Edtor's Note: This story has been updated to include the response of the Rev. Paul T. Stallsworth of Lifewatch and a sidebar on the debate regarding when life begins.
The U.S. Supreme Court ruled June 30 that requiring some for-profit corporations to pay for insurance coverage of contraception violates a federal law protecting religious freedom.
The 5-4 decision in Burwell v. Hobby Lobby Inc., and the linked Conestoga Wood Specialties Corp. case, limits the coverage of birth control without patients’ cost sharing, as mandated under regulations for the Affordable Care Act, also known as Obamacare.
United Methodist teachings
For United Methodists, the case has touched on issues outlined in the denomination’s Social Principles. These social teachings, which deal with health care, abortion and religious liberty, are part of the United Methodist Book of Discipline, the denomination’s law book.
• One Social Principle discusses family planning in the context of “The Right to Health Care.” It affirms “the right of men and women to have access to comprehensive reproductive health/family planning information and services that will serve as a means to prevent unplanned pregnancies, reduce abortions, and prevent the spread of HIV/AIDS.” The passage cites John 10:10b, which quotes Jesus: “I came that they may have life, and have it abundantly.”
• The Social Principle dealing with abortion says: “Our belief in the sanctity of unborn human life makes us reluctant to approve abortion.” However, the teaching also says: “We recognize tragic conflicts of life with life that may justify abortion, and in such cases we support the legal option of abortion under proper medical procedures by certified medical providers." The social teaching specifically prohibits using abortion as a means of contraception or gender selection.
• The United Methodist Church also supports the separation of church and state. "We believe that the state should not attempt to control the church, nor should the church seek to dominate the state,” the Social Principle says. “The rightful and vital separation of church and state, which has served the cause of religious liberty, should not be misconstrued as the abolition of all religious expression from public life."
United Methodists and other Christians across the theological spectrum have been watching the case. Some hail the ruling as a triumph for religious liberty, while others worry about its effects on worker rights and women’s health care.
“This is a landmark decision for religious freedom,” said Lori Windham, senior counsel for The Becket Fund for Religious Liberty and counsel for Hobby Lobby. “The Supreme Court recognized that Americans do not lose their religious freedom when they run a family business.”
The Rev. William Lawrence, dean and professor of American church history at Southern Methodist University’s Perkins School of Theology in Dallas, noted that the ruling is “another indication of a deeply divided Supreme Court whose views are almost predictably drawn along ideological lines.”
The court, he added “seems to have handed a very narrow victory to one segment of the American economic order and also a defeat for women whose economic opportunities may be minimized to a limited assortment of employers. In effect, this court decision allows persons with financial clout to control the personal decisions of those without financial clout.”
For United Methodists, the legal dispute involves potentially competing interests outlined in the denomination’s Social Principles — the free exercise of religion and access to health care for all, including contraception.
The United Methodist Board of Church and Society, the agency charged with advocating for the denomination’s social teachings, was among the groups that advocated for the passage of the Affordable Care Act and was part of an amicus brief to the Supreme Court in support of the law’s insurance mandate. But the agency did not submit an amicus brief in this case.
In a statement, the church agency said that it would be monitoring the impact of the ruling, including how it will affect women's and families’ access to contraceptives.
The agency said that “religious liberty requires employers to respect and honor the conscience and moral decision-making of their employees,” including women.
“We deeply care about women's health and rights,” the statement said. “In addition, we deeply care about religious liberty. We believe that both are core tenets of a just society and will continue our faithful advocacy for both.”
Harriett Jane Olson, the top executive of United Methodist Women and an attorney, said her group is reviewing the court’s lengthy opinion but is concerned about the impact it will have on women’s reproductive health.
“United Methodist Women has long affirmed the right of all women to have access to affordable birth control (including emergency contraception) and comprehensive family planning in consultation with her doctor,” Olson said. “We also feel that no health care plan is complete or just without this access. … For this reason alone, the Hobby Lobby case is troubling.”
The issues involved in the case
At issue in the case was whether the Religious Freedom Restoration Act of 1993 applies to the owners of closely held corporations in how they handle their companies’ insurance. A closely held company is one that has only a limited number of shareholders and is not traded publicly on a regular basis.
