potential scenario:
"I believe that prayer cures all, so I am not going to pay for insulin for my employees' kids who have diabetes." Or: "I don't believe that we should accept blood products, so I am not going to support insurance that pays for that, even though my employees have different beliefs." One would hope that this is far-reaching, but is it?
Will this SCOTUS decision really impact coverage of diabetes and other chronic conditions?
Of course, no one really knows -- but one thing's for certain: it is possible.
Anytime you mention healthcare reform and the 2010-enacted Affordable Care Act, you're bound to get disagreement and passionate responses. Just look at our recent post by correspondent Wil Dubois, who offered a case study on ACA from his perspective "in the trenches" as a healthcare professional in a New Mexico clinic. The resulting comments were plentiful, varied, and in many cases vitriolic about anything relating to Obamacare.
Here's the thing about this Hobby Lobby case: even though the High Court handed down a narrowly-tailored ruling that may seem like it only applies to a small number of medications and those who work at this one big national craft store, it may be setting a dangerous precedent. And legal precedent is what influences law for many, many years to come.
Remember, before joining the 'Mine, I spent six years at a legal newspaper reading court opinions. I've spent my share of time dissecting caselaw and hearing how attorneys and judges take outside issues and past rulings into consideration. So I wasn't hesitant to read all 95 pages of the Hobby Lobby decision, and brush up on related cases that involve similar legal arguments from companies all across the country. My take is that we're talking a bigger picture here, and there are a lot of unanswered questions that will have to play out in courtrooms and conference rooms all across America.
In this case, aside from issuing a 55-page decision that includes a pair of concurring and dissenting opinions, the SCOTUS also ruled on a handful of other cases that go beyond what the Hobby Lobby case. Tied in with this, the court (on the following day) issued six other orders on cases where other companies sought to use this same argument to not pay for all forms of contraception covered by the ACA. This includes pregnancy counseling, which the ACA mandate includes, and a couple of the companies do not want to cover in their health insurance plans.
The lower federal courts had ruled against those companies, but SCOTUS sent the cases back "downstairs" to the lower appellate courts, instructing them to apply the new rationale issued in the Hobby Lobby case.
Nationwide, there are other many cases that go beyond contraception and want to use this argument, but they've been waiting to find out what SCOTUS would do. And now, it's on -- and the High Court's rationale will be used and interpreted any number of ways based on how local lawyers and judges see things.
Employers Playing God?
The question is, does this case give employers too much power over their employees basic health rights? Some don't think so, but others in legal scholar roles who cover the SCOTUS do believe so. Cases have already been in the works making this argument for a broad number of issues that apparently conflict with religious beliefs of company executives, and with the new SCOTUS ruling it's not a far stretch to think the courthouse doors will swing open even more.
Just look at this Talking Point Memo that came out later in the week, about how some religious groups have sent a letter to President Barack Obama asking that they be excluded from the anti-discrimination practices just weaved into his executive order protecting the LGBT community. They're basically relying on the Hobby Lobby rationale to urge the president to support them. Note that just three days after this big decision, the Court again expanded its ruling to allow religious organizations like church and faith-based schools to be exempt from following certain federal mandates because of their religous beliefs.
And does anyone remember the whole controversy over faith-based healing? i.e. how some religions decline to recognize modern medicine to the extent of not giving insulin to diabetic children suffering from DKA? Seriously, what's to stop these organizations (and their congregations) to now make the claim that they don't have to abide by state or federal law protecting children's health?!
The Healthare Football
It's good to know that there are some legal safeguards in place that lawyers and judges will have to weigh, but that doesn't mean these issues won't be raised and tied up in our nation's court systems. We just hate to see something as basic to human needs as healthcare coverage become a political football, trivialized by a partisan power struggle.
And guess what happens to us, the PWDs affected, in the meantime? We'll have to face these challenges unprotected -- at least until a court says otherwise -- and there's no guarantee we will win in the end and be granted access to our medically-necessary items.
To my eye it's a very slippery slope that the five justices who issued the majority decision have started pushing us down.
In other words, I'm worried. You may be too, but only time and further courtroom decisions will tell whether our concerns are justified.