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CPBJ Extra Blog

Catching up on the contraceptive mandate

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The time has come for a contraception mandate review.

First, I've seen this letter by Hobby Lobby founder David Green several times in the past week. Some of the postings make it look new, but it's quite old; read it closely and you'll see that it was written when Hobby Lobby first went to court over the matter, which as best I can tell was in September 2012.

The Hobby Lobby case, partnered with that of Lancaster County company Conestoga Wood Specialties Corp., now has a Supreme Court date of March 25. And, I should note, although the $100-per-employee-per-day penalty for noncompliance is obviously a central talking point on the case, with all the lawsuits and injunctions and so on, I haven't heard that anyone has actually started paying the penalty yet.

Conestoga and Hobby Lobby represent the for-profit side of the issue. As you may recall, there are two other categories: religious employers, such as churches, which are exempt from the mandate; and nonprofit religious institutions, such as hospitals and schools, which, to quote, "don't have to contract, arrange, pay, or refer for contraceptive coverage" but whose employees will be provided free access via an insurer or third-party administrator making separate payments for contraceptive services.

That convoluted arrangement is the focus of the other contraception mandate case that has been in the news lately, that of the Little Sisters of the Poor. Here's a helpful read on that case. The most recent development there was the Supreme Court's Jan. 24 order allowing those organizations to sidestep both enforcement and triggering of the third-party provision while litigation is pending by officially notifying the government of their objections in writing instead of using the prescribed form.

The order concludes with these words: "The Court issues this order based on all of the circumstances of the case, and this order should not be construed as an expression of the Court's views on the merits."

Randall Wenger is chief counsel at Harrisburg-based Independence Law Center, which has been representing Conestoga since the beginning of its case and is now partnering with attorneys at the Alliance Defending Freedom. I asked him the question of the hour: Does the Little Sisters order have any bearing on Conestoga's case?

"I think it has some bearing, but the Court was clear to say that issuing the injunction 'should not be construed as an expression of the Court's views on the merits,'" Wenger said. "Still, if the Court thought the religious liberties claim was frivolous, it would not ordinarily issue such an injunction. And as long as the mandate burdens religion in some contexts, it's hard to say there's not a burden for the Hahns, who own Conestoga."

• • •

Legislatively, the newly proposed Republican alternative to Obamacare — the acronymically titled Patient Choice, Affordability, Responsibility and Empowerment (CARE) Act — faces long odds. But nonetheless, it's interesting to look at it and see what parts of Obamacare its writers consider popular enough to keep ... such as offering dependent coverage up to age 26.

I'd say, though, that the provision that would cap the tax exclusion for an employee's health coverage at 65 percent of an average plan's cost is probably more notable. That would be a big change, folks. Do you as business owners think you could ever support that idea? Why or why not?

• • •

The question of what constitutes appropriate health care advertising is not exactly a headline-grabbing topic, but it's important and, I suspect, increasingly so. I blogged about it a couple of months ago and touched on the da Vinci controversy before that. So, naturally, I found this blog's dissection of a da Vinci campaign quite interesting.

Time to fire somebody

A white coat is a sacred trust

Where is the UI Board of Trustees?

In Chicago (as elsewhere), follow the money

How a fish rots

• • •

Finally, I found this report to be an interesting look at how combining data analysis and patient engagement techniques can help patient care. This one looks so simple and so effective that it could almost be termed a health care life hack.

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