The religious freedom law requires that the government “shall not substantially burden a person’s exercise of religion” unless that burden is “the least restrictive means” to advancing a compelling government interest.
The evangelical Green family owns Hobby Lobby and the Mardel Christian education store chain, and the Mennonite Hahn family owns cabinetmaker Conestoga Wood Specialties. Specifically, the owners objected to covering four forms of contraception — two brands of the emergency “morning after” pill and two kinds of intrauterine devices (IUDS). In covering these contraceptives, the company owners argued, they would be “complicit in abortion.”
The Affordable Care Act has included mandatory coverage of the 20 forms of contraception approved by the U.S. Food and Drug Administration, including the four in dispute.
The majority ruling, written by Justice Samuel Alito, said the U.S. Department of Health and Human Services regulations “fail the least-restrictive means test.”
Polling on Mandate
While Hobby Lobby and Conestoga Wood Specialities carried the day at the Supreme Court, it remains to be seen how the companies’ position will fare in the court of public opinion.
Prior to the June 30 ruling, a number of polls found majority support for the health law’s requirement that private health plans cover the full cost of birth control.
For example, the Kaiser Health Tracking Poll, released in April, found “the public supports the requirement by a nearly 2-to-1 margin (61 percent support, 32 percent oppose).”
Kaiser also asked specifically whether for-profit companies whose owners have objections to birth control should be subject to the mandate. Fifty-five percent said yes, “even if it violates their owners’ personal religious beliefs.” Forty percent said for-profit companies “should NOT be required to cover birth control in their works’ health plans, even if it violates their owners’ personal religious beliefs.”
The Rev. Paul T. Stallsworth, president and editor of Lifewatch as well as a United Methodist pastor in North Carolina, stressed that the companies in the case did not object to all forms of birth control. Lifewatch is an unofficial United Methodist group that seeks to witness for life and against abortion.
"The ruling basically gives freedom of religion a stronger role to play than what we might call the freedom from the cost of abortifacients," he said.
He sees the ruling as complementary to The United Methodist Church's mission of disciple-making.
"I believe that disciples need a public space in which to practice their faith," Stallsworth said. "Religion is not just a private matter. Religion has to do with the public sphere as well. ...Our faith has public and even political ramifications, and I think the religious freedom ensures that will continue to be the case."
Scope of ruling
The court itself did not agree on how sweeping the ruling was.
In her dissent, Justice Ruth Bader Ginsburg wrote the court’s “expansive notion of corporate personhood … invites for-profit entities to seek religion-based exemptions from regulations they deem offensive to their faith.”
Some United Methodists echoed Ginsburg’s concern.
The Methodist Federation for Social Action, an unofficial progressive United Methodist group, submitted an amicus brief in the case, arguing against a religion exemption for Hobby Lobby.
“Today’s ruling on contraceptive coverage in the Hobby Lobby case from the Supreme Court sets a dangerous precedence for corporate abuse over the religious freedom of individual persons of faith,” said Chett Pritchett, the group’s executive director. He noted that all three women on the court dissented from the majority opinion.
“Due to the United States workforce becoming more and more religiously diverse,” Pritchett added, “a ruling for corporations will negatively impact a growing sector of employees.”
The majority decision noted that it applies solely to the contraception requirement and should not be thought to apply to such insurance mandates as vaccinations or blood transfusions, which may conflict with an employer’s religious beliefs.
On July 1, the Supreme Court confirmed, The Associated Press reports, that the ruling applies broadly to any contraceptive coverage required in the new health care law, not just the four methods the justices considered in this case. Specifically, the order also applies to companies owned by Catholics who oppose all contraception. Three such companies had cases pending the result of the Hobby Lobby case.
Even before the June 30 ruling, the majority opinion noted, the contraception mandate already did “not apply to tens of millions of people.”
When Does Life Begin?
The U.S. Supreme Court ruling in the Hobby Lobby does not dispute the plaintiffs’ belief that the four contraceptive methods at issue induce abortions.
