Roman Catholic hospitals in California were dealt a legal and philosophical blow last week when the state's high court upheld the constitutionality of a law requiring employers to cover birth control as part of their pharmacy benefits.
In a 6-1 decision, the California Supreme Court ruled against Catholic Charities, which had challenged the 4-year-old law on the grounds that it violates the religious freedom of church-affiliated organizations, such as charities and hospitals, by forcing them to endorse a practice they believe is sinful.
While the ruling may not prompt radical changes at the state's 61 Catholic hospitals-most already cover contraceptives in one way or another-it sets a "disturbing" precedent for government regulation of faith-based providers, said William Cox, president and chief executive officer of the Alliance of Catholic Health Care in Sacramento. "In the longer run, it creates a substantial threat to the religious liberties of Catholic hospitals," Cox said, adding that the ruling could open the door to requiring employers to offer health insurance that covers abortion.
Catholic Healthcare West, which operates 37 hospitals in California, is reviewing "the broader implications of this very significant decision," said company spokesman Mark Klein. But he added that the San Francisco-based system won't be directly affected by the ruling because it has covered contraceptives since 1997.
Nor does St. Joseph Health System-which does not formally cover birth control-plan any immediate policy changes in light of the "disappointing" ruling, spokeswoman Carolyn Carter said. The 10-hospital system covers common contraceptives only if they are prescribed for noncontraceptive purposes, such as endometriosis. "It remains to be seen how (the ruling) will affect us," Carter said.
Catholic hospitals could sidestep the mandate by dropping pharmacy benefits altogether. But Cox doesn't believe hospitals will consider that option, given the importance of prescription drugs. "This law has really put us between a rock and a hard place," he said.
Catholic Charities will likely appeal the decision in federal court, but not before a decision is handed down in a similar case now winding its way though the New York courts, said Carol Hogan, spokeswoman for the California Catholic Conference, which represents the state's Catholic community on public policy issues. California and New York are among 20 states that since 1996 have enacted laws requiring employer-sponsored health plans with prescription drug benefits to cover birth control.
The state Supreme Court ruled that the charity was not exempt because it employs workers of various religions and offers secular services such as counseling and low-income housing to the public without directly preaching about Catholic values.