The first thing to say about this decision is that it is one for the Constitution and it is common sense. Now I am not a student of your Constitution, but I think I know enough to venture an opinion in relation to what is an horrendous piece of legislation, especially in regard to the overreach of Government. As an outsider I have to speak to what I know best, and that is the Australian system of medical insurance.
Medicare is the current name for universal health coverage here in Australia. What is covered by Medicare is in fact very limited because it does not include such things as dental, physiotherapy or podiatry except in limited circumstances. It also does not cover seeing a dietician or an exercise physiologist. On the other hand it covers doctor visits and some hospital expenses. It also covers most but not all blood tests, and it covers some of the cost of getting an x-ray (with qualifications and lots of them). The cost of medications is not covered by Medicare.
I can only speak to my own experiences and I can give lots of examples about how the patient ends up with lots of out of pocket expenses. Take for example the fact that when I was examined for a skin cancer check, the doctor diagnosed that I had a BCC on my nose (thank goodness it was a BCC and not an SCC). I was sent to a specialist and fortunately this particular one charged a reasonable amount for the consultation at $80. He agreed that I had a BCC. The choice was to have it removed under full anaesthetic at a private hospital (day surgery) or have removed under local anaesthetic. We had just changed the medical insurance company so there was a question about right to benefits. The cost difference was $800 vs $300, and other differences was feeling sick afterwards, and no ill effects until the anaesthetic wore off. Either way, it was a big bandage on the nose!! The cost of pathology was fully covered by Medicare, but the $300 was not refundable. The whole of the out of pocket for the procedure was $300. This is but one example, and I can give others where the out of pocket expenses have been adding up quite significantly, because a procedure is not covered by Medicare.
Prescriptions is covered under a different scheme. Medicines are placed on what is called the “free” list but they are not free. There is a co-payment and there are expensive medicines that are made affordable by the scheme. Someone not on a healthcare care is now paying close to $40 per prescription for some medication. If the item costs less than the current level that has to be paid then you only pay that amount hence some cost as low as $11 or even less than that. However if you have a healthcare card then the co-payment is roughly $7 (and still they complain when they pay such a small amount).
Hospitalisation and emergency services is also a different matter. A person can front to the emergency department of a hospital and is not charged anything with the government being charged via Medicare (this is one area where there needs to be reform). One can go to hospital as a Public patient but there is a waiting list. The alternative is to have private health insurance. All Australians have a choice about what fund they will use to cover everything that is not covered by Medicare, as well as cover for private hospital care. Using the private hospital system is often the difference between waiting a very long time for a procedure and getting relief as soon as possible. (I hope this makes sense).
From this description, one thing should be clear, and that is women who want to use contraceptives pay for their contraceptives. It is not provided for free!! Australian women continue to thrive without getting all uptight because of “access”. You want the prescription, then you pay for it.
Hobby Lobby took on the HHS because it was compelled to agree to use an insurance contract that included contraceptives that are abortifacients. They were not objecting to the regular type pill. The issue seems to have been very narrow in the Hobby Lobby case because the owners of the company had an objection to having to pay for anyone choosing to use an abortifacient via their health insurance. The way I see this, it is government overreach to demand that employers have to cover such items in the first place, especially over the religious objections of individuals.
It should be noted here that there are other cases that have been making their way through the court system. The Supreme Court has sent some of the cases back to the lower courts and told them to reconsider, based on the Hobby Lobby decision. Already in one case, that of EWTN an injunction has been granted so that the station does not face a fine until the case is decided. What is involved here is the compulsion by government to force a religious organisation (EWTN was founded by Mother Angelica) that is against the use of contraceptive devices to provide cover for these contraceptives. This compulsion strikes at the very heart of the Establishment clause. The EWTN case has wider ramifications than that of Hobby Lobby.
The whinging whining progressives are all up in arms because the majority of the USSC has gone against the HHS in its decision. The minority opinion in my view is an absolute disgrace and I should add the opinions of both Kagan and Sotomeyer in this case leaves a lot to be desired. In fact both of these justices should have recused themselves from making a decision in the Hobby Lobby case – but that is another issue.