Your money, your choice

(Apologies to the Republican National Committee for the title.)

Writing in the New York Times today, Linda Greenhouse reports that religious non-profits have filed seven cases with the U.S. Supreme Court challenging language in Obamacare (aka the Affordable Care Act) that allowed religious non-profit employers to opt out of a requirement that they provide contraception as part of a health care plan.

When an organization opts out of this requirement, coverage is provided by the organization’s insurance company, without the organization’s involvement, so the employee may still obtain contraception.  In the Hobby Lobby decision in 2014, the Supreme Court required accommodation for for-profit companies whose owners held religious objections to birth control.

The cases filed before the Supreme Court argue that even requesting to opt out of the requirement made the organizations complicit in the employee’s use of birth control.   An eighth case goes further, arguing that whether or not the organizations are right about the law, just holding a strong belief that the accommodation is wrong is sufficient cause to be entirely relieved of any action that might facilitate their employees obtaining birth control.

Greenhouse goes on to look at these cases in light of statutory and case law, paying particular attention to the Religious Freedom Restoration Act of 1993.  Her article is worth reading.

But, what has been lost in all of the discussions about this issue is  that the religious organizations are essentially telling their  employees how to spend their own money.   Employer-paid health insurance is part of an employee’s compensation.  It’s been that way since the practice began as a way to get around wage controls during World War II, and it is that way now.   Twenty five years of helping start and run a small engineering consulting firm demonstrated to me that health insurance (like vacation and other benefits) is compensation.

As a small firm we were at a disadvantage when courting potential employees for just this reason.  We could offer comparable or better pay, vacation and retirement benefits, but we could not compete directly with the much broader and less expensive health insurance coverage that large firms could offer.  Our business manager would   sit down with candidates, tote up the dollar value of salary and each benefit, including health insurance, and show them that our package was equal to or better than the other firm’s offer.

Obamacare is a baby step toward getting employers entirely out of the health insurance business.   When we reach that point, religious organizations of all types will no longer be able even to argue complicity in their employees’ own decisions.    Another benefit will be that small businesses will be able to compete for talent on a more equal footing with large businesses (and will be able to do something productive with the time they used to spend negotiating with insurance companies.)

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