But among physicians, legal experts and ethicists the question of when conception occurs is not always straightforward. The United Methodist Church itself has no set definition of when life begins.
Emergency contraception, also called “morning after” pills, prevent pregnancy primarily by delaying ovulation. According to Princeton University, there is “no evidence to suggest that either the FDA-approved emergency contraceptive options…work after an egg is fertilized.” Other sources suggest the pill can in some cases prevent implantation.
In contrast, an intrauterine device (IUD) works by preventing sperm from fertilizing an egg. It also may prevent implantation of a fertilized egg.
For the Rev. Paul T. Stallsworth, a United Methodist pastor, preventing implantation is tantamount to ending life. He says he believes “a new human being begins when egg meets sperm and there is union.”
“Do a lot of such zygotes perish naturally? Of course, that happens for whatever reason,” Stallsworth said. “But I think it’s a biological fact of life that life begins at conception.”
Still, not everyone agrees that conception starts with fertilization. The American Congress of Obstetricians and Gynecologists as well as federal regulations define conception as the moment when a fertilized egg implants in the uterus.
To Dr. Barbara Lukert, a retired endocrinologist and United Methodist in Kansas City, Kan., even that definition does not necessarily answer the more general question of when life begins.
“Those who believe that life begins with the first breath can defend that position as well as those who believe life begins at conception,” she said. “We don’t know when life begins and may never have an objective definition. Therefore, why should any group or individual be allowed to impose their beliefs about this issue on others? It’s a matter of opinion, not fact.”
The rule, from the beginning, exempted religious employers such as churches and other houses of worship.
Initially, the rule did not exempt religiously affiliated employers such as hospitals and universities that do not primarily employ or serve people who share their religious tenets.
But, after a public outcry, President Obama announced in February 2012 what he termed an “accommodation” for religiously affiliated employers with moral objections to artificial contraception. For such employers, he said, the insurers would cover the costs rather than the employers themselves.
Additionally, the Department of Health and Human Services has exempted employers who provide “grandfathered health plans” — those that existed before March 23, 2010.
What happens next
Both Alito’s majority opinion and Justice Anthony Kennedy’s concurrence suggest the U.S. government allow the same accommodation for the family-owned companies cited in the case that it does for nonprofit religious organizations.
“The accommodation works by requiring insurance companies to cover, without cost sharing, contraception coverage for female employees who wish it,” Kennedy’s opinion said. “That accommodation equally furthers the government’s interest but does not impinge on the plaintiffs’ religious beliefs.”
“Either this ‘middle man’ has to absorb the cost itself (the owners can’t be required to put up the money), or it will get a government subsidy to help cover the cost,” writes Lynn Denniston of SCOTUSBlog, in an analysis of the case. Denniston noted that this solution still might not satisfy some with religious objections to the contraception mandate.
Possible church responses
Amy Laura Hall, associate professor of Christian ethics at United Methodist-related Duke Divinity School in Durham, N.C., suggested United Methodists might respond to the ruling by petitioning each Hobby Lobby franchise to take a more holistic approach to supporting children.
She recommended urging Hobby Lobby to have on-site subsidized child care, nursing rooms, six-month parental leave policies and a cooperative form of job share opportunities for parents whose children have temporary or abiding special needs. She also suggested boycotting Hobby Lobby until the company “displays moral consistency.”
“Basically, let's either make Hobby Lobby a place where women actually can be working and flourishing mothers or, with our dollars, make this ruling really good news for Michael's,” she said.
The Rev. Kimberly D. Reisman, a member of the World Methodist Council Steering Committee and general editor of the Wesleyan Accent platform, said the law of the land is not the same thing as the church’s faith commitments.
“We have to keep at the forefront of our minds that all life is valued by God, including both unborn children and living women, and God wants both to be able to flourish,” Reisman said. “We have to find a way to live in such a way that shows our commitment to both. Nine times out of 10, we fail on one side or the other. …I’m not pretending to have all the answers. But we have got to live in that tension.”
Hahn is a multimedia news reporter for United Methodist News Service. Contact her at (615) 742-5470 or [email protected]. She is not related to the Hahn family in the case.