Based on the reactions of the five conservative justices during oral arguments in March, the court could rule that corporations whose owners have religious objections are exempt from the ACA's requirement to cover employees for Food and Drug Administration-approved contraceptives. That could lead to different health coverage from one company to another, Justice Elena Kagan noted. Some experts warn that company owners also could refuse to provide coverage for other healthcare services that violate their religious beliefs.
Jonathan Adler, a law professor at Case Western Reserve University who has spearheaded another major legal challenge to the ACA, said the high court is likely to articulate principles for what types of requirements on employer coverage are permissible. Then HHS would have to come up with rules to bring enforcement into compliance. One possibility, Adler speculated, is an accommodation similar to the one the Obama administration reached with Catholic hospitals, providing contraceptive coverage without making the hospitals pay for it.
Whatever the result, most observers expect it to be a volatile 5-4 ruling.